醋酸亮丙瑞林联合反加替勃龙治疗子宫内膜异位症的临床疗效观察

Clinical Efficacy Observation of Leuprolide Acetate Combined with Tibolone in the treatment of Endometriosis

目的:探讨醋酸亮丙瑞林联合反加替勃龙治疗子宫内膜异位症的临床疗效。方法:收集2015年10月至2016年10月入院的80例子宫内膜异位症患者随机分为两组,醋酸亮丙瑞林组患者给予醋酸亮丙瑞林,联合组患者则加用替勃龙,比较两组患者相关临床指标、骨密度、总体治疗效果与Kupperman评分。结果:联合组患者治疗后24周FSH(3.04±0.53)、LH(4.41±0.73)与E2水平(31.45±6.33)组间比较均显著性高于醋酸亮丙瑞林组(2.38±0.40,3.45±0.70,25.78±5.19),BGP(16.60±4.17)与CA125水平(13.27±4.04)均显著性低于醋酸亮丙瑞林组(24.17±5.89,18.77±4.60);治疗后24周(1.072±0.068)、停药后6个月(1.085±0.060)与12个月腰椎BMD水平(1.082±0.061)组间比较均显著性高于醋酸亮丙瑞林组(1.035±0.062,1.050±0.051,1.054±0.050);总有效率(87.5%)显著性高于醋酸亮丙瑞林组(70%);治疗后潮热、出汗值(5.90±0.76)、外阴阴道不适值(1.90±0.55)、关节疼分值(0.60±0.18)与Kupperman评分(7.94±1.80)组间比较均低于醋酸亮丙瑞林组(7.12±0.88,3.33±1.08,1.05±0.42,10.77±2.35),差异具有统计学意义(P<0.05)结论:醋酸亮丙瑞林联合反加替勃龙治疗子宫内膜异位症的临床疗效显著,可提高安全性,具有借鉴意义。

Objective： To investigate the clinical efficacy of leuprolide combined with tibolone in the treatment of endometriosis. Methods： 80 patients with endometriosis admitted from October 2015 to October2016 were randomly divided into two groups： leuprolide acetate group and leuprolide acetate group Boulong,.The clinical indicators,bone mineral density,overall treatment effect and Kupperman score of the two groups were compared. Results： The levels of 24 w FSH（3.04 ± 0.53）,LH（4.41 ± 0.73） and E2（31.45 ± 6.33）in the combined group were significantly higher than those in the leuprolide group（2.38 ± 0.40,3.45 ± 0.70,25.78 ± 5.19）,BGP（16.60 ± 4.17） and CA125 levels（13.27 ± 4.04） were significantly lower than those in the leuprolide group（24.17 ± 5.89 and 18.77 ± 4.60） The level of lumbar BMD at 6 months（1.085 ± 0.060） and 12 months after lumbar spine withdrawal（1.082 ± 0.061） were significantly higher than those in leuprolide group（1.035 ± 0.062,1.050 ± 0.051,1.054 ± 0.050）; The total effective rate（87.5%） was significantly higher than that of leuprolide group（70%）; after treatment,hot flashes,sweating value（5.90 ± 0.76）,vulvar vaginal discomfort value（1. 90 ± 0. 55）（0. 60 ± 0. 18） and Kupperman score（7. 94 ± 1. 80）were lower than those in the leuprolide group（7.12 ± 0.88,3.33 ± 1.08,1.05 ± 0.42 and 10.77 ± 2.35 respectively）,the difference was statistically significant（P 0.05）. Conclusion： The clinical efficacy of leuprolide combined with tibolone in the treatment of endometriosis is significant,which can improve the safety and has reference value.