曼月乐联合米非司酮治疗子宫腺肌病的临床研究

Clinical research on the efficacy of Mirena in combined with mifepristone in the treatment of adenomyosis

目的:观察左炔诺孕酮缓释系统(LNG-IUS,曼月乐)联合米非司酮治疗子宫腺肌病(AM)的临床效果。方法:选取我院收治的AM患者76例,随机分为治疗组与对照组,各38例,治疗组采用曼月乐联合米非司酮治疗,对照组仅给予放置曼月乐治疗,对比两组治疗前、后症状及性激素水平变化,并采用B超检查子宫体积及内膜厚度变化。结果:两组治疗前后月经周期比较,差异无统计学意义(P>0.05);两组治疗后月经期时间较治疗前缩短,月经量PBAC评分、痛经VAS评分较治疗前显著下降(P<0.05);治疗组治疗后痛经程度改善显著优于对照组(P<0.05);两组治疗后子宫内膜厚度及子宫体积较治疗前显著下降(P<0.05),但两组间比较无明显差异(P>0.05);治疗组治疗后血清CA125明显低于对照组(P<0.05),两组治疗前后黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E_2)水平比较,差异无统计学意义(P>0.05)。结论:曼月乐联合米非司酮可有效缓解AM患者临床症状,对性激素无明显影响,值得临床推广应用。

Objective： To observe the clinical effects of levonorgestrel slow-release system （LNG-IUS, Mirena） in combined with mifepristone in the treatment of adenomyosis （AM）. Methods： A total of 76 patients with AM who were admitted in our hospital were included in the study and randomized into the treatment group and the control group with 38 cases in each group. Patients in the treatment group were given Mirena in combined with mifepristone, while patients in the control group were only placed with Mirena. Changes of symptoms and sex hormone levels before and after treatment were compared between the two groups. B ultrasound was used to examine the uterine volume and intimal thickness. Results： There was no sig nificant differences in menstrual cycle before and after treatment between the two groups （P〉0.05）. After treatment, the menstrual duration in the two groups was significantly shortened when compared with before treatment, PBAC and VAS scores were significantly reduced （P〈0.05）. The improvement degree of dysmenorrhea after treatment in the treatment was significantly superior to that in the control group （P〈0.05）. The endometrial thickness and uterine volume after treatment were significantly reduced when compared with before treatment （P〈0.05）, but there was no significant difference between the two groups （P〉0.05）. The serum CA125 after treatment in the treatment group was significantly lower than that in the control group （P〈0.05）. LH, FSH, and E2 levels before and after treatment were not significantly different between the two groups （P〉0.05）. Conclusions.. For AM patients, Mirena in combined with mifepristone can effectively alleviate the clinical symptoms with no effect on sex hormone levels; therefore, it is worthy of application in large scale.