芳香化酶抑制剂治疗子宫腺肌病的临床效果研究

The Research of the Clinical Effects of Aromatase Inhibitors for the Treatment of Adenomyosis

目的:观察芳香化酶抑制剂对子宫腺肌病患者痛经、月经量增多的治疗效果。方法:对46例要求保守治疗的子宫腺肌病患者及8例为准备放宫内左炔诺孕酮缓释系统(曼月乐)就医咨询的子宫腺肌病患者,观察其服用来曲唑治疗前后痛经程度及月经量的改善情况,以评估芳香化酶抑制剂对于子宫腺肌病的治疗效果。结果:46例患者来曲唑治疗3月后与治疗前相比,痛经评分治疗前为9.2±2.6分,治疗3个月后为4.8±1.2分,痛经评分显著下降,差异有统计学意义(P<0.01);治疗痛经有效率为82.6%(38/46)。以治疗前月经量100%计算,治疗3月后月经量为80%,月经量较治疗前稍有减少,但差异无统计学意义(P>0.05)。8例为准备放曼月乐就医咨询子宫腺肌病患者,短时间内服用来曲唑,治疗痛经有效率为75.0%(6/8)。结论:芳香化酶抑制剂对子宫腺肌病患者改善痛经有明显的治疗效果,但对于改善月经量效果不明显。

Objective：The aim of the study was to evaluate the clinical effects of aromatase inhibitors in the treatment of adenomyosis. Methods：We selected 54 patients who suffered of adenomyosis,among them 46 cases received the conservative treatment and 8 cases received levonorgestrel-releasing intrauterine device （Mirena）treatment. Changes of dysmenorrhea and menstrual volume were observed before and after the treatment, then the clinical effects of aromatase inhibitors for the treatment of adenomyosis were evaluated. Results：All the 46 patients received aromatase inhibitor therapy for 3 months. ,The score of the dysmenorrhea after the therapy was 4. 8± 1.2 ,significantly lower than that of pre-treatment score 9. 2 ±2.6（ P 〈0. 01 ）. And the remission rate of dysmenorrhea was 82.6% （38/46）. The menstrual volume before and after the therapy were 100% and 80%, respectively,which show no significant difference（ P 〉0. 05）. For the 8 cases who saw a doctor for the medical consultation of Mirena, received a aromatase inhibitor therapy for a short time,the remission rate of dysmenorrhea was 75, 0% （6/8）. Conclusions：Aromatase inhibitors had an obvious effect in the treatment of adenomyosis in alleviating clysmenorrhea,but the effect was not obvious in reducing the menstrual volume.