左炔诺孕酮宫内节育系统治疗痛经及经量增多的子宫腺肌症86例的临床效果探讨

Efficacy of Levonorgestrel Intrauterine System in the Treatment of Dysmenorrhea and Increased by Adenomyosis of Uterus :A Report of 86 Patients

目的探讨左炔诺孕酮宫内节育系统（曼月乐）治疗痛经及经量增多的子宫腺肌症86例临床效果。方法临床资料为2014年12月-2015年12月来我院妇科就诊的子宫腺肌症患者172例。随机将患者分为药物治疗组和曼月乐组,药物治疗组患者给予口服甲睾酮治疗,曼月乐组患者给予曼月乐环治疗,在治疗后第6个月对患者进行随访,两组患者观察痛经变化情况,记录月经量、月经周期;曼月乐组患者观察子宫内变化情况。结果两组患者在治疗前痛经评分和疼痛分级差异无统计学意义（P〉0.05）;治疗后随访结果痛经程度和疼痛分级均比治疗前有所改善,且具有统计学意义（P〈0.05）;曼月乐组患者的痛经和疼痛改善程度优于药物治疗组患者,且具有统计学意义（P〈0.05）,曼月乐组患者在治疗后6个月疼痛基本消失。两组患者在治疗前月经情况比较无统计学差异（P〉0.05）;在治疗后两组患者月经量、月经周期均有所改善,且具有统计学意义（P〈0.05）;曼月乐组患者月经量和月经周期少于药物治疗组患者,且具有统计学意义（P〈0.05）。结论曼月乐治疗痛经及经量增多的子宫腺肌症的临床效果显著,可有效减少患者痛经症状及月经量,与口服激素药物比较安全、有效、容易被患者接受,可在临床中广泛使用。

Objective To investigate the efficacy of levonorgestrel intrauterine system（mirena）in the treatment of 43 patients with dysmenorrhea and increased by adenomyosis of uterus. Methods Clinical data for the December 2014 to December 2015 period to adenomyosis patients with 172 cases in our hospital gynecology clinic. Patients were randomized to treatment groups and the mirena group,drug treatment group were treated with oral methyltestosterone treatment group were treated with mirena ring treatment,in the first six months after treatment,patients were followed up for two changes observed in patients with dysmenorrhea,menstrual flow record,menstrual cycle,mirena group of patients observed changes in the uterus. Results The two groups of patients before treatment of dysmenorrhea pain scores and grade difference was not statistically significant（P〈0.05）,follow-up results dysmenorrhea and pain rating than before treatment improved after treatment,and was statistically significant（P〈0.05）,the degree of pain relief of dysmenorrhea and mirena group of patients was significantly better than patients treated with the drug,and was statistically significant（P〈0.05）,the mirena group of patients 6 months after treatment the pain disappeared. No significant difference between the two groups（P〈0.05）in the treatment of premenstrual situation,menstrual flow in two groups of patients after treatment,the menstrual cycle were improved,and statistically significant（P〈0.05）,mirena group patients with menstrual flow and menstrual cycle was significantly less than in patients treated with the drug,and was statistically significant（P〈0.05）. Conclusion Mirena treatment of dysmenorrhea and increased by the amount of the clinical effects of adenomyosis is significant,can effectively reduce the symptoms of dysmenorrhea and menstrual flow in patients with oral hormonal drugs safe,effective,easy to patients,it can be widely used in the clinic use.