炔诺酮治疗单纯子宫内膜增生伴月经过多的临床效果与安全性

Clinical effect and safety of norethisterone in the treatment of simple endometrial hyperplasia with menorrhagia

目的观察炔诺酮治疗单纯子宫内膜增生伴月经过多的临床效果与安全性。方法回顾性分析2018年8月-2019年12月珠海市斗门区侨立中医院收治的主因月经过多就诊患者120例的临床资料。患者根据临床症状与用药方案不同分为普通用药组(月经周期不规律的患者) 27例,递增用药组(经期过长的患者,旨在减少下月月经量) 51例及递减用药组(仅用于本月1个周期的月经止血,后改为普通用药或递增用药) 42例。比较3组治疗效果(包括月经量控制效果与子宫内膜变化)及不良反应(包括肝功能异常及血糖、血脂、血液黏稠度升高)发生情况。结果普通用药组、递增用药组与递减用药组月经量控制总有效率分别为85.19%、88.24%和92.86%;3组子宫内膜转化总有效率分别为88.89%、84.31%和83.33%;普通用药组未发生不良反应事件,递增用药组与递减用药组不良反应总发生率分别为5.88%和7.14%,两两比较差异均无统计学意义(P>0.05)。结论炔诺酮治疗单纯子宫内膜增生伴月经过多的临床效果与安全性均较佳,患者月经量控制与子宫内膜增生转化效果显著,具有较高的临床应用价值。

Objective To observe the clinical effect and safety of norethisterone in the treatment of simple endometrial hyperplasia with menorrhagia. Methods The clinical data of 120 patients with menorrhagia in Doumen District Qiao Li Hospital of traditional Chinese Medicine from August 2018 to December 2019 were retrospectively analyzed. According to the clinical symptoms and medication plan,the patients were divided into general medication group( 27 patients with irregular menstrual cycle),incremental medication group( 51 patients with long menstrual period,aiming at reducing menstrual volume in next month) and decreasing medication group( 42 patients only used for menstrual hemostasis in one cycle of this month,then changed to general medication or incremental medication). The treatment effect( including menstrual volume control effect and endometrial changes) and adverse reactions( including abnormal liver function and increased blood glucose,blood lipid and blood viscosity) were compared among the three groups. Results The total effective rates of menstrual volume control were 85. 19%,88. 24% and 92. 86% in the general medication group,the increasing medication group and the decreasing medication group,respectively. The total effective rates of endometrium in the three groups were 88. 89%,84. 31% and83. 33% respectively. The total incidence of adverse reactions was 5. 88% in the increasing group and 7. 14% in the decreasing group. In the above results,there was no significant difference among the three groups( P > 0. 05). Conclusion Norethisterone has better clinical effect and safety in the treatment of simple endometrial hyperplasia with menorrhagia. The effect of menstrual volume control and endometrial hyperplasia transformation is significant,which has high clinical application value.