| 王燕,周萍.复方口服避孕药的不同服药方法对子宫内膜异位症痛经的疗效分析[J].安徽医药,2019,23(6):1226-1229. |
| 复方口服避孕药的不同服药方法对子宫内膜异位症痛经的疗效分析 |
| Curative effect analysis on different administration methods of combined oral contraceptives in the treatment of dysmenorrhea caused by endometriosis |
| 投稿时间：2018-04-22 |
| DOI： |
| 中文关键词: 复方口服避孕药 连续性用药 周期性用药 子宫内膜异位症 疼痛 |
| 英文关键词: Combined oral contraceptives Continuous administration Periodic administration Endometriosis Pain |
| 基金项目:蚌埠医学院科研课题(Byky1296NF) |
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| 中文摘要: |
| 目的 观察复方口服避孕药不同服药方法治疗子宫内膜异位症痛经的疗效分析。方法 采用随机数字表法将2012年12月至2016年3月淮南市第一人民医院妇产科收治87例子宫内膜异位症痛经病人分为A、B、C三组,A组采用促性腺激素释放激素激动剂(GnRH-a)治疗,B组则给予达英-35连续性口服,C组则行达英-35周期性口服,比较各组临床疗效、治疗前后疼痛评分、性激素水平、血清血糖类抗原125(CA125)、骨密度水平及不良反应情况,停药后随访12个月,统计各组复发率。结果 A组治疗总有效率为96.55%,与C组的71.43%相比差异有统计学意义(χ2=6.762,P＜0.009),与B组的90.00%比较差异无统计学意义(χ2=1.000,P=0.317)；A、B两组治疗后痛经评分、卵泡雌激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平均显著低于C组(P＜0.05),但A、B两组组间比较差异无统计学意义(P＞0.05)；三组治疗后性交痛[(0.44±0.12)分 比(1.01±0.34)分 比(1.48±1.17)分]、盆腔痛[(0.56±0.45)分 比(0.85±0.37)分 比(1.86±1.28)分]评分比较差异有统计学意义(均P＜0.05)；各组治疗后CA125水平比治疗前均显著下降(P＜0.05)；A组治疗后骨密度(1.24±0.05)g/cm2,显著小于B、C两组,但A组的骨钙素(BGP)水平(6 994.91±5 001.28)ng/L,显著大于B、C两组(P＜0.05)；各治疗组不良反应发生率、复发率比较均差异无统计学意义(P＞0.05)。结论 复方口服避孕药连续性给药治疗子宫内膜异位症与GnRHa疗效相当,相比其周期性给药有优势,且安全性较高。 |
| 英文摘要: |
| Objective To observe the clinical efficacy of different administration methods of combined oral contraceptives in the treatment of dysmenorrhea caused by endometriosis.Methods Eighty-seven patients with dysmenorrhea caused by endometriosis who were treated in Department of Gynaecology and Obstetrics,The First People's Hospital of Huainan from December 2012 to March 2016 were assigned into group A,group Band group C.Group Awas treated with gonadotropin releasing hormone agonist (GnRH-a),group Bwas treated with continuous oral administration of Diane-35,and group Cwas treated with periodic oral administration of Diane-35.The clinical efficacy,pain scores,sex hormone levels,serum levels of blood glucose antigen 125 (CA125),bone mineral density and adverse reactions were compared among groups.All patients were followed up for 12 months after drug withdrawal,and the recurrence rates in the three groups were statistically analyzed.Results The total effective rate of treatment in group A (96.55%) was significantly higher than 71.43% of group Cwith significant difference (χ2=6.762, P<0.009),and was higher than 90% of group Bwith no significant difference (χ2=1.000, P=0.317).After treatment,scores of dysmenorrhea,levels of follicle stimulating hormone (FSH),luteinizing hormone (LH) and estradiol (E2) in group Aand group Bwere significantly lower than those in group C (P<0.05),but there was no significant difference between group Aand group B (P>0.05).There were significant differences among the three groups in dyspareunia scores[(0.44±0.12) vs. (1.01±0.34) vs. (1.48±1.17)] and pelvic pain scores[(0.56±0.45) vs. (0.85±0.37) vs. (1.86±1.28)] (all P<0.05).After treatment,levels of CA125 in all groups were significantly lower than those before treatment (P<0.05).After treatment,the bone mineral density of group A (1.24±0.05) g/cm2was significantly lower than that in group Band group C;the level of bone gla protein (BGP) of group A (6 994.91±5 001.28) ng/L was significantly higher than that in group Band group C (P<0.05).There was no significant difference among groups in the incidence of adverse drug reactions and the recurrence rate in 12 months of follow-up (P>0.05).Conclusion The curative effect of continuous oral administration of combined oral contraceptives is similar to that of GnRHa in treating endometriosis.Compared with periodic administration,it has more advantages and higher safety. |
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