左炔诺孕酮宫内节育系统联合去氧孕烯炔雌醇片治疗子宫腺肌病疗效探讨

The Effect of Levonorgestrel Intrauterine Contraceptive System Combined with Desogestrel and Ethinyl Estradiol Tablets in the Treatment of Adenomyosis

目的评价左炔诺孕酮宫内节育系统联合去氧孕烯炔雌醇片治疗子宫腺肌病的疗效。方法选取2015年1月—2020年1月该院收治的146例子宫腺肌病患者,进行随机分组处理,每组73例。其中参照组运用左炔诺孕酮宫内节育系统,研究组运用左炔诺孕酮宫内节育系统联合去氧孕烯炔雌醇片治疗。对其治疗效果、不良反应、临床恢复情况、治疗前后血清白介素-10、γ干扰素水平、子宫内膜厚度和子宫体积予以统计。结果研究组和参照组治疗前的白介素-10和γ干扰素水平、子宫内膜厚度和子宫体积差异无统计学意义(P>0.05);研究组治疗后3个月白介素-10、子宫内膜厚度、子宫体积均低于参照组,γ干扰素水平高于参照组,差异有统计学意义(P<0.05)。研究组治疗总有效率为97.26%(71/73),参照组治疗总有效率为89.04%(65/73),研究组高于参照组,差异有统计学意义(χ^(2)=3.865,P=0.049)。研究组的经血量恢复正常时间为(29.67±2.97)d、月经周期恢复时间为(58.26±1.94)d,参照组的经血量恢复正常时间为(57.26±4.86)d、月经周期恢复时间为(84.26±5.12)d,研究组优于参照组,差异有统计学意义(t=41.388、40.573,P<0.05)。研究组头痛、恶心、月经周期中出现点滴出血、乳房胀痛等不良反应总发生率为2.74%,明显低于参照组不良反应总发生率10.96%,差异有统计学意义(χ^(2)=3.865,P=0.049)。结论左炔诺孕酮宫内节育系统和去氧孕烯炔雌醇片在子宫腺肌病患者治疗中具有效果好和安全性高的优点,患者临床恢复情况良好,可予以广泛推广实施。

Objective To evaluate the efficacy of levonorgestrel intrauterine contraceptive system combined with desogestrel and ethinyl estradiol tablets in the treatment of adenomyosis.Methods From January 2015 to January 2020,146 adenomyosis patients admitted to this hospital were randomly divided into groups,with 73 cases in each group.The reference group used levonorgestrel intrauterine birth control system,and the study group used levonorgestrel intrauterine birth control system combined with desogestrel ethinyl estradiol tablets.The treatment effects,adverse reactions,clinical recovery,serum interleukin-10,interferon gamma levels before and after treatment,endometrial thickness and uterine volume were counted.Results There was no significant difference in the levels of interleukin-10 and interferon gamma,endometrial thickness and uterine volume between the study group and the reference group before treatment(P>0.05);the interleukin-10 and endometrial thickness and uterine volume of the study group were lower than that of the reference group at 3 mouth after treatment,and the level of interferonγwas higher than that of the reference group,the difference was statistically significant(P<0.05).The total effective rate of treatment in the study group was 97.26%(71/73),and the total effective rate of treatment in the reference group was 89.04%(65/73),the study group was higher than the reference group,and the difference was statistically significant(χ^(2)=3.865,P=0.049).The menstrual blood volume of the study group returned to normal time was(29.67±2.97)d,the menstrual cycle recovery time was(58.26±1.94)d,the menstrual blood volume returned to normal time of the reference group was(57.26±4.86)d,menstrual cycle recovery time was(84.26±5.12)d,the study group was better than the reference group,the difference were statistically significant(t=41.3.88,40.573,P<0.05).The total incidence of adverse reactions such as headache,nausea,spotting during the menstrual cycle,and breast pain in the study group was 2.74%,which was significantly lower than the total incidence of 10.96%in the reference group,the difference was statistically significant(χ^(2)=3.865,P=0.049).Conclusion The levonorgestrel intrauterine contraceptive system and desogestrel ethinyl estradiol tablets have the advantages of good effect and high safety in the treatment of patients with adenomyosis.The patients have a good clinical recovery and can be widely promoted and implemented.