米非司酮治疗围绝经期功能失调性子宫出血的临床疗效观察

Clinical curative effects of mifepristone in treatment of perimenopausal dysfunctional uterine bleeding

目的：探讨米非司酮治疗围绝经期功能性子宫出血的临床疗效。方法选择围绝经期患者80例，采用随机数表法将所有患者分为对照组和研究组，每组40例。对照组在诊断性刮宫术后第10天每天睡前口服安宫黄体酮10 mg，连用14 d 后停药，待撤退性出血15 d 后口服安宫黄体酮10 mg／d，连用10 d，重复用药5个月。研究组在清宫日起每晚睡前口服米非司酮12．5 mg，共服药6个月。门诊随访，观察两组近期疗效、远期疗效、激素水平变化、贫血改善情况及药物不良反应。结果治疗组总有效率为95．0％，对照组总有效率为82．5％，两组差异有统计学意义（χ2＝7．82，P ＝0．005）。研究组复发率为5．0％，对照组复发率为15．0％，差异有统计学意义（χ2＝5．56，P ＝0．018）。治疗后两组的 FSH、LH、E2、P 均降低，但研究组降低程度明显大于对照组，差异均有统计学意义（均 P ＜0．05）。研究组子宫内膜厚度降低程度大于对照组，差异具有统计学意义（P ＝0．0001）。结论米非司酮治疗围绝经期功能失调性子宫内膜出血临床疗效显著、安全方便，值得临床上推广应用。

Objective To investigate the clinical effect of mifepristone in treatment of perimenopausal dysfunctional uterine bleeding.Methods 80 cases of patients with perimenopausal dysfunctional uterine bleeding were selected and randomly divided into control group and research group,with 40 cases in each group.The control group was in the diagnosis of curettage after 10 days of oral provera 10mg every night before going to bed,stopped drug application in 14 days,15 days to retreat hemorrhages oral provera 10mg/day,stayed for 10 days,repeated drug use 5 months.The research group was treated with oral mifepristone every night before going to bed since cleaning up the uterus,12.5mg,for 6 months.Outpatient follow -up for 6 months,the recent curative effect,long -term curative effect,hormone level changes,anemia and adverse drug reactions were observed.Results The total effective rate of the research group was 95.0%,which of the control group was 82.5%,there was statistically significant difference（χ2 =7.82, P =0.005）;The recurrence rate of the research group was 5.0%,which of the control group was 15.0%,there was statistically significant difference（χ2 =5.56,P =0.018）.The FSH,LH,E2 and P of the two groups were decreased, but which of the research group were lower significantly than those of control group,the differences were statistically significant （all P 〈0.05）.The decreased degree of endometrium in the research group was larger than that of the control group,the difference was statistically significant（P =0.0001）.Conclusion Treatment of mifepristone perimenopausal dysfunctional uterine bleeding is significant,safe and convenient,which is worthy of clinical application.