不同超小剂量米非司酮治疗子宫腺肌病临床疗效研究

Investigation on clinical efficacy of different ultra-low-doses mifepristone in treatment of adenomyosis

目的:探讨不同超小剂量米非司酮治疗育龄妇女子宫肌腺病的临床效果,并观察其对内分泌及代谢的影响。方法:选择2007年5月～2009年11月间在广州市妇女儿童医疗中心妇科门诊确诊的子宫腺肌病患者120例,随机分为两组,每组60例,第一组患者服用米非司酮6 mg/天,连服6个月;第二组患者服用米非司酮12 mg/天,连服6个月,定期随访,比较不同剂量米非司酮的疗效,不良反应及对内分泌功能的影响。结果:两组痛经症状均有所缓解,但治疗总有效率差异无统计学意义(χ2=1.01,P>0.05);临床用药后第一组病人出现恶心反胃症状发生率19.16%,明显低于第二组(53.12%);第一组病人血清性激素平均水平无明显变化,第二组病人血清孕酮水平明显降低,两组对比差异有统计学意义(P<0.01)。结论:两种超小剂量米非司酮治疗子宫腺肌病均安全有效,但以剂量偏小者较为适宜,对内分泌功能影响较小。

Objective ： To explore the clinical efficacy of ultra - low - doses mifepristone in treatment of adenomyosis in women of childbearing age and observe its effect on endocrine function and metabolism. Methods ： 120 cases diagnosed as adenomyosis from May 2007 to November 2009 were divided into two groups randomly, 60 cases in each group, and all the cases took mifepristone for 6 months, 6 mg per day and 12 mg per day, respectively. Regular follow up was conducted, the clinical efficacy, adverse reactions and effect on endocrine function were compared between the two groups. Results ： The symptom of dysmenorrhea in the two groups relieved, but there was no significant difference in total effectiveness rate between the two groups （x^2 = 1.01, P 〉 0. 05 ） ; the rate of nausea and vomiting in the first group was 19. 16% , which was significantly lower than that in the second group （53. 12% ） . There was significant difference in serum level of progesterone between the two groups （ P 〈 0. 01 ） . Conclusion ： The two different ultra - low - doses mifepristone are both effective and safe in treatment of adenomyosis while the lower dose is recommended, which is more appropriate and has less impact on endocrine function.