摘要
目的研究醋酸亮丙瑞林联合莉芙敏治疗子宫内膜异位症(EM)的疗效和安全性。方法选择2009年12月1日～2010年12月1日于阜新市第二人民医院妇科住院接受治疗的子宫内膜异位症患者60例,随机分为A、B组,每组各30例。A组患者术后月经复潮第1～2天内皮下注射醋酸亮丙瑞林3.75mg,每4周1次,连续6次,疗程24周;B组在使用醋酸亮丙瑞林的基础上配合口服莉芙敏,比较两组患者治疗前、后的血清激素、绝经症状严重程度、骨代谢生化指标及临床疗效。结果 (1)治疗后FSH、LH和E2水平均低于治疗前,差异有统计学意义;治疗后,B组的雌二醇水平高于A组,FSH及LH水平低于A组,但差异均无统计学意义(P>0.05)。(2)A、B两组患者治疗后的Kupperman评分总平均分别为(19±5)分和(12±2)分,两组间比较,差异有统计学意义(P<0.05);两组间潮热出汗、失眠及肌肉关节疼痛的发生率比较,差异均有统计学意义(P<0.05);感觉异常的发生率两组间比较,差异均无统计学意义(P>0.05)。(3)用药后均存在骨代谢生化指标钙、磷明显升高,与用药前差异有统计学意义;用药后B组患者各指标升高程度低于A组,差异有统计学意义;两组患者用药前后腰椎骨密度有显著差异,A组用药后与B组用药后相比也存在差异,B组用药前后无显著差异。(4)两组患者完全缓解率及部分缓解率无差异,复发率为A组略高于B组,推测可能与样本量小有关,有待于扩大样本进一步研究。结论皮下注射醋酸亮丙瑞林对于EM保守性手术后的巩固治疗疗效确切,同时配合口服莉芙敏是能减轻其不良反应,增强患者依从性,同时也是安全有效的。
Objective To evaluate effects and safety of Leuprolide acetate combined with remifemin tablets in the treatment of endometriosis. Methods Sixty endometriosis patients underwent laporoscopic surgery in the second people＇s hospital of Fuxin City were selected from December 1st, 2009 to December 1st, 2010, they were randomly divided into group A and group B, 30 cases in each group, the group A received 3.75 mg leuprolide acetate once 4 weeks, 24 weeks in all. The group B received leuprolide acetate and added oral Remifemin tablets. The serum hormones, menopause symptom severity, biochemical markers of bone metabolism and clinical effect in the two groups of patients before and after treatment were compared. Results （1）After treatment, FSH, LH and E2 were lower than before treatment, the differences between before and after treatment were statistical significance; After treatment, the E2 level of group B was slightly higher than which of group B, the levels of FSH and LH of group B were lower than which of group A, but the diffrences were not statistics significance （P 0.05）. （2） After treatment, the average Kupperman scoring of group A and group B was （19±5） and （12±2）, respectively, there were significant differences between the two groups; The incidence of Hot flashes, insomnia and muscle and joint pain between the two groups were statistically significant （P 0.05）; Comparison between the two groups in the incidence of paresthesia, the differences were not statistically significant （P 0.05）. （3）After treatment, calcium and phosphorus levels were significantly elevated, the differences between before and after treatment were statistically significant （P 0.05）; After treatment, the indexes of group B with less elevated than group A, the difference was statistical significant （P 0.05）; Patients of two groups before and after treatment had significant differences in bone mineral density of lumbar vertebrae, patients in group A after the Administration compared with group B vary, group B before and after drug was not significantly different. （4）Complete remission rate and partial response rate in patients of two groups with no differences, the recurrence rate for group A was little more than group B, speculation may be related to small sample size, samples need to be expanded further. Conclusion Subcutaneous injection of leuprolide acetate for EM conservative operation to consolidation treatment is precise and assist with oral remifemin tablets was able to mitigate its adverse effects, enhanced patient compliance, as well as safe and effective.
出处
《中国当代医药》
2013年第16期103-105,共3页
China Modern Medicine
