孕激素治疗围绝经期异常子宫出血的效果评价

The assessment of progesterone treating abnormal uterine bleeding(AUB)in peri-menopause patients

目的：探讨孕激素治疗围绝经期异常子宫出血的临床效果,寻找能迅速止血、调整月经和简便、副作用小的性激素治疗方法。方法：选取口服地屈孕酮（A组,91例）、甲羟孕酮（B组,97例）和炔诺酮（C组,89例）治疗的患者277例,对临床资料进行比较。结果：三组止血有效率分别为68.13%、71.13%、95.51%,A组与B组差异无统计学意义（P〉0.05）;C组高于前两组,差异均有统计学意义（P〈0.05）。第一个疗程结束,三组月经恢复正常率,分别为57.14%、68.04%、83.15%,A组与B组差异无统计学意义（P〉0.05）;C组高于前两组,差异均有统计学意义（P〈0.05）。结论：地屈孕酮、甲羟孕酮、炔诺酮治疗围绝经期异常子宫出血均有效,炔诺酮效果优于前二种孕激素,序贯口服2~3个周期的患者,未见不良结局。

Objective：To investigate the clinical effect of progesterone for treating abnormal uterine bleeding（AUB）in peri-menopause patients,and to look for a hormone therapy that not only can decrease the amount of menstruation rapidly,but regulate menstruation simplified with small side effect.Methods：277 peri-menopause AUB patients were randomly divided into three groups[group A：Dydrogesterone（91 cases）;group B：Medroxyprogesterone（97 cases）;group C：Norethindrone（89 cases）].Then the clinical effects were observed and compared.Results：The rate of hemostasis efficiency was 68.13% in group A,71.13% in group B,95.51% in group C.No significant difference was observed between Group A and Group B（P 0.05）.Hemostasis efficiency rate was the highest in Group C than other two groups,they have significant difference（P 0.05）.And the rate of the menstruation normalized after the first course of the treatment was 57.14%、68.04%、83.15% individually.No significant difference was observed between Group A and Group B（P 0.05）.And the menstruation normalized rate was the highest in Group C than other two groups,they have significant difference（P 0.05）.Conclusions：The Dydrogesterone,Medroxyprogesterone and Norethindrone all have an effective treatment on per-menopause patients with abnormal uterine bleeding（AUB）,while the treatment effect of Group norethisterone was significantly better than other two groups.It also clarified that using norethisterone 2~3 cycles has fewer side effects,adverse effect was not observed.