左炔诺酮宫内缓释系统及其联合促性腺激素释放激素激动剂治疗子宫腺肌病的临床对照研究

Clinical Comparative Study on LNG-IUS and GnRH-α Combined with LNG-IUS in the Treatment of Adenomyosis

目的比较促性腺激素释放激素激动剂(GnRH-α,诺雷得)联合左炔诺酮宫内缓释系统(LNG-IUS,曼月乐)与单独放置曼月乐治疗子宫腺肌病的临床疗效。方法回顾性分析2016年1月至2017年12月我院收治的45例子宫腺肌病患者的临床资料,分为诺雷得+曼月乐组和曼月乐组,比较两组患者治疗前及治疗3个月、 6个月、 12个月后的痛经评分、子宫体积、子宫内膜厚度、血清Ca125值和不良反应。结果治疗3个月、 6个月、 12个月后,两组患者的痛经评分、子宫内膜厚度、血清Ca125值与治疗前比较差异均有统计学意义(P <0.05)。曼月乐组治疗前后的子宫体积比较无统计学差异(P>0.05),而诺雷得+曼月乐组治疗前后的子宫体积比较有统计学差异(P <0.05)。两组的不良反应发生率比较无统计学差异(P>0.05)。结论诺雷得联合曼月乐治疗子宫腺肌病,能够有效缓解症状,控制子宫体积,适用于要求保留子宫的子宫腺肌病患者。

Objective To compare the clinical efficacy gonadotropin releasing hormone agonist(GnRH-α, noride) combined with levonorgestrel-releasing intrauterine system(LNG-IUS, Mirena) and Mirena alone in the treatment of adenomyosis. Methods The clinical data of 45 patients with adenomyosis admitted to our hospital from January 2016 to December 2017 were retrospectively analyzed. They were divided into noride + Mirena group and Mirena group. The dysmenorrhea scores, uterine volume, endometrial thickness and serum Ca125 value before treatment and 3 months, 6 months and 12 months after treatment, and adverse reactions were compared between the two groups. Results 3 months, 6 months and 12 months after treatment, the dysmenorrhea scores, endometrial thickness and serum Ca125 values of the two groups had statistical difference with those before treatment(P <0.05). No statistical difference was found in the uterine volume before and after treatment in Mirena group(P >0.05), while statistical difference was found in the uterine volume before and after treatment in noride + Mirena group(P <0.05). No statistical difference was found in the incidence of adverse reactions between the two groups(P>0.05). Conclusions Noride combined with Mirena in the treatment of adenomyosis can significantly relieve the dysminorrhea, and control the uterine volume, which is suitable for adenomyosis patients who require to retain the uterus.