妈富隆用于改善放置宫内节育器初期子宫异常出血的临床研究

Effect of Marvelon on early stage of IUD induced bleeding

目的:探讨妈富隆用于改善放置宫内节育器(IUD)初期子宫异常出血的临床效果。方法:选择年龄﹤40岁,自愿放置TCu220C或吉妮致美IUD避孕妇女随机分组。Ⅰ组在放置IUD当天开始每晚口服妈富隆1片,至当月月经周期第25天停药;Ⅱ组同Ⅰ组服药后停药7d,下一周期再服用21d停药;对照组放置IUD后不服用妈富隆。各组中放置TCu220CIUD的分别有54例(ⅠA组)、58例(ⅡA组)、50例(A对照组),放置吉妮致美IUD的分别有58例(ⅠB组)、54例(ⅡB组)、50例(B对照组),比较各组放置IUD后子宫异常出血情况。结果:ⅠA组在术后及第1、2次月经流血情况明显好于A对照组(P<0.05),但第1次月经的点滴出血天数较对照组明显延长(P<0.05),第2、3次月经点滴出血天数与对照组无统计学差异;Ⅱ组月经点滴出血天数明显少于Ⅰ组;放置吉妮致美IUD组月经量增多发生情况好于放置TCu220CIUD(P<0.05),但同样需服用2个月经周期的妈富隆才能明显改善月经增多和点滴出血的情况。结论:放置IUD后当月给予口服妈富隆可以减少月经量增多情况,但不能缩短经期点滴出血时间,服用2周期妈富隆在缩短经期和减少经量增多方面有明显效果。对于月经量偏多或经期偏长者可以考虑放置IUD后口服妈富隆2周期,以改善放置IUD初期子宫异常出血情况。

Objective： To explore the clinical effect of Marvelon use on early stage of intrauterine device （IUD） induced bleeding. Methods： Women aged less than 40 years and seeking for IUD （TCu220C IUD or GeneFlex IUD） insertion were enrolled and divied into six groups. Women in group I received one tablet of Marvelon every night immediately after IUD insertion until the 25th day of the menstrual cycle; those in group II received the same regimen as group I, while took Marvelon for another 21 days after 7 days pause. And women in the control group did not use Marvelon. Fifty-four women in IA group, 58 in IIA group and 50 in control group A underwent TCu220C IUD insertion, and 58 women in IB group, 54 in IIB group and 50 in control group B underwent GeneFlex IUD insertion. The amount and duration of vaginal bleeding were evaluated. Results： When compared to control group A, less and shorter postoperative bleeding and the first and second menstrual bleeding were found in group IA （P〈0.05）, and the duration of spotting in the first period was significantly prolonged （P〈0.05）, while no significant differences were found in the second and third period （P〉0.05）. The duration of spotting was significantly shorter in group II than goup I. When compared to women with TCu220C IUD insertion, the incidence of menorrhagia was less in women with GeneFlex IUD insertion（P 〈0.05）. The incidence of menorrhagia and spotting could be decreased by using two periods of Marvelon. Conclusion： After IUD insertion, oral intake of Marvelon can reduce the incidence of menorrhagia, but can not shorten the duration of spotting; While another cycle use with 7 days interval can significantly reduce the amount and the duration of menstruation. So for women with more and longer menstruation, postoperative Marvelon use and repeating use in the following month should be considered to reduce the amount and duration of menstruation.