米非司酮与孕三烯酮治疗子宫腺肌病的疗效观察

Therapeutic Efficacy of Mifepristone and Gestrinone on Adenomyosis

目的探讨米非司酮、孕三烯酮分别治疗子宫腺肌病的疗效及长期用药的安全性。方法选择76例要求药物治疗的子宫腺肌病患者随机分为两组,分别予米非司酮、孕三烯酮口服。米非司酮组于月经第1天起口服米非司酮10 mg,每天1次,孕三烯酮组每次2.5 mg,每周2次,第1次于月经第1天服用,3 d后服用第2次,以后每周相同时间服用。两组患者均连续服用6个月,比较治疗前与服药6个月后痛经、闭经、胃肠道反应、肝功能、子宫大小变化及复发情况。结果米非司酮组服药6个月后痛经症状缓解率、闭经率、停药后复发情况与孕三烯酮组比较差异无统计学意义(P>0.05)。胃肠道反应,肝功能异常发生率,血清孕激素水平,子宫大小变化情况相比,差异均有统计学意义(P值均<0.05)。结论米非司酮较孕三烯酮治疗子宫腺肌病更加安全有效,且副作用少。

Objective To investigate the effect of mifepristone and gestrinone on adenomyosis.Methods 76 patients with adenomyosis,who volunteered for medicine treatment,were randomly divided into two groups： Group 1（mifepristone group） and Group 2（gestrinone group）.Group 1 took mifepristone 10 mg,per day from the first day of menstruation.Group 2 took gestrinone 2.5 mg twice per week,one on the first menstrual day and the other three days later.The administration was the same every week afterwards.The two groups followed the administration respectively for 6 consecutive months.Their dysmenorrheal,amenorrhea,gastrointestinal reactions,liver function,sex hormone level changes,uterine size and recurrence before the treatment and 6 months after the treatment were compared.Results The situation of Group 1 after 6 months of administration showed no remarkable difference compared with that of Group 2 in terms of remission rate,dysmenorrheal rate,amenorrhea rate,serum FSH,LH and E2 levels and recurrence incidence after medication withdrawal（P0.05）.But the difference in gastrointestinal reactions,the incidence of abnormal liver function,serum P levels adn changes in uterine size was significant（P0.05）.Conclusion Compared with gestrinone,mifepristone is safer,more effective and free from side effects in the treatment of adenomyosis.