去氧孕烯炔雌醇治疗绝经过渡期功能失调性子宫出血的临床疗效及对血清性激素水平的影响

The efficacy of desogestrel and ethinyl estradiol tablet for perimenopausal dysfunctional uterine bleeding and the effect of this medication on sex hormones

目的探讨去氧孕烯炔雌醇治疗绝经过渡期功能失调性子宫出血（功血）的临床疗效及对血清性激素水平的影响。方法选择2010年4月至2012年10月在本院治疗并确诊为绝经过渡期功血患者94例，随机分为观察组和对照组，各47例。观察组在诊断性刮宫术后3天给予去氧孕烯炔雌醇治疗，对照组在诊断l生刮宫术后3天给予醋酸甲羟孕酮片治疗。对比观察两组止血时间、临床疗效和药物不良反应。检测患者治疗前后促卵泡生成素（FSH）、黄体生成素（LH）、雌激素（E：）的水平。结果观察组临床疗效总有效率为97．87％，明显高于对照组53．19％，差异有统计学意义（P〈0．05）；观察组控制出血时间和完全止血时间均低于对照组，差异有统计学意义（P〈0．05）。治疗后观察组FSH水平明显下降，与对照组和本组治疗前比较，差异有统计学意义（P〈0．05）；而LH、E：水平与治疗前比较，差异无统计学意义（P〉0．05）。对照组治疗前后FSH、LH和E，的水平比较，差异无统计学意义（P〉0．05）。对照组不良反应率高于观察组，差异有统计学意义（P〈0．05）。结论去氧孕烯炔雌醇在围绝经期功血患者止血中安全有效，值得临床应用。

Objective To explore the clinical efficacy of desogestrel and ethinyl estradiol tablet for perimenopausal dysfunctional uterine bleeding （PDUB） and the effect of this agent on sex hormones. Methods A total of 94 patients with PDUB who had been hospitalized from April 2010 to October 2012 were randomly divided into a study group and a control group. The study group received desogestrel and ethinyl estradiol tablets starting from the third day after diagnostic curettage, while the control group received medroxyprogesterone acetate. Time to hemostasis, clinical efficacy, adverse reactions were compared between the two groups. Levels of follicle stimulating hormone （FSH）, luteinizing hormone （LH） and estradiol （E2） were detected. Results The total effectiveness rate was significantly higher in the study group than in the control group （97.87% vs. 53.19%, P〈0.05）. Time to control of bleeding and time to complete s hemostasis was significantly shorter in the study group than in the control group. After treatment, FSH level was significantly decreased as compared with the control group （P〈O.05）; Levels of FSH, LH and E2 did not differ significantly in the control group after treatment （P〉0.05）. The rate of adverse reactions was significantly higher in the control group than in the study group （P〈O.05）. Conclusions Desogestrel and ethinyl estradiol tablets is effective and safe in the treatment of perimenopausal dysfunctional uterine bleeding. The therapy is worth popularizing clinically.