戊酸雌二醇联合黄体酮序贯治疗功能失调性子宫出血的临床效果

Clinical effect of sequential therapy of Estradiol Valerate combined with Progesterone in the treatment of dysfunctional uterine bleeding

目的探讨戊酸雌二醇联合黄体酮序贯治疗功能失调性子宫出血(简称功血)的临床效果。方法选择2017年5～10月我院诊断为功血的189例患者作为研究对象,按照随机数字表法分为对照组(n=94)和联合组(n=95)。对照组单纯应用戊酸雌二醇进行治疗,联合组应用戊酸雌二醇联合黄体酮序贯治疗,对两组临床治疗效果进行比较分析。结果联合组住院时间、控制出血时间,止血时间均明显短于对照组,差异有统计学意义(P<0.05);联合组子宫内膜厚度和子宫平滑肌功能评分均明显高于对照组,差异有统计学意义(P<0.05)。联合组恢复正常排卵的患者比例高于对照组,月经量>80 ml的比例低于对照组,差异有统计学意义(P<0.05)。两组治疗前卵泡刺激素(FSH)、黄体生成素(LH)、孕酮(P)和雌二醇(E2)水平比较,差异无统计学意义(P>0.05);治疗后,联合组FSH和LH水平明显低于对照组,P和E2水平明显高于对照组,差异有统计学意义(P<0.05)。结论应用戊酸雌二醇联合黄体酮序贯治疗方法,可有效控制功血症状,有效促进子宫功能恢复,具有较高的临床应用价值,应积极进行推广。

Objective To investigate the clinical effect of sequential therapy of Estradiol Valerate combined with Progesterone in the treatment of dysfunctional uterine bleeding. Methods A total of 189 patients diagnosed with dysfunctional uterine bleeding in our hospital from May to October 2017 were selected as the research subjects. They were divided into control group (n=94) and combined group (n=95) according to random number table method. In the control group, Estradiol Valerate alone was used, while in the combined group, sequential therapy of Estradiol Valerate combined with Progesterone was adopted. The clinical effect of the two groups was compared and analyzed. Results The hospital stay, bleeding control time and hemostasis time were significantly shorter in the combined group than those in the control group with statistical significances (P<0.05). The endometrial thickness and uterine smooth muscle function scores in the combined group were significantly higher than those in the control group with statistical significances (P<0.05). The proportion of patients who recovered normal ovulation in the combined group was higher than that in the control group (P<0.05). The proportion of menstrual volume >80 ml was lower in the combined group than that in the control group with significant difference (P<0.05). There were no significant differences in the levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone (P) and estradiol (E2) between the two groups before treatment (P>0.05). After treatment, in the combined group, the FSH and LH levels were significantly lower, while P and E2 levels were significantly higher compared with those in the control group with statistical significances (P<0.05). Conclusion The application of sequential treatment of Estradiol Valerate combined with Progesterone can effectively control the symptoms of dysfunctional uterine bleeding and facilitate the recovery of uterine function. It has a high clinical application value and should be actively promoted.