甲基睾丸素联合米非司酮治疗更年期功能性子宫出血的疗效观察

Observation of the effect of methyl testosterone combined with mifepristone in the treatment of menopausal dysfunctional uterine bleeding

目的 探讨甲基睾丸素联合米非司酮在治疗更年期功能性子宫出血上的有效性和安全性,评价联合用药方法的临床应用价值.方法 将130例更年期功能性子宫出血患者按数字表法随机分为两组,每组65例.对照组患者单独口服米非司酮进行治疗,而观察组患者则在对照组治疗的基础上联合甲基睾丸素进行治疗.观察并记录两组患者治疗前后的血清激素水平以及子宫内膜厚度的变化,比较两种治疗方法的临床疗效和不良反应的发生情况差异.结果 治疗后,观察组的卵泡刺激素、黄体生成素、孕激素等血清激素水平的降低趋势显著优于对照组（t=12.892、13.525、14.228,均P〈0.05）,而子宫内膜厚度的降低情况也明显优于对照组（t=13.362,P〈0.05）;观察组的临床治疗总有效率为96.92%,明显高于对照组的80.00%（χ^2=9.68,P〈0.05）,而观察组不良反应率为12.31%,则明显低于对照组的27.69%（χ^2=9.15,P〈0.05）.结论 甲基睾丸素联合米非司酮应用于治疗更年期功能性子宫出血,可以明显缓解患者的疾病情况,其疗效明显优于单独使用米非司酮,并且不良反应小,值得在临床上推广使用.

Objective To explore the efficacy and safety of methyl testosterone combined with mifepristone in the treatment of menopausal dysfunctional uterine bleeding, and to evaluate the clinical value of combination therapy. Methods According to the digital table, 130 patients with menopausal dysfunctional uterine bleeding were ran- domly divided into two groups,65 cases in each group. The control group was only treated with mifepristone, while the observation group was treated with methyl testosterone based on the treatment of the control group. Before and after treatment,the levels of serum hormone and the changes in endometrial thickness were observed and recorded. The clinical efficacy and the incidence of adverse reactions of the two treatment methods were compared. Results After treatment, the levels of serum hormone such as follicle stimulating hormone, lnteinizing hormone and progesterone of the observation group were significantly lower than those of the control group （ t = 12. 892,13. 525,14. 228, all P 〈 0.05 ）. And the endometrial thickness of the observation group was significantly decreased than that of the control group （t = 13. 362 ,P 〈0.05）. The total effective rate of the observation group was 96.92% ,which was significantly higher than 80.00% of the control group（ X2 = 9.68, P 〈 0. 05 ）. And the incidence rate of adverse reactions of the observation group was 12.31% ,which was significantly lower than 27.69% of the control group （X^2=9. 15, P 〈 0. 05）. Conclusion Methyl testosterone combined with mifepristone in the treatment of menopausal dysfunctional uterine bleeding can significantly alleviate the patients＇disease status, the efficacy is superior to use mifepristone alone, which is worthy of use in clinical practice.