青春期排卵障碍性异常子宫出血止血后四种调整周期方案的疗效比较

Efficacy comparison of four adjustment cycles after hemostasis in adolescent abnormal uterine bleeding-ovulatory disorders

目的比较青春期排卵障碍性异常子宫出血(AUB-O)止血后四种调整周期方案的疗效。方法选择2016年6月~2018年6月江西省妇幼保健院门诊及住院部收治的100例青春期AUB-O患者,采用随机数字表法分为四组,每组各25例。A组实施孕激素方案,B组实施人工周期小剂量雌激素方案,C组实施人工周期常规雌激素方案,D组实施炔雌醇环丙孕酮片避孕药方案,连续治疗3个周期,随访6个月。比较四组治疗后临床效果,治疗期间不良反应总发生率及随访结束时基础体温(BBT)双相率及复发率。结果治疗3个周期后,D组治疗总有效率高于A、B、C组,差异有统计学意义(P<0.05);A、B、C组的治疗总有效率比较,差异无统计学意义(P>0.05)。四组不良反应发生情况比较,差异无统计学意义(P>0.05)。随访6个月后,D组BBT双相率高于A、B、C组,差异有统计学意义(P<0.05);A、B、C组的BBT双相率比较,差异无统计学意义(P>0.05);D组复发率低于A、B、C组,差异有统计学意义(P<0.05);A、B、C组的复发率比较,差异无统计学意义(P>0.05)。结论口服炔雌醇环丙孕酮片治疗可提高青春期AUB-O患者BBT双相率,降低复发率,且不良反应发生率无明显增加,治疗的安全性及有效性均较好。

Objective To compare the efficacy of four adjustment cycle programs after hemostasis in adolescent abnormal uterine bleeding-ovulatory disorders(AUB-O).Methods A total of 100 adolescent AUB-O patients who were admitted to the Outpatient and Inpatient Department of Jiangxi Maternity and Child Health Hospital from June 2016 to June 2018 were selected.They were divided into four groups by a random number table method,with 25 cases in each group.Progesterone regimen was used in group A;artificial cycle at a low-dose estrogen regimen was used in group B;artificial cycle in a routine estrogen regimen was used in group C;contraceptive regimen of Ethinyl Estradiol and Cyproterone Tablets was adopted in group D.All of these interventions were treated continuously for three cycles and followed up for six months.The clinical efficacy of the four groups after treatment,the incidence of adverse reactions during treatment,the biphasic rate of basal body temperature(BBT)and the recurrence rate at the end of follow-up were compared.Results After three cycles of treatment,the total effective rate of treatment in group D was higher than that of group A,B,and C,with statistical significance(P<0.05).There was no significant difference in total effective rate of treatment among group A,B,and C(P>0.05).There was no significant difference in the occurrence of adverse reactions among the four groups(P>0.05).After six months of follow-up,the biphasic rate of BBT in group D was higher than that of group A,B,and C,with statistical significance(P<0.05).There was no significant difference in the biphasic rate of BBT in group A,B,and C(P>0.05).The recurrence rate of group D was lower than that of group A,B,and C,with statistical significance(P<0.05).On regard of the recurrence rate,there was no significant difference among group A,B,and C(P>0.05).Conclusion Oral administration of Ethinyl Estradiol and Cyproterone Tablets can increase the biphasic rate of BBT in adolescent AUB-O patients,reduce the recurrence rate,without significant increase of the incidence of adverse reactions.The safety and effectiveness of the treatment are good.