左炔诺孕酮宫内缓释系统联合小剂量米非司酮治疗子宫腺肌病的效果

Effect of levonorgestrel intrauterine sustained-releasesystem combined with low-dose mifepristone in the treatment of adenomyosis

  • 摘要:
      目的  探讨左炔诺孕酮宫内缓释系统(LNG-IUS)联合小米非司酮治疗子宫腺肌病的效果。
      方法  将本院收治的94例子宫腺肌病患者随机分为对照组和观察组,各47例。对照组给予单纯LNG-IUS治疗,观察组给予LNG-IUS联合小剂量米非司酮治疗,均随访观察4个月。比较2组治疗前后血清糖类抗原125(CA125)、痛经视觉模拟评分法(VAS)评分、月经量变化和B超检查情况,并评估临床疗效和治疗安全性。
      结果  治疗后, 2组血清CA125、痛经VAS评分、月经量、子宫体积、子宫内膜厚度均较治疗前显著下降(P < 0.05), 与对照组比较,观察组上述指标下降更为显著(P < 0.05);观察组治疗总有效率显著高于对照组(P < 0.05); 2组仅出现少量轻度不良反应,安全性较好。
      结论  LNG-IUS联合小剂量小米非司酮能显著降低子宫腺肌病患者血清CA125水平和改善临床症状,且安全性较好。

     

    Abstract:
      Objective  To investigate the effect of levonorgestrel intrauterine sustained-release system (LNG-IUS) combined with mifepristone in the treatment of adenomyosis.
      Methods  A total of 94 patients with adenomyosis admitted to our hospital were randomly divided into control group and observation group, with 47 cases in each group. The control group was treated with LNG-IUS alone, while the observation group was treated with LNG-IUS combined with low-dose mifepristone. All patients were followed up for 4 months. The serum carbohydrate antigen 125 (CA125), dysmenorrhea Visual Analogue Scale (VAS), changes of menstrual volume and results of B ultrasonography were compared before and after treatment, and the clinical efficacy and treatment safety were evaluated.
      Results  After treatment, the serum CA125, dysmenorrhea VAS score, menstrual amount, uterine volume and endometrial thickness of the two groups decreased significantly compared with treatment before(P < 0.05). Compared with the control group, the above indexes of the study group decreased more significantly (P < 0.05). The total effective rate was significantly higher than that of the control group (95.74% vs. 80.85%, P < 0.05). There were only a few mild adverse reactions, and higher safety in the two groups.
      Conclusion  LNG-IUS combined with low-dose mifepristone can significantly reduce serum CA125 level, improve clinical symptoms in patients with adenomyosis, and has higher safety.

     

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