戊酸雌二醇与去氧孕烯炔雌醇治疗青春期功能性子宫出血的疗效比较

Comparison on the Effects of Estradiol Valerate and Desogestrel Ethinylestradiol in Treating Adolescent Functional Uterine Bleeding

目的比较戊酸雌二醇与去氧孕烯炔雌醇治疗青春期功能性子宫出血的疗效。方法选取中山市博爱医院2010年11月至2013年10月诊治的青春期功能性子宫出血患者136例,采用随机数字表法分为戊酸雌二醇组（68例）和去氧孕烯炔雌醇组（68例）。戊酸雌二醇组患者口服戊酸雌二醇（每次3~4 mg,每日3~4次,止血后,每次2 mg,每日3次,每隔3日减少药量1/3,降至每次1 mg,每日1次,止血20 d停药）,去氧孕烯炔雌醇组患者口服去氧孕烯炔雌醇片（每次2~3片,每日2次,止血后,每次1片,每日2次,止血20 d停药）,比较两组患者的止血状况、临床疗效、治疗效果、不良反应发生情况。结果去氧孕烯炔雌醇组控制出血时间、完全止血时间均显著短于戊酸雌二醇组[（17±4）h比（27±6）h、（25±4）h比（36±8）h,均P〈0.05],去氧孕烯炔雌醇组总有效率显著高于戊酸雌二醇组（100.0%比91.2%）,去氧孕烯炔雌醇组基础体温双相比率、超声下有排卵比率、规律月经比率均显著高于戊酸雌二醇组（76.5%比33.8%、72.1%比23.5%、97.1%比60.3%,P〈0.01）,去氧孕烯炔雌醇组不良反应发生率显著低于戊酸雌二醇组（4.4%比14.7%,P〈0.05）。结论戊酸雌二醇与去氧孕烯炔雌醇均是治疗青春期功能性子宫出血的有效药物。去氧孕烯炔雌醇的治疗效果更佳。

Objective To compare the effects of estradiol valerate and desogestrel ethinylestradiol in treating adolescent functional uterine bleeding.Methods A total of 136 patients with adolescent functional uterine bleeding admitted in Zhongshan Pok Oi Hospital from Oct .2011 to Oct.2013 were selected and ran-domly divided into estradiol valerate group and desogestrel ethinylestradiol group , with 68 cases in each group.Patients in estradiol valerate group orally took estradiol valerate （ 3-4 mg/time, 3-4 times/d, after hemostasis,2 mg/time,3 times/d,every 3 day reduced dose of 1/3,until 1 mg/time,1 times/d, withdrew after 20 d of hemostasis） .Patients in desogestrel ethinylestradiol group orally took desogestrel ethinylestradiol （2-3 tablet/time,2 times /d,after hemostasis,1 tablet/time,2 times /d,withdrew after 20 d of hemostasis） . Hemostatic status, clinical efficacy, therapeutic effect, adverse reactions were compared between the two groups.Results Time of bleeding control,complete hemostasis time in desogestrel ethinylestradiol group were significantly lower than estradiol valerate group[（17 ±4） h vs（27 ±6） h,（25 ±4） h vs（36 ±8） h, P〈0.05].Total effective rate of desogestrel ethinylestradiol group was significantly higher than estradiol valerate group（100.0% vs 91.2%）.Dual phase ratio of basic temperature,ovulation rate under ultrasound, and ratio of regular menstruation in desogestrel ethinylestradiol group were significantly higher than those in estradiol valerate group（76.5% vs 33.8%,72.1% vs 23.5%,97.1% vs 60.3%,P〈0.01）.Incidence of adverse reactions in desogestrel ethinylestradiol group was significantly lower than that in estradiol valerate group（4.4% vs 14.7%,P 〈0.05）.Conclusion Estradiol valerate and desogestrel ethinylestradiol are both effective drugs in the treatment for adolescent functional uterine bleeding ,while the therapeutic effect of desogestrel ethinylestradiol is better.