三苯氧胺或炔诺酮合用前列腺素抗早孕效果观察

本文比较三苯氧胺(TMX)或炔诺酮(NET)配伍dl-15-甲基前列晾素F_(2α)(15-m-PGF_(2α))的抗早孕效果。共123例早孕妇女,分成四组,Ⅰ组:单纯用TMX;Ⅱ组:TMX合用15-m-PGF_(2α)海绵栓;Ⅲ组TMX合用15-m-PGF_(2α)注射剂;Ⅵ纽NET合用15-m-PGF_(2α)注射剂。抗早孕效果以Ⅳ组最佳,完全流产率达95%(与其它三组比较P<0.05),不全流产率3.3%,其余依次Ⅲ组完全流产率85%,不全流产率15%;Ⅱ组完全流产率50%,不全流产率30%;Ⅰ组完全流产率8.7%。NET与15-m-PGF_(2α)配伍的抗早孕效果优于TMX,且价格便宜,建议临床可推广使用。

Clinical study of early pregnancy termination by administration of DL-15-methyl prostaglandin F2 alpha combined with tamoxifen or norethisterone.]

The incompleteness of abortion and the severe side effects of single-dose prostaglandin have been extensively recognized. In December 1988, The Obstetric and Gynecological Hospital of Shanghai Medical University started a clinical investigation of the effectiveness of the combined doses of prostaglandin made in China (15-m-Pgf2alpha) with other drugs for early-stage abortion. 123 pregnant women within 49 days of their last menstruation were assigned to 4 groups. Group 1 had 23 cases who used Tamoxifen (TMX) alone orally; group 2 had 20 cases who used a suppository containing both TMX and 15-m-PGF2, combined with oral administration of TMX; group 3 had 20 cases who used injection of TMX with 15-m-Pgf2alpha combined with oral administration TMX; and group 4 used injection of Norethindrone (NET) with 15-m-Pgf2alpha combined with oral administration of NET. The most effective abortifacient combination was in group 4 with 95% complete abortions and 3.3% incomplete abortions. Group 3 ranked second, with 85% complete abortions and 15% incomplete abortions. Group 2 had 50% complete abortions, 30% incomplete abortions and 20% failures. Group 1 had 8.7% complete abortions and 91.3% failures. The higher effectiveness of the combination of NET, rather than TMX, with the prostaglandin showed that NET would be a better choice in the combination. Besides, the cost of TMX was over 30 times higher than NET; therefore, NET should be recommended in clinical use for abortions. Further studies are needed to reduce the dose of prostaglandin and to identify the optimum dosage and combination of NET and TMX with prostaglandin in order to improve the effectiveness of the abortifacient and reduce its side effects.