不同剂量米非司酮治疗子宫肌瘤的临床疗效比较

Efficacy Comparison of Different Dosages of Mifepristone for Uterine Fibroids

目的探讨不同剂量米非司酮治疗子宫肌瘤的疗效与安全性。方法随机选取2012年4月至2013年8月医院收治的子宫肌瘤患者90例,分为观察组和对照组,两组均予米非司酮片,观察组剂量为12.5 mg,对照组为25 mg。治疗结束后,比较和分析患者的治疗有效率、子宫肌瘤体积、不良反应发生率和血清中激素水平等。结果对照组总有效率为84.44%,观察组为95.56%,明显高于对照组,两组对比具有明显差异(U=2.154 6,P=0.031 2)。治疗前后观察组子宫肌瘤体积分别为(45.18±12.12)mm及(30.15±9.55)mm,对照组分别为(46.13±12.21)mm及(30.98±9.57)mm,治疗后两组患者子宫肌瘤体积均较治疗前明显变小,差异具有统计学意义(P<0.05);观察组和对照组的子宫肌瘤体积比较,差异无统计学的意义(P>0.05)。对照组不良反应发生率为12例(26.27%),明显高于观察组的3例(6.67%),差异具有统计学的意义(P<0.05)。治疗后,两组患者血清激素水平变化有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05)。结论米非司酮的最佳给药剂量为每天12.5 mg,安全性好、有效性高、不良反应少且经济可行,值得临床推广。

Objective To explore the efficacy and safety of different doses of mifepristone in the treatment of uterine fibroids. Methods 90 cases with uterine fibroids from April 2012 to August 2013 were randomly divided into observation group and control group. The two groups were given mifepristone tablets for treatment, the dosage of the observation group was 12.5 mg, and the control group was 25 mg. After the end of treatment, the efficiency, fibroid volume before and after uterine, the patients＇ adverse reaction rates were compared and analyzed. Results The total effective rate was 84. 44% in the control group, which was significantly lower than 95.56% in the obser- vation group; （U=2. 154 6, P=0.031 2）; the uterine fibroid volume in the observation group before the treatment was （45. 18± 12. 12） mm, after treatment was （30. 15±9.55）mm, and the uterine fibroid volume in the control group before the treatment was （46. 13±12.21）mm, after treatment was （30.98±9.57）mm, which had significantly reduced compared with before treatment（P 〈 0.05）; after treatment, the two groups had no significant difference in the uterine fibroid volume（ P 〉 0. 05）; the total adverse reaction rate in the control group was 26.27% （12 cases）, which was significantly higher than 6.67% （3 cases） in the observation group（P 〈 0.05）. Conclusion The best dosage of mifepristone is 12. 5 mg per day. The treatment is safe, effective, with few adverse reactions and is economic and feasible, which is worthy of clinical promotion.