戊酸雌二醇片/雌二醇环丙孕酮片联合屈螺酮炔雌醇片对功能性子宫出血患者宫内内分泌环境的影响

Effect of Complex Packing Estradiol Valerate Tablets, Estradiol Valerate and Cyproterone Acetate Tablets Combined with Drospirenone and Ethinylestradiol Tablets for the Intrauterine Endocrine Environment in Patients with Functional Uterine Bleeding

目的探讨戊酸雌二醇片/雌二醇环丙孕酮片联合屈螺酮炔雌醇片对功能性子宫出血(functional uterine bleeding,FUB)患者宫内内分泌环境的影响。方法前瞻性选取2013年1月—2016年6月笔者所在医院收治的FUB患者76例,依据随机分配原则分为单优组和克优组,每组38例,单优组在诊刮术后5 d给予屈螺酮炔雌醇片口服治疗,克优组在此基础上给予戊酸雌二醇片/雌二醇环丙孕酮片口服治疗。结果克优组治疗后血清卵泡雌激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平明显低于单优组,克优组治疗显效率明显高于单优组,差异有统计学意义(P<0.05),单优组和克优组不良反应发生率基本相同,差异无统计学意义。随访12个月期间,克优组复发率明显低于单优组,差异有统计学意义(P<0.05)。结论戊酸雌二醇片/雌二醇环丙孕酮片联合屈螺酮炔雌醇片治疗可有效改善FUB患者的宫内内分泌环境,有利于提高患者的近远期疗效,且具有良好的安全性,值得临床作进一步推广。

OBJECTIVE To discuss the effect of complex packing estradiol valerate tablets, estradiol valerate and cyproterone acetate tablets combined with drospirenone and ethinylestradiol tablets for the intrauterine endocrine environment in patients with functional uterine bleeding（FUB）. METHODS 76 patients with FUB were perspectively selected from January 2013 to June 2016 in auther＇s hospital, according to the random distribution. All patients were divided into single ya group and C ya group, 38 cases in each group. Single ya group was given drospirenone and ethinylestradiol tablets oral treatment 5 d after endocervical curettage, C ya group was given complex packing estradiol valerate tablets, estradiol valerate and cyproterone acetate tablets oral based on the single ya group treatment. RESULTS The serum follicle hormone（FSH）, luteinizing hormone（LH）, estradiol（E2） levels after treatment of C ya group were significantly lower than those of single ya group（P〈0.05）. The therapeutic efficiency rate of C ya group was significantly higher than that of single ya group, the difference was statistically significant（P〈0.05）. The adverse reaction rates of single ya group and C ya group were basically the same, there was no significant difference, during a followed up of 12 months. The recurrence rate of C ya group was significantly lower than that of single ya group, the difference was statistically significant（P〈0.05）. CONCLUSION Complex packing estradiol valerate tablets, estradiol valerate and cyproterone acetate tablets combined drospirenone and ethinylestradiol tablets treatment can effectively improve the intrauterine endocrine environment in patients with FUB. It is helpful to improve the near and forward future curative effect of patients, and it has good safety, it＇s worth for further clinical promotion.