GnRH-α联合替勃龙治疗子宫内膜异位症的疗效观察

Observation on the curative effect of GnRH-α combined with tibolone in treatment of endometriosis

目的：探讨GnRH-α联合替勃龙治疗子宫内膜异位症的临床疗效。方法：选择2010年2月-2012年2月因子宫内膜异位症行腹腔镜手术的120例患者，根据随机原则分为观察组和对照组，每组60例。两组患者于术后3～5天给予醋酸曲普瑞林皮下注射，对照组在治疗第8周时口服戊酸雌二醇，观察组在第8周时口服替勃龙片，对两组患者的FSH、LH、BGP、E2、腰椎骨密度和停药后月经复潮时间等指标进行观察和分析。结果：观察组患者在治疗6个月后的FSH、LH和E2水平相比较对照组显著降低，而BGP水平显著升高（t=3．145，2．569，3．419，3．109，P〈0．05）；腰椎骨密度显著高于对照组（t=2．518，P〈0．05）；两组患者停药后的月经复潮时间无统计学差异（P〉0．05）。结论：GnRH-α反向添加替勃龙治疗子宫内膜异位症相比较戊酸雌二醇具有疗效好，安全性高等优点，值得在临床上推广。

Objective： To explore the clinical efficacy of gonadotropin releasing hormone agonist （GnRH -oα） combined with tibo- lone in treatment of endometriosis. Methods： One hundred and twenty patients receiving laparoscopic surgery because of endometriosis from February 2010 to February 2012 were selected and randomly divided into observation group and control group, 60 patients in each group; the patients in the two groups were treated with subcutaneous injection of triptorelin acetate at 3 -5 days after surgery; the patients in control group were treated with oral administration of estradiol valerate on the eighth week after treatment, while the patients in observation group were treated with oral administration of tibolone pills on the eighth week after treatment; the levels of follicle -stimulating hormone （FSH）, luteinizing hormone （LH） , bone gla protein （BGP） and estradiol, bone mineral density （BMD） of lumbar vertebra, and the recovery time of menstruation after stopping treatment in the two groups were observed and analyzed. Results ： The levels of FSH, LH, and estradiol in ob- servation group at 6 months after treatment were statistically significantly lower than those in control group, but the level of BGP in observa- tion group was statistically significantly higher than that in control group （ t = 3. 145, 2. 569, 3.419, 3. 109, P 〈 0.05 ） ; BMD of lumbar vertebra in observation group was statistically significantly higher than that in control group （ t = 2. 518, P 〈 0.05 ） ; there was no statistically significant difference in the recovery time of menstruation after stopping treatment between the two groups （ P 〉 0. 05 ） . Conclusion ： Com- pared with estradiol valerate, GnRH - α combined with tibolone in treatment of endometriosis has the advantages of good efficacy and high safety, which is worthy to be popularized in clinic.