米非司酮与曼月乐用于围绝经期功能失调性子宫出血治疗的疗效对比

Comparison of curative effects of Mifepristone and Mirena in treatment of perimenopausal women with dysfunctional uterine bleeding

目的:探讨米非司酮和曼月乐(左炔诺孕酮宫内缓释系统)治疗围绝经期妇女功能失调性子宫出血的疗效。方法:120例围绝经期功能失调性子宫出血患者随机分为曼月乐组(40例)、间断给药组(40例)和连续给药组(40例),对3组治疗前与治疗后3个月和6个月子宫内膜厚度、血红蛋白变化、有效率进行比较。结果:曼月乐组的有效率为92.5%,间断给药组有效率为70.0%,米非司酮持续给药组有效率为67.5%,曼月乐组与米非司酮组比较,差异有统计学意义(P<0.05);3组治疗后子宫内膜厚度均变薄,尤以曼月乐组最为显著;3组治疗后血红蛋白显著增加,曼月乐组较其他两组显著升高,差异有统计学意义(P<0.05);间断给药组与连续给药组疗效、子宫内膜厚度、血红蛋白比较,差异无统计学意义(P>0.05);结论:曼月乐和米非司酮不同给药方式治疗围绝经期功血安全、有效,尤其以曼月乐治疗疗效更显著。

Objective： To explore the curative effects of Mifepristone and Mirena （levonorgestrel - releasing intrauterine system） in treatment of perimenopausal women with dysfunctional uterine bleeding. Methods： One hundred and twenty perimenopausal women with dysfunctional uterine bleeding were randomly divided into Mirena group, intermittent administration group and successive administration group, 40 women in each group ; the thicknesses of endometrium, hemoglobin levels and effective rates before treatment and at three and six months after treatment in the three groups were compared. Results： The effective rates in Mirena group, intermittent administration group and successive administration group were 92. 5% , 70. 0% and 67.5% , respectively, there was statistically significant difference between Mirena group and intermittent administration group, successive administration group （ P 〈 0. 05 ） ; after treatment, the thicknesses of endometrium in the three groups tended to thin, especially in Mirena group; after treatment, the levels of hemoglobin in the three groups increased significantly, especially in Mirena group, there was statistically significant difference （ P 〈 0. 05 ） ; there was no statistically significant difference in endometrial thickness and hemoglobin level between intermittent administration group and successive administration group （P 〉 0.05 ） . Conclusion： Mirena and Mifepristone of different modes of administration are safe and effective in treatment of perimenopausal women with dysfunctional uterine bleeding, especially Mirena, whose curative effect is more significant.