米非司酮联合孕三烯酮治疗子宫内膜异位症临床观察

Clinical observation of mifepristone combined with gestrinone in the treatment of endometriosis

目的子宫内膜异位症是临床常见的育龄女性疾病,对女性的生活质量及生殖健康产生严重的影响。本研究探讨米非司酮联合孕三烯酮对子宫内膜异位症患者症状改善和性激素水平的影响,为子宫内膜异位症的临床用药提供参考。方法选择2014-10-04-2015-10-04于光山县人民医院接受治疗的子宫内膜异位症患者152例,按照治疗方法的不同分为对照组和观察组,各76例。对照组采取孕三烯酮治疗,观察组采取米非司酮联合孕三烯酮治疗。比较两组临床疗效、不良反应发生情况、性激素水平、盆腔症状评分和总体征评分。结果观察组治疗总有效率为96.05%,高于对照组84.21%,χ2=5.991,P=0.014。治疗后,观察组盆腔触痛评分为(1.04±0.16)分,低于对照组(1.63±0.21)分,t=19.482,P<0.001;观察组硬结评分为(0.84±0.13)分,低于对照组(1.71±0.23)分,t=28.708,P<0.001;观察组性交痛评分为(0.53±0.09)分,低于对照组(0.75±0.18)分,t=9.530,P<0.001;观察组痛经评分为(0.57±0.17)分,低于对照组(1.08±0.23)分,t=15.545,P<0.001;观察组盆腔痛评分为(0.61±0.13)分,低于对照组(0.88±0.21)分,t=9.530,P<0.001。治疗后,观察组黄体生成素水平为(7.41±1.83)U/L,低于对照组的(8.22±1.62)U/L,t=2.889,P=0.004;观察组促卵泡生成素水平为(6.80±2.09)U/L,低于对照组的(8.01±2.28)U/L,t=3.410,P<0.001;观察组雌激素水平为(197.45±46.84)pmoL/L,低于对照组(245.73±48.76)pmoL/L,t=6.225,P<0.001;观察组孕酮水平为(2.06±1.03)nmoL/L,低于对照组(3.14±1.12)nmoL/L,t=6.188,P<0.001。观察组不良反应发生率为27.63%,与对照组(23.68%)比较,χ2=0.310,P=0.577。观察组妊娠率为68.42%,高于对照组的36.84%,χ2=15.200,P<0.001。结论米非司酮联合孕三烯酮治疗子宫内膜异位症安全可靠,可显著缓解患者临床症状,降低性激素水平,提升患者妊娠率。

OBJECTIVE Endometriosis is a common disease in women of childbearing age,which has a serious impact on the quality of life and reproductive health of women.This study aims to explore the effect of mifepristone combined with gestrinone on the improvement of symptoms and the level of sex hormones in patients with endometriosis and provide reference for clinical medication of endometriosis.METHODS A total of 152 patients with endometriosis who were treated in People＇s Hospital in Guangshan County from October 4,2014 to October 4,2015 were selected and were divided into control group and observation group according to different treatment methods,with 76 cases in each group.Control group was given gestrinone,while observation group was treated with mifepristone combined with gestrinone.The clinical efficacy,adverse reactions,sex hormone level,pelvic symptom score,total signs after treatment were compared between the two groups.RESULTS The total effective rate of the observation group was 96.05%,higher than that of the control group 84.21%,χ^2=5.991,P=0.014.After treatment,the pelvic tenderness score of the observation group was（1.04±0.16）score,lower than that of the control group（1.63±0.21）score,t=19.482,P〈0.001,the induration score of the observation group was（0.84±0.13）score,lower than that of the control group（1.71±0.23）score,t=28.708,P〈0.001,the dyspareunia score of observation group was（0.53±0.09）score,lower than the control group（0.75±0.18）score,t=9.530,P〈0.001,the score of dysmenorrhea in the observation group was（0.57±0.17）score,lower than that of the control group（1.08±0.23）score,t=15.545,P〈0.001,and the pelvic pain score of the observation group was（0.61±0.13）score,lower than that of the control group（0.88±0.21）score,t=9.530,P〈0.001.After treatment,the level of luteinizing hormone in the observation group was（7.41±1.83）U/L,lower than that of the control group（8.22±1.62）U/L,t=2.889,P=0.004,the level of follicle stimulating hormone in the observation group was（6.80±2.09）U/L,lower than that of the control group（8.01±2.28）U/L,t=3.410,P〈0.001,the level of estrogen in the observation group was（197.45±46.84）pmoL/L,lower than that in the control group（245.73±48.76）pmoL/L,t=6.225,P〈0.001,the level of progesterone in the observation group was（2.06±1.03）nmoL/L,lower than that of the control group（3.14±1.12）nmoL/L,t=6.188,P〈0.001.The incidence of adverse reactions in the observation group was 27.63%,compared with 23.68%in the control group,χ^2=0.310,P=0.577.The pregnancy rate in the observation group was 68.42%,higher than that in the control group 36.84%,χ^2=15.200,P〈0.001.CONCLUSION Mifepristone combined with gestrinone in treatment is safe and reliable,and it can relieve clinical symptoms,decrease sex hormone levels and increase pregnancy rate.