孕三烯酮不同给药方案治疗子宫内膜异位症的疗效及耐受性观察

Efficacy and tolerability of different administration regimens of gestrinone on endometriosis

目的研究孕三烯酮不同给药方案治疗子宫内膜异位症的疗效及耐受性。方法将90例子宫内膜异位症患者按随机原则分为三组（A、B、C组），均自月经日开始给予孕三烯酮2.5 mg，A组2次/周，B组3次/周，C组3次/周＋保肝药。比较三组阴道出血率、性激素水平及肝功能变化情况。结果治疗后，三组卵泡刺激素（FSH）、黄体生成素（LH）水平均显著降低（P〈0.05），组间比较差异未见统计学意义（P〉0.05）；治疗后1个月，A组雌激素水平（E2）高于B、C组，差异有统计学意义（P〈0.05）。A组阴道出血率显著高于B、C组，差异有统计学意义（P〈0.05）。A、B组治疗后丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）较治疗前显著升高（P〈0.05），C组较治疗前无显著改变（P〉0.05）；治疗后3个月，A、B组ALT、AST显著高于C组（P〈0.05）。结论孕三烯酮联合保肝药治疗可一定程度上减少阴道出血，缓解孕三烯酮所致药物性肝损伤，具有较高的临床价值。

Objective To study the efficacy and tolerability of different administration regimens of gestrinone on endometriosis.Methods Ninety cases with endometriosis were randomly divided into group A, B and C. All patients were treated with 2.5 mg gestrinone starting at the first day of menstruation, the medication frequency was 2 times per week in group A, 3 times per week in group B, while 3 times per week added with hepatoprotectants in group C. The rate of vaginal bleeding, expressions of sex hormone and liver function were compared among the three groups.Results The expressions of folicle-stimulating hormone （FSH） and luteinizing hormone （LH） decreased significantly after treatment in all groups （P〈0.05）, there was no significant difference among the three groups （P〉0.05）. The expression of estrogen（E2） in group A was significantly higher than that in group B and C after 1 month of treatment, the differences were statistically significant （P〈0.05）. The rate of vaginal bleeding in group A was significantly higher than that in group B and C, the differences were statistically significant （P〈0.05）; alanine aminotransferase （ALT） and aspartate aminotransferase （AST） in group A and B significantly increased after treatment （P〈0.05）, but change of those in group C were not significant （P〉0.05）. ALT and AST in group A and B after 3 months of treatment were significantly higher than those in group C （P〈0.05）.Conclusions The combination of gestrinone and hepatoprotectants can reduce vaginal bleeding, alleviate the drug-induced liver injury caused by gestrinone, which has a high clinical value.