不同剂量米非司酮治疗子宫腺肌病的效果观察

Effect observation on different doses of mifepristone in the treatment of adenomyosis

目的探讨不同剂量米非司酮治疗子宫腺肌病的疗效与安全性,以选择合适剂量米非司酮治疗子宫腺肌病。方法 57例子宫腺肌病患者,根据服用药物剂量不同分为A组(33例)和B组(24例)。A组患者给予米非司酮25 mg/周;B组患者给予米非司酮5 mg/d。两组患者均治疗3个月,观察患者治疗前后子宫大小、月经量、血红蛋白含量、血清CA125水平、视觉模拟评分法(VAS)的变化及不良反应发生情况,比较两组患者治疗效果。结果 A组总有效率为93.9%,稍低于B组的95.8%,但差异无统计学意义(P>0.05)。治疗后,两组患者VAS评分、月经量、血清CA125水平均显著低于治疗前,血红蛋白含量显著高于治疗前,子宫体积小于治疗前,差异均具有统计学意义(P<0.05);治疗后,两组月经量、VAS评分、子宫体积、血红蛋白含量、血清CA125水平比较差异无统计学意义(P>0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论给予子宫腺肌病患者米非司酮25 mg/周口服和5mg/d口服均可取得良好的治疗效果,不良反应少,患者耐受性好,两种方法均可作为短期治疗子宫腺肌病的首选。每日服药血药浓度稳定,而每周服药更加方便,为不同要求的患者提供了多种选择。

Objective To discuss the efficacy and safety of different doses of mifepristone in the treatment of adenomyosis, so as to select the appropriate dose of mifepristone for the treatment of adenomyosis. Methods A total of 57 adenomyosis patients were divided by different doses of drug administration into group A（33 cases） and group B（24 cases）. Group A was treated with mifepristone by 25 mg/week, and group B was treated with mifepristone by 5 mg/d. Both groups were treated for 3 months, and observation were made on changes of uterine size, menstrual volume, hemoglobin content, serum CA125 level, visual analogue scale（VAS） score before and after treatment and occurrence of adverse reactions. The treatment effect was compared between the two groups. Results Group A had a little lower total effective rate as 93.9% than 95.8% in group B, but the difference was not statistically significant（P〈0.05）. After treatment, both groups had obviously lower VAS score, menstrual volume and serum CA125 level than before treatment, obviously higher hemoglobin content than before treatment, and smaller uterine size than before treatment. Their difference was statistically significant（P〈0.05）. After treatment, both groups had no statistically significant difference in menstrual volume, VAS score, uterine size, hemoglobin content and serum CA125 level（P〈0.05）. Both groups had no statistically significant difference in incidence of adverse reactions（P〈0.05）. Conclusion For patients with adenomyosis, oral administration of mifepristone by 25 mg/week and 5 mg/d can obtain good therapeutic effect with less adverse reaction and good tolerance. Both two methods can be the first choice for the short-term treatment of adenomyosis. Daily drug concentration is stable, and it is more convenient for medication every week, which provides a variety of options for the different requirements of patients.