子宫内膜异位症术后应用GnRH—a及小剂量雌激素反加疗法的临床价值

Clinical value of GnRH-a and low-dose estrogen reverse addition therapy on endometriosis after the operation

目的探讨子宫内膜异位症术后应用促性腺激素释放激素激动剂（GnRH-a）及小剂量雌激素反加疗法的临床价值。方法选取98例子宫内膜异位症患者，根据随机数字表法分为观察组和对照组，每组49例。对照组患者仅采用GnRH-a治疗，观察组患者采用GnRH-a联合小剂量雌激素反向添加疗法。比较两组患者治疗前后性激素及癌胚抗原（CA125）水平、VAS评分、Kupperman评分及不良反应发生情况。结果治疗后两组患者血清卵泡刺激素（FSH）、雌二醇（E2）、促黄体素（LH）及CA125水平均显著降低，且观察组E2水平显著高于对照组（P〈0.05）。两组患者治疗前后VAS评分及Kupperman评分差异均有统计学意义（P〈0.05），但组间比较差异未见统计学意义（P〉0.05）。观察组的潮热、情绪不稳及性欲减退发生率显著高于对照组（P〈0.05），而乏力和失眠差异未见统计学意义（P〉0.05）。结论子宫内膜异位症患者在术后采用GnRH-a联合雌激素反加疗法可以显著改善低激素症状，减少不良反应的发生，值得推广。

Objective To investigate the clinical value of GnRH-a and low-dose estrogen reverse addition therapy on endometriosis after operation.MethodsNinety-eight patients with endometriosis were selected. According to the random number table method, the 98 patients were divided into observation group and control group, with 49 cases in each group. The control group were treated with gonadotropin releasing hormone agonist （GnRH-a）, while the observation group was treated with GnRH-a combined with low-dose estrogen reverse addition therapy. The levels of sex hormones and CA125, VAS score, Kupperman scores and adverse reactions were compared between the two groups before and after treatment.ResultsAfter treatment, the levels of FSH, E2, LH and CA125 were significantly decreased in the two groups, and the level of E2 in the observation group was significantly higher than that in the control group （P〈0.05）. There were significant differences in VAS score and Kupperman score of two groups before and after treatment （P〈0.05）, but there was no significant difference between the two groups （P〉0.05）. In the observation group, the incidences of hot flashes, emotional instability and decreased libido were significantly higher than those in the control group （P〈0.05）, while there was no significant difference in the incidence of fatigue or insomnia between the two groups （P〉0.05）.ConclusionsThe use of GnRH-a combined with estrogen after the operation of endometriosis can significantly improve the symptoms of low hormones, reduce the incidence of adverse reactions, and it is worthy promotion.