安宫黄体酮联合戊酸雌二醇在子宫内膜异位症术后患者中的应用

Study of angonin progesterone combined with estradiol valerate in postoperative patients with endometriosis

目的探讨安宫黄体酮联合戊酸雌二醇在Ⅱ~Ⅳ期子宫内膜异位症(EMS)术后患者中的应用效果。方法将我院进行EMS手术的92例患者,随机将其分为对照组和试验组,各46例。对照组给予曲普瑞林3.75 mg,每次4周,皮下注射;试验组在此治疗基础上给予1 mg·d^-1戊酸雌二醇+6 mg·d^-1安宫黄体酮,口服,直至治疗结束。比较2组患者的临床疗效、血清雌二醇(E2)、卵泡刺激素(FSH)、促黄体生成素(LH)水平以及视觉模拟评分(VAS)、Kupperman评分;统计2组治疗期间的药物不良反应发生率。结果治疗后,试验组和对照组总有效率分别为95.65%,80.43%,差异有统计学意义(P<0.05)。治疗后,试验组和对照组血清E2水平分别为(91.53±14.18),(132.37±17.54)pmol·L^-1;血清FSH水平分别为(2.35±0.79),(3.78±1.32)U·L^-1;血清LH水平分别为(2.21±0.72),(3.91±1.16)U·L^-1;VAS分别为(1.67±0.71),(2.38±1.02)分;Kupperman评分分别为(2.76±0.11),(4.24±0.36)分;潮热发生率分别为23.91%,58.70%;失眠发生率分别为19.57%,39.13%;情绪波动发生率分别为15.22%,34.78%,差异均有统计学意义(均P<0.05)。结论安宫黄体酮联合戊酸雌二醇治疗EMS,疗效确切,能够显著降低患者性激素水平,缓解患者术后疼痛感。

Objective To explore the effect of angonin progesterone combined with estradiol valerate in postoperative patients with stage Ⅱ-Ⅳ endometriosis(EMS). Methods A total of 92 patients who underwent EMS surgery were randomly divided into control group and treatment group, with 46 patients in each group. Control group was given triptorelin 3.75 mg, 4 weeks a time, subcutaneous injection;treatment group was given oral treatment with estradiol valerate 1 mg·d^-1 + progesterone 6 mg·d^-1 on the basis of control group, until the end of treatment. The clinical efficacy, the levels of serum estradiol(E2), follicle stimulating hormone(FSH), luteinizing hormone(LH) and the visual analogue scale(VAS), Kupperman scores before and after treatment were compared;the occurrence of adverse drug reactions during the treatment between the two groups were compared. Results After treatment, the total effective rates in treatment group and control group were 95.65% and 80.43%, with significant difference(P<0.05).After treatment, the levels of serum E2 in treatment group and control group were( 91. 53 ± 14. 18),( 132. 37 ± 17. 54) pmol·L^-1;the levels of serum FSH were( 2. 35 ± 0. 79),( 3. 78 ± 1. 32) U·L^-1;the levels of serum LH were( 2. 21 ± 0. 72),( 3. 91 ± 1. 16) U · L^-1;the VAS were 1. 67 ± 0. 71,2. 38 ± 1. 02;the score of Kupperman were 2. 76 ± 0. 11,4. 24 ± 0. 36;the incidence of hot flashes were 23. 91%,58. 70%;the incidence of insomnia were 19. 57%,39. 13%;the incidence of mood swing were 15. 22%,34. 78%, all with significant difference( all P < 0. 05). Conclusion Angonin progesterone combined with estradiol valerate for EMS is effective,can significantly reduce the patient’s sex hormone levels,relieve postoperative pain.