左炔诺孕酮宫内缓释系统与小剂量米非司酮在子宫腺肌病治疗中的疗效比较研究

Effect of Levonorgestrel Releasing Intrauterine System and Small Dose of Mifepristone in the Treatment of Adenomyosis

目的探讨左炔诺孕酮宫内缓释系统与小剂量米非司酮在子宫腺肌病治疗中的治疗效果。方法选择2015年1月—2016年12月我院妇产科接受治疗的100例子宫腺肌病患者,随机分为左炔诺孕酮宫内缓释系统组和米非司酮组,每组50例,分别接受子宫放置左炔诺孕酮宫内缓释系统与口服小剂量米非司酮进行治疗。检查两组患者治疗前、后子宫体积、月经情况及骨密度,采用视觉模拟评分法(VAS)评估治疗前、后痛经疼痛情况,并观察两组患者临床疗效。结果治疗前和治疗后,两组月经量、月经周期、经期、VAS得分、骨密度及子宫体积分别比较,差异均无统计学意义(P>0.05)。两组治疗后与治疗前比较,月经量减少,月经周期延长,经期缩短,VAS得分降低,子宫体积减小,差异有统计学意义(P<0.05)。两组患者总有效率及不良反应发生率比较,差异均无统计学意义(P>0.05)。结论左炔诺孕酮宫内缓释系统与小剂量米非司酮在子宫腺肌病治疗中均具有较为理想的治疗效果,可有效改善患者月经情况及痛经症状,子宫体积减小,疗效确切,安全性高。

Objective To investigate the therapeutic effect of levonorgestrel releasing intrauterine system and small dose of mifepristone in the treatment of adenomyosis. Methods 100 cases of adenomyosis patients selected from January 2015 to December 2016 in our hospital gynecology and obstetrics treatment, were randomly divided into the levonorgestrel releasing intrauterine system group and mifepristone group, 50 cases in each group, were treated with uterine respectively use levonorgestrel releasing intrauterine system and low dose mifepristone treatment. The volume of uterus,menstruation and bone mineral density were measured before and after treatment in two groups. The visual analogue scale( VAS) was used to assess the pain before and after treatment,and the clinical efficacy of the two groups was observed. Results Before treatment and after treatment,the two groups of menstrual volume, menstrual cycle, menstrual period, VAS score, bone mineral density and uterine volume were compared( P > 0. 05). The two groups compared with before treatment, menstrual volume decreased,menstrual cycle extension,menstrual shortening,VAS score decreased,uterine volume decreased( P < 0. 05). There was no difference in the total effective rate and adverse reaction rate between the two groups( P > 0. 05). Conclusion The levonorgestrel releasing intrauterine system and small dose of mifepristone has ideal therapeutic effect in the treatment of adenomyosis,which can effectively improve the patients' menstruation and dysmenorrhea symptoms,uterine volume reduction,curative effect,high safety.