小剂量米非司酮联合内美通治疗围绝经期子宫肌瘤的疗效观察

Observation of the curative effect of low dose mifepristone combined with nemestran in climacteric uterine leiomyoma

目的:探讨小剂量米非司酮联合内美通治疗围绝经期子宫肌瘤的临床效果。方法:将绝经前有症状的子宫肌瘤患者100例随机分成两组,A组50例为小剂量米非司酮联合内美通组,每天口服米非司酮10mg,同时口服内美通5mg,每周2次,连服3个月。B组50例为米非司酮组,每天口服米非司酮及安慰剂,剂量与服药方法同A组;治疗前后B超测量子宫体积、肌瘤体积;检测用药前后雌、孕激素、血红蛋白和肝肾功能,观察服药后的不良反应。结果:两组患者治疗期间均闭经,子宫雌孕激素水平维持于较低水平,血红蛋白上升。两组治疗后子宫体积、最大肌瘤的平均体积缩小,以A组更明显,治疗后两组之间差异有统计学意义(P<0.01)。结论:小剂量米非司酮联合内美通治疗子宫肌瘤有较好的临床效果,是安全有效的保守疗法。

Objective：To explore the clinical effect and safety of treating climacteric uterine leiomyoma with low dose mifepristone combined with nemestran.Methods：The patients were divided into two groups in random,with 50 cases in each group.The patients in the group A were given with mifepristone 10 mg once daily and nemestran 5 mg twice a week by mouth for 3 months,while the patients in the group B with mifepristone and placebo in the same dose and way as group A.The dimension of uterus and myoma was monitored respectively by B-mode ultrasound before and after treatment,the levels of estrogen,progesterone and hemoglobin as well as liver and renal functions were all measured at the same time.The side effects of drugs were assessed.Results：The results showed that the menoschesis occurred,and the distend and pain of hypogastric region and anemia were redressed in all patients during the treatment.The levels of serum estrone and progestogen after treatment were significantly lower than those before treatment.The mean dimension of uterus and uterine leiomyoma in both group after treatment reduced compared with that before treatment,especially in group B.The curative effect in the group A was significantly better than that in the group B （P〈0.01）.Conclusion：Treatment of climacteric uterine leiomyoma with low dose mifepristone and nemestran has quit good efficacy,with low recurrence and less side effects,and is worth to extend.