不同剂量孕酮治疗无排卵性异常子宫出血的临床疗效观察

Observation of clinical effects of different doses of progesterone on anovulatory abnormal uterine bleeding

目的探讨不同剂量孕酮治疗无排卵性异常子宫出血的临床疗效。方法200例无排卵性异常子宫出血患者,按不同剂量孕酮治疗分为对照组和观察组,每组100例。两组患者均口服黄体酮治疗,对照组服用200 mg/d,观察组服用100 mg/d。对比两组的临床疗效、撤药性出血率、阴道出血时间、阴道出血量评分、治疗前后子宫内膜厚度、不良反应发生率。结果观察组治疗总有效率为97.00%,与对照组的100.00%比较,差异无统计学意义(P>0.05)。观察组撤药性出血率、阴道出血时间、阴道出血量评分与对照组比较,差异无统计学意义(P>0.05)。治疗前及治疗后,观察组子宫内膜厚度与对照组比较,差异无统计学意义(P>0.05)。观察组不良反应发生率3.00%明显低于对照组的12.00%,差异有统计学意义(P<0.05)。结论100 mg/d及200 mg/d剂量的孕酮治疗无排卵性异常子宫出血的效果相当,但100 mg/d剂量的孕酮不良反应更小,临床可使用低剂量治疗,以确保疗效及安全性。

Objective To discuss the clinical effects of different doses of progesterone on anovulatory abnormal uterine bleeding.Methods A total of 200 patients with anovulatory abnormal uterine bleeding were divided into control group and observation group,with 100 cases in each group.Both groups were treated with progesterone orally.The control group took 200 mg/d and the observation group took 100 mg/d.The clinical efficacy,drug withdrawal bleeding rate,vaginal bleeding time,vaginal bleeding volume score,endometrial thickness before and after treatment,incidence of adverse reactions were compared between the two groups.Results The total effective rate of treatment of the observation group was 97.00%,which had no statistically significant difference compared with that of the control group 100.00%(P>0.05).There was no statistically significant difference in drug withdrawal bleeding rate,vaginal bleeding time,vaginal bleeding volume score between the two groups(P>0.05).Before and after treatment,there was no statistically significant difference in endometrial thickness between the two groups(P>0.05).The incidence of adverse reactions 3.00%of the observation group was obviously lower than that of the control group 12.00%,and the difference was statistically significant(P<0.05).Conclusion Progesterone 100 mg/d and 200 mg/d are equivalent to the treatment of anovulatory abnormal uterine bleeding,but the adverse reactions of progesterone 100 mg/d are smaller.Low-dose treatment can be used in clinic to ensure the efficacy and safety.