摘要
目的观察中重度子宫内膜异位症(EMT)腹腔镜保守手术术后采用促性腺激素释放激素激动剂(GnRH-a)治疗时,坤泰胶囊对于改善患者围绝经期症状的临床疗效和相对安全性。方法选择潍坊市人民医院2016年9月~2018年8月共80例中重度EMT腹腔镜保守手术术后应用GnRH-a的患者,随机分为坤泰组、替勃龙组。2组均于月经来潮第1日给予亮丙瑞林深部肌肉注射,往后每28d注射1次,共6次。坤泰组于第2次注射亮丙瑞林后,口服坤泰胶囊4粒,3次/d,共5个月,而替勃龙组则2.5mg,1次/d,共5个月,观察患者的围绝经期症状及盆腔疼痛情况。采用Kupperman评分和VAS评分,测定血清性激素水平(FSH及E2),并记录坤泰组和替勃龙组不良事件的发生频率。结果①在反向添加治疗之前,两组Kupperman评分及VAS评分差异无显著性(P>0.05);反加治疗5个月后,即治疗后,两组Kupperman评分均明显降低,VAS评分同样较前降低,坤泰组与替勃龙组间差异无显著性(P>0.05)。②亮丙瑞林注射后,两组患者E2以及FSH水平均明显降低,两组在反向添加治疗后E2水平明显升高,FSH仍处于低水平,且治疗后替勃龙组E2水平明显高于坤泰组(P<0.05)。③替勃龙组阴道流血以及乳房胀痛的发生率明显高于坤泰组(P<0.05)。结论坤泰胶囊不仅能有效缓解长期应用GnRH-a所引起的围绝经期症状,且药物不良反应的发生率低于替勃龙等激素类药物。在预防EMT复发的基础上,减少不良反应的发生,尤其适用于激素禁忌患者。因此,中重度EMT患者腹腔镜保守手术后应用GnRH-a与坤泰胶囊联合是一种安全、有效的治疗方法,既能取得相应疗效,又能保证患者的生活质量,值得临床推广。
Objective Observing the clinical efficacy and relative safety of Kuntai capsules in improving peri-menopausal symptoms in patients undergoing laparoscopic conservative surgery after moderate and severe endometriosis(EMT) treatment with gonadotropin-releasing hormone agonist(GnRH-a).Methods Weifang People’s Hospital was selected from September 2016 to August 2018. A total of 80 patients with GnRH-a who underwent laparoscopic conservative operation of moderate to severe EMT aged 25 to 40 years were randomly divided into Kuntai group and Tibolone group.Both groups were given deep intramuscular injection of leuprolide on the first day of menstrual cramps,and then injected once every 28 days for 6 times.After the second injection of leuprolide,Kuntai group took 4 capsules of Kuntai capsule 3 times/day for 5 months,while in the Tibolone group,2.5 mg once daily for 5 months.Peri-menopausal symptoms and pelvic pain.Serum sex hormone levels(FSH and E2) were determined using the Kupperman score and VAS score,and the frequency of adverse events in the Kuntai and Tibolone groups was recorded.Results ①There was no significant difference between the two groups in Kupperman score and VAS score before the reverse treatment(P>0.05).After 5 months of treatment,after treatment,the Kupperman scores of the two groups were significantly reduced,VAS score Similarly,there was no significant difference between the Kuntai group and the Tibolone group(P>0.05).②After leuprolide injection,the E2 and FSH levels were significantly lower in the two groups.After treatment,the level of E2 was significantly increased,FSH was still at a low level,and the level of E2 in the Tibolone group was significantly higher than that in the Kuntai group(P<0.05).③The incidence of vaginal bleeding and breast tenderness in the Tibolone group was significantly higher than that in the Kuntai group(P<0.05).Conclusion Kuntai capsule can not only effectively alleviate the peri-menopausal symptoms caused by long-term application of GnRH-a,and the incidence of adverse drug reactions is lower than that of Tibolone and other hormone drugs.On the basis of prevention of recurrence of EMT,reduce the occurrence of adverse reactions,especially for patients with hormone contraindications.Therefore,the application of GnRH-a combined with Kuntai capsule after laparoscopic conservative operation in patients with moderate to severe EMT is a safe and effective treatment method,which can not only achieve the corresponding curative effect,but also ensure the quality of life of patients,which is worthy of clinical promotion.
作者
张婷婷
王丽
刘学良
程亦杰
崔雅馨
刘欣
ZHANG Tingling;WANG Li;LIU Xueliang;CHENG Yijie;CUI Yaxin;LIU Xin(Department of Obstetrics and Gynecology,Weifang Medical University Weifang 261053,China;Department of Gynecology,Weifang Peoples Hospital)
出处
《潍坊医学院学报》
2019年第3期235-237,共3页
Acta Academiae Medicinae Weifang
