米非司酮用于子宫肌瘤患者治疗及避孕的研究

Study on mifepristone as a therapeutic and contraceptive method for patients with uterine leiomyoma

目的：探讨子宫肌瘤患者应用米非司酮治疗和避孕的效果。方法：将１１４例随机分为两组。第１组（６８例），子宫＜妊娠７周大。在月经第８至１５天给予米非司酮２５ｍｇ／ｄ，第１６至２３天，每天给予甲地孕酮１ｍｇ合并乙炔雌二醇０．０２５ｍｇ。３个月经周期为一疗程，停药２个周期后继续用药。第２组（４６例），子宫相当妊娠７～１２周大，每天服用米非司酮１０ｍｇ，１２周为一疗程，在２次转经后继续服用。用阴道超声了解治疗前和２个疗程后肌瘤的变化，服药期间不用其它方法避孕。结果：服药组无意外妊娠发生。２个疗程后，两组肌瘤平均体积均较前显著缩小（Ｐ＜０．０１）。血清ＰＲＬ、ＡＣＴＨ、皮质醇和肝肾功能均正常。结论：长期间断序贯应用米非司酮和甲地孕酮加乙炔雌二醇和米非司酮１０ｍｇ连续应用１２ｗ的方案，可成为子宫肌瘤患者及避孕和治疗的方法，且无明显副作用。

Objective:To study on the effect of therapy and contraception with mifepristo ne for patients with uterine leiomyoma.Methods:The patients was divided into two groups.In group Ⅰ(68 cases),T he size of uterus was less than seven we eks pregnant uterus.A dose of 25mg/d of mifepristone was given during menstral c ycle 8 to 15d,and 1 mg of megestrol acetate plus 0.025mg ethinyl estradiao1( EE) during cycle 16 to 23d,one therapeut ic course included three menstrual cycles,then repeated above therapyIn group Ⅱ(46 cases),t he size of uterus was as large as 7-12w of pregnant uterus,10 mg of mifepri stone was given daily beginning on day 5 of menstrual therapeutic course.The ab ove regime was repeated after two natura l menstrual cycles.No other contraceptiv e method was used in all trial groups.Results:No accident pregnancy occurred in the two groupsAfter two th erapeutic courses,the volume of leiomyom a of the two group both dereased significantly.(P<0.01) Serum hormone such as PRL, ACTH,corticosteroid and liver or rena l function were normal.conclusions :The long term and interval s equential regime of mifepristone used an d megestrol plus EE or 10 mg mifepristo ne daily for 12 weeks suggest a possible use a s a contraceptive and therapeutic methods for patients with uterine leiomyoma.There is no sign ificant side effects.