促性腺激素释放激素激动剂延长给药间隔治疗子宫腺肌病和子宫内膜异位症的疗效

目的探讨促性腺激素释放激素激动剂(GnRH-a)延长给药间隔周期治疗子宫腺肌病、子宫内膜异位症(内异症)的疗效。方法子宫腺肌病、内异症患者共60例,随机分成两组(n=30)。按药方传统给药方法,每4周肌肉注射曲普瑞林3.75mg,共6次,疗程均为24周,设为对照组;以延长给药间隔周期的新方案作为研究组,每6周肌肉注射曲普瑞林3.75mg,共4次,疗程亦为24周,但总用药量减少两次。观察治疗前后痛经程度、子宫体积、血清性激素水平的变化。结果治疗结束时,两组痛经缓解率均为100%;研究组与对照组子宫体积平均缩小分别为37.6%与39.2%。两组患者药物治疗前后黄体生成素(LH)、卵泡刺激素(FSH)及雌二醇(E2)水平均明显降低(P<0.001),E2降至绝经期水平,分别为(65.6±8.7)pmol/L和(60.0±6.3)pmol/L;用药前,第1次用药后及治疗后12周、24周,研究组与对照组相比,差异均无统计学意义(P>0.05)。结论应用GnRH-a延长给药间隔的新方案治疗子宫腺肌病、内异症,同样能达到与传统方案相同的疗效,即低雌激素状态的抑制效应,但治疗费用显著降低。

Effect of extended-interval dosing regimen of gonadotropin releasing hormone agonist in the treatment of adenomyosis and endometriosis

Objective To study the effect of extended-interval dosing regimen of gonadotropin releasing hormone agonist(GnRH-a) in the treatment of adenomyosis and endometriosis.Methods Sixty patients suffering from adenomyosis and endometriosis were randomly divided into two groups, extended-interval dosing (study group) and convention dosing(control group).Patients were treated with intramuscular injection of triptorelin 3.75 mg either every 6 weeks of totally four doses regimen(study group) or every 4 weeks of six doses regimen(control group). The changes in the degree of dysmenorrhea and uterine volume were investigated.The level of sexual hormone was also detected both before and after therapy.Results After six months of therapy,the reliving rate of dysmenorrheal was 100% both in the new and convention regimen. The uterine volume was reduced by 37.6% and 39.2%. The level of LH,FSH and E2 significantly decreased(P<0.001). The E2 level was reduced to the postmenopausal level. The hormone profile of study group was similar to that of control group(P>0.05).Conclusion The use of extended-interval dosing regimen of triptorelin depot in adenomyosis and endometriosis results in a consistent hypoestrogenised state,which is similar to that achieved by conventional regimen. The new regimen significantly reduces the cost of treatment.