半量促性腺激素释放激素激动剂治疗子宫内膜异位症的疗效

Effect of half-dose GuRH-a on endometriosis

目的探讨促性腺激素释放激素激动剂在治疗子宫内膜异位症中的作用。方法将腹腔镜保守性手术后41例子宫内膜异位症患者随机分为两组：传统用量组（21例）术后给予达菲林3．75mg，肌肉注射，每4周1次，连续6次，半量组（20例）术后给予达菲林1．9mg，肌肉注射，每4周1次，连续6次。结果两组患者痛经症状均有不同程度减轻，两组患者至用药12周妇科检查盆腔触痛消失，所有患者肛门坠胀感缓解，传统用量组临床缓解率为87．1％，半量组为86．3％，差异无统计学意义（P〉0．05）；传统用量组21例患者B超检查复发率为4．8％，半量组为5％，差异无统计学意义（P〉0．05）；传统用量组21例患者78．6％患者出现明显的潮热、多汗等低雌激素症状，半量组20例患者治疗过程中未发现低雌激素症状，差异有统计学意义（P〈0．01）。结论半量促性腺激素释放激素激动剂在缓解低雌激素症状是安全有效的，半量疗法能减轻促性腺激素释放激素激动剂的不良反应而不影响其疗效。

Objective To investigate the effect of half-dose GuRH-a on endometriosis. Methods Forty-one patients with endometriosis underwent laparoscopic conservative operation were randomly divid- ed into traditional dose group（21 cases） , with intramuscular injection of diphereline 3.75 rag, once every four weeks for 6 times, and half-dose group, with intramuscular injection of diphereline 1.9 mg, once ev- ery four weeks for 6 times. Results The symptom of dysmenorrhea in both two groups relieved in differ- ent degrees. Twelve weeks after treatment, the patients received gynecologial examination and the tender- ness in pelvic disappeared in both groups. Anal expansion relieved in most patients. The clinical remis- sion rate of the traditional dose group was 87.1% , while that of the half-dose group was 86.3% , there was no significanct difference （P 〉 0.05）. Checked by type-B ultrasound, the recurrence rate of the tra- ditional dose group was 4. 8% , while that of the half-dose group was 5% , there was no significant differ- ence （P 〉 0.05）. Obvious low estrogen symptoms like afternoon fever and hyperhidrosis occurred in 78.6% of the traditional dose group, while no such symptoms occurred in the half-dose group, and there was significant difference （P 〈 0.01 ）. Condusions It is safe and effective to use half-dose CuRH-a for treating endometriosis. The half-dose treatment method can obtain the same effect as the traditional dose treatment, and decrease the side effects.