米非司酮联合左炔诺孕酮宫内节育系统治疗子宫腺肌症的临床效果

Clinical effect of Mifepristone combined with Levonorgestrel intrauterine birth control system in the treatment of adenomyosis

目的探讨米非司酮联合左炔诺孕酮宫内节育系统治疗子宫腺肌症的临床效果。方法选取2018年1月—2020年1月于南通市通州区人民医院妇科门诊就诊的90例子宫腺肌症患者为研究对象。按照随机数字表法分为对照组与观察组,每组各45例。对照组采用米非司酮治疗,观察组采用米非司酮联合左炔诺孕酮宫内节育系统治疗。比较两组患者治疗前后的月经量、子宫情况、促卵泡激素(FSH)、雌二醇(E2)及黄体生成激素(LH)水平,采用视觉模拟评分法(VAS)评估痛经情况,比较两组患者治疗期间的不良反应发生情况。结果治疗前,两组患者的月经量及VAS评分比较,差异无统计学意义(P>0.05);治疗后,观察组的月经量少于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的子宫体积及子宫内膜厚度比较,差异无统计学意义(P>0.05);治疗后,观察组的子宫内膜厚度及子宫体积均小于对照组,差异有统计学意义(P<0.05)。治疗前后,两组患者的FSH、E2、LH比较,差异无统计学意义(P>0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论米非司酮联合左炔诺孕酮宫内节育系统治疗能够减轻子宫腺肌症患者痛经程度、减少月经量,同时不会引起激素水平波动,不增加不良反应发生率,效果显著,值得推广。

Objective To explore the clinical effect of Mifepristone combined with Levonorgestrel intrauterine birth control system in the treatment of adenomyosis.Methods A total of 90 patients with adenomyosis who visited the department of gynaecology in Nantong Tongzhou People′s Hospital from January 2018 to January 2020 were selected as the research subjects.According to random number table method,they were divided into control group and observation group,with 45 cases in each group.The control group was treated with Mifepristone,and the observation group was treated with Mifepristone combined with Levonorgestrel intrauterine birth control system.Menstrual volume,uterine condition,levels of follicle generating hormone(FSH),estradiol(E2)and luteinizing hormone(LH)in two groups before and after treatment were compared.Visual analogue scale(VAS)was used to evaluate dysmenorrhea.The incidence of adverse reactions in two groups during treatment was compared.Results Before treatment,there was no significant difference in menstrual volume and VAS score between two groups(P>0.05).After treatment,the menstrual volume of the observation group was less than that of the control group,and the VAS score of the observation group was lower than that of the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in uterine volume and endometrial thickness between two groups(P>0.05).After treatment,endometrial thickness and uterine volume in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Before and after treatment,there were no significant differences in FSH,E2 and LH between two groups(P>0.05).There was no statistical significance in the total incidence of adverse reactions between two groups(P>0.05).Conclusion Mifepristone combined with Levonorgestrel intrauterine birth control system can relieve the degree of dysmenorrhea and reduce menstrual volume in patients with adenomyosis and meanwhile will not cause hormone level fluctuations and increase the incidence of adverse reactions.The effect is remarkable and it is worthy of promotion.