戊酸雌二醇联合地诺孕素治疗非器质性月经过多的疗效观察

The efficacy of oestradiol valerate combined with dienogest for menorrhagia without organic pathology

目的观察对非器质性月经过多的患者联合使用戊酸雌二醇（E2v）和地诺孕素（DNG）的疗效和安全性。方法筛选62例非器质性月经过多的女性按随机数字表法分为观察组（31例）和对照组（31例）。两组患者在相同支持治疗的基础上，观察组给予E2V联合DNG治疗，对照组仅给予E2V治疗。两组均完成3个周期的治疗。记录治疗期间每个治疗周期后月经失血图评分法（PBAC）评分、出血控制和完全止血时间，测定治疗前后血红蛋白浓度，记录各种不良反应的发生情况。结果观察组出血控制时间、完全止血时间显著低于对照组[（16．5±2．2）h比（23．4±2．9）h，（23．3±8．4）h比（40．9±4．6）hi，差异有统计学意义（P〈0．01）。治疗前两组患者血红蛋白浓度、PBAC评分比较差异无统计学意义（P〉0．05），治疗3个周期后观察组血红蛋白浓度高于对照组，但差异无统计学意义（P〉0．05）；观察组治疗1、2、3个周期后PBAC评分均显著低于对照组，差异有统计学意义（P〈0．01）。两组不良反应发生率均为12．9％（4／31），均无严重的不良反应事件发生。结论对于非器质性月经过多的患者联合使用E2V和DNG可迅速控制出血，减少月经失血量，且不增加不良反应，是一种安全有效的治疗方案，值得临床推广。

Objective To investigate the efficacy and safety of oestradiol valerate （E2V） combined with dienogest （DNG） for menorrhagia without organic pathology. Methods Sixty-two menorrhagia without organic pathology patients were randomized divided into observation group （31 cases） and control group （31 cases）. E2V combined with DNG were given in observation group while control group with E2V only. Both of the treatment lasted for 3 cycles. The changes in menstrual blood loss was assessed by the pictorial blood loss assessment chart （PBAC）. The time of control bleeding, stop bleeding, the level of hemoglobin and adverse reaction were compared. Results The time of control bleeding, stop bleeding in observation group were significantly lower than those in control group[ （ 16.5±2.2） h vs.（23.4 ± 2.9） h, （23.3 ± 8.4） h vs. （40.9 ±4.6） hi （P 〈0.01）. The level of hemoglobin and PBAC scores between two groups had no significant difference before treatment （P 〉 0.05）. After treatment for 3 cycles, the level of hemoglobin in observation group was higher than that in control group, but had no significant difference （P 〉 0.05 ）, the PBAC scores in observation group was lower than that in control group after treatment for 1,2,3 cycles （P 〈 0.01 ）. Both of the rate of adverse reaction in two groups was 12.9%（4/31 ）. No severe adverse reaction happened in two groups. Conclusions E2V combined with DNG is more rapid and effective in reducing menstrual blood loss. It does not increase the rate of adverse reaction and worthy of clinical application.