米非司酮治疗子宫内膜异位症的临床分析

Clinical Analysis of Endometriosis Treatment Using Mifepristone

目的:观察盆腔子宫内膜异位症(endometriosis,EMs)患者术后服用不同剂量米非司酮对内分泌功能的影响。方法:27例行保守性手术的盆腔EMs患者随机分3组:观察1组和2组各10例,分别服用米非司酮6.25mg/d和12.5mg/d,两组均于术后第1次月经来潮5d内开始服药,疗程6个月;对照组7例不用药物仅定期随访。比较应用不同剂量米非司酮治疗EMs的疗效、不良反应及对内分泌功能的影响。结果:3组患者痛经症状均得到不同程度缓解。观察1组恶心症状发生率(30%)明显低于观察2组(60%)。观察1组血清性激素水平均无明显变化,但观察2组用药后血清孕酮明显降低(P<0.05)。结论:小剂量米非司酮用于盆腔EMs术后巩固治疗,安全、有效,不良反应小,对内分泌功能影响小,亦可导致子宫内膜增生过长。

Objective： To investigate the clinical effects of mifepristone with different dosage in postoperative patients with endometriosis, and observe the influences of mifepristone on endocrine function. Methods： 27 cases suffered conservative surgeries for pelvic endometriosis were randomly divided into 3 groups： observation group 1 （10 cases, with the administration of 6.25 mg/d mifepristone）; observation group 2 （10 cases, 12.5 mg/d mifepristone）; and the control group （7 cases, regular follow-up with no medication）. The 20 subjects of observation groups 1 and 2 were administered mifepristone within 5 days during the first menstrual period postoperation, with a therapy course of 6 months. The clinical effects, adverse reactions, and the influences on endocrine funeti on of mifepristone with different dosage were compared. Results： The menorrhalgia symptoms were relieved in these 3 groups. The incidence of nausea in the observation group 1 （30%） were obviously lower than the group 2 （60%）. The changes of serum levels of sex hormones in the observation group 1 were not significant, while the progesterone levels in group 2 degraded obviously （P〈0.05）. Conclusions： Low dose mifepristone can be applied in the postoperative consolidation therapy for pelvic endometriosis for its safety, utility, few adverse effects, little influences on endocrine function, and the improvement of endometrial hyperplasia.