地屈孕酮联合来曲唑治疗子宫内膜异位症的临床研究

Clinical study on letrozole combined with dydrogesterone in treatment of endometriosis

目的观察地屈孕酮联合来曲唑治疗子宫内膜异位症的临床疗效。方法选取2015年5月—2016年5月在大连市妇女儿童医疗中心进行治疗的子宫内膜异位症患者86例,根据治疗方案的差别分为对照组(43例)和治疗组(43例)。对照组患者于月经结束后2 d开始口服来曲唑片,1片/次,1次/d。治疗组在对照组基础上口服地屈孕酮片,1片/次,2次/d。两组均连续治疗6个月。观察两组的临床疗效,比较两组治疗前后促卵泡生成素(FSH)、黄体生成激素(LH)、雌二醇(E2)、血管内皮生长因子(VEGF)、肿瘤标志物糖类抗原125(CA125)水平的变化情况。结果治疗后,对照组和治疗组的总有效率分别为76.74%、95.35%,两组比较差异有统计学意义(P<0.05)。治疗前后两组患者FSH、LH水平比较差异没有统计学意义。治疗后,两组患者E2、VEGF、CA125均较同组治疗前明显降低,同组治疗前后差异具有统计学意义(P<0.05)。治疗后,治疗组E2、VEGF、CA125水平低于对照组,两组比较差异有统计学意义(P<0.05)。结论地屈孕酮联合来曲唑治疗子宫内膜异位症具有较好的临床疗效,可缓解患者的临床症状,改善血清性激素水平,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of letrozole combined with dydrogesterone in treatment of endometriosis. Methods Patients（86 cases） with endometriosis in Dalian Municipal Women and Children＇s Medical Central from May 2015 to May 2016 were divided into control and treatment groups based on different treatments. Each group had 43 cases. Patients in the control group were po administered with Letrozole Tablets 2 d after menstruation finished, 1 tablet/time, once daily. Patients in the treatment group were po administered with Dydrogesterone Tablets on the basis of the control group, 1 tablet/time, twice daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacy, the change of FSH, LH, E2, VEGF, and CA125 in two groups before and after treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 76.74% and 95.35%, respectively, and there were differences between two groups（P〈 0.05）. There was no statistically significant about FSH and LH levels between two groups before and after treatment. After treatment, E2, VEGF, and CA125 in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈 0.05）. After treatment, E2, VEGF, and CA125 in the treatment groups were lower than those in the control group, and there were differences between two groups（P〈 0.05）. Conclusion Letrozole combined with dydrogesterone has a significant effect in treatment of endometriosis, and can alleviate the clinical symptoms of patients, also can improve the serum sex hormone levels, which has a certain clinical application value.