左炔诺孕酮宫内缓释系统联合屈螺酮炔雌醇治疗子宫腺肌病的疗效观察

Efficacy of Levonorgestrel Releasing Intrauterine System Combined with Drospirenone Ethinyl Estradiol Tablets in the Treatment of Adenomyosis

目的:探讨放置左炔诺孕酮宫内缓释系统(LNG-IUS)联合屈螺酮炔雌醇与单独放置LNG-IUS治疗子宫腺肌病的临床疗效。方法:选择2010年1月至2011年1月来我院就诊的102例确诊为子宫腺肌病的患者,随机分组为单独使用LNG-IUS的对照组(48例)和放置LNG-IUS并口服屈螺酮炔雌醇的观察组(54例)。随访6个月,对两组的痛经情况、月经量变化、经后点滴出血时间、脱环率进行比较。结果:在放置后第1、3月,两组痛经评分、月经量评分方面比较,观察组均优于对照组(P<0.01;P<0.05),第6月时两组比较差异无统计学意义(P>0.05)。放置第1、3月时,观察组点滴出血时间明显缩短,与对照组比较差异有统计学意义(P<0.05),第6月时两组比较,差异无统计学意义(P>0.05)。两组治疗后6月内总的脱环率比较,差异有统计学意义(P<0.05)。结论:LNG-IUS联合屈螺酮炔雌醇口服,对于快速缓解或消除痛经症状,快速减少月经量,缩短点滴出血时间及降低脱环率均有很好的效果。

Objective：To evaluate the clinical efficacy of levonorgestrel-releasing intrauterine system placed （LNG-IUS） combined with drospirenone ethinyl estradiol tablets and placed alone LNG-IUS treatment of adeno- myosis. Methods ：102 cases of patients diagnosed with adenomyosis from January 2010 to January 2011 in our hospital were recruited in to the study,who were divided randomly into two groups：to LNG-IUS alone control group（48 cases）and placed LNG-IUS combined with oral drospirenone ethinyl estradiol tablets in the study group（54 cases）. All of the cases were followed up for six months,the rate of dysmenorrhea, menstrual flow changes after spotting time,and decyclizing rate were compared between the two groups. Results： In the first and third month after placement, as to dysmenorrhea score and menstrual flow rates, the efficacies in study group were better than those of control group（ P 〈0.01 ;P 〈 0.05）, however,in the sixth month,there was no significant difference between the two groups（ P 〉0.05）. In the first and third month after placement,spotting time of the study group was significantly shorter with that of control group （ P 〈 0.05）, however in the sixth month,the difference was not statistically significant （P 〉 0.05）. There was significant difference on the total ring off rate between the two groups （ P 〈 0.05）. Conclusions： LNG-IUS combined with drospirenone ethinyl estradiol tablets orally can reach satisfactory clinical efficacy on reliefing or eliminating symptoms of dysmenor- rhea quickly, reducing menstrual flow rapidly, shortening spotting time, and reducing the rate of de-rings.