他莫昔芬联合米非司酮对围绝经期子宫肌瘤的疗效及血清性激素水平的影响

Effects of tamoxifen combined with mifepristone on efficacy and serum hormone levels of uterine fibroids in perimenopausal period

目的探讨他莫昔芬联合米非司酮对围绝经期子宫肌瘤的疗效及血清性激素水平的影响。方法选取2012年3月—2017年3月在宝鸡市妇幼保健院诊治的97例围绝经期子宫肌瘤患者,按治疗方法分成对照组、观察组,分别47、50例。对照组进行米非司酮治疗,观察组在此基础上联合他莫昔芬治疗,两组均治疗6个月。比较两组治疗前后瘤体体积、血清性激素水平的变化,比较两组临床疗效、治疗期间不良反应的发生情况。结果治疗前两组患者瘤体体积间无显著差异;两组治疗后瘤体体积均明显减小,同组治疗前后比较差异有统计学意义(P<0.05);且观察组明显小于对照组,差异有统计学意义(P<0.05)。两组的临床疗效总有效率间无显著差异,但观察组显效率更高(P<0.05)。治疗前两组患者血清FSH、LH、E、P水平间无显著差异;治疗后两组的血清FSH、E、P水平均显著降低同组治疗前后比较差异有统计学意义(P<0.05);且观察组显著低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率间比较无显著差异。结论他莫昔芬联合米非司酮对围绝经期子宫肌瘤的疗效确切,安全可靠,可显著减少瘤体体积、降低血清FSH、E、P水平,值得临床推广应用。

Objective To investigate the effect of tamoxifen combined with mifepristone on the efficacy and serum sex hormone levels of uterine fibroids in menopausal women. Methods Selected 97 patients with uterine fibroids in menopausal women in our hospital from March 2012 to March 2017. All patients were divided into control group and observation group by treatment method, 47, 50 cases respectively. The control group was treated with mifepristone. The observation group was given tamoxifen on the basis of the control group. The changes of tumor volume and serum sex hormone levels before and after treatment were compared between two groups. The clinical efficacy and the incidence of adverse reactions during the treatment between two groups were compared. Results： There was no significant difference between the two groups of tumor volume before treatment. The tumor volume of both groups were significantly decreased after treatment （P 〈 0.05）, and the observation group was significantly smaller than the control group （P 〈 0.05）. There was no significant difference between the two groups in the total effective rate, but the effective rate in the observation group was significantly higher than that in the control group （P 〈 0.05）. There was no significantdifference in serum FSH, LH, E, P levels between the two groups before treatment. Serum FSH, E, P levels in the two groups were significantly decreased after treatment （P 〈 0.05）, and the observation group was significantly lower than the control group （P 〈 0.05）. The incidence of adverse reactions between the two groups showed no significant difference. Conclusions Tamoxifen combined with mifepristone on peri-menopausal uterine fibroids curative effect is accurate, safe and reliable, can significantly reduce the volume of the tumor, lower serum FSH, E, P levels, worthy of clinical application.