小剂量米非司酮联合复方炔诺酮治疗功能失调性子宫出血的效果及其对PRL、E_(2)及子宫平滑肌功能的影响

Efficacy of Low Dose Mifepristone Combined with Compound Norethindrone in the Treatment of Dysfunction Uterine Bleeding and Its Effect on PRL,E_(2)and Uterine Smooth Muscle Function

目的:探讨小剂量米非司酮联合复方炔诺酮治疗功能失调性子宫出血的效果及其对泌乳素(PRL)、雌二醇(E_(2))及子宫平滑肌功能的影响。方法:选择2019年1月-2021年1月在本院接受治疗的111例功能失调性子宫出血患者,采用随机数表法分为联合组(n=56)和对照组(n=55)。对照组给予复方炔诺酮治疗,联合组给予小剂量米非司酮联合复方炔诺酮治疗。比较两组临床效果、治疗前后血清PRL、E_(2)、促卵泡生成素(FSH)、孕酮(P)、黄体生成素(LH)水平、收缩频率、收缩幅度、子宫内膜厚度,以及控血、止血时间、不良反应发生情况。结果:联合组总有效率92.86%,较对照组的78.18%更高(P<0.05);治疗前,两组血清PRL、E_(2)水平比较差异无统计学意义(P>0.05);治疗后,联合组和对照组血清PRL、E_(2)水平均降低,且联合组低于对照组(P<0.05);治疗前,联合组和对照组子宫平滑肌功能比较差异无统计学意义(P>0.05);治疗后,联合组和对照组收缩频率、收缩幅度均升高,且联合组高于对照组(P<0.05);治疗前,联合组和对照组FSH、P、LH水平及子宫内膜厚度比较差异无统计学意义(P>0.05),治疗后,联合组和对照组FSH、P、LH水平及子宫内膜厚度均降低,且联合组低于对照组(P<0.05);联合组控血、止血时间均显著早于对照组(P<0.05);两组不良反应发生率分别为10.71%、12.73%,差异无统计学意义(P>0.05)。结论:在功能失调性子宫出血患者中应用小剂量米非司酮联合复方炔诺酮疗效显著,可能与其可有效改善血清PRL、E_(2)水平及子宫平滑肌功能有关。

Objective:To explore the efficacy of low dose Mifepristone combined with Compound Norethindrone in the treatment of dysfunction uterine bleeding and its effect on Prolactin(PRL),estradiol(E_(2))and uterine smooth muscle function.Method:A total of 111 patients with dysfunctional uterine bleeding who received treatment in our hospital from January 2019 to January 2021 were selected and divided into combined group(n=56)and control group(n=55)by random number table method.The control group was treated with Compound Norethindrone and the combined group was treated with low dose Mifepristone combined with Compound Norethindrone.The clinical efficacy,serum PRL,E_(2),follicle stimulating hormone(FSH),progesterone(P),luteinizing hormone(LH)levels,systolic frequency,systolic amplitude,endometrial thickness before and after treatment,blood control time,hemostasis time and the occurrence of adverse reactions were compared between the two groups.Result:The total effective rate of the combined group was 92.86%,which was higher than that of the control group(78.18%)(P<0.05).Before treatment,there were no significant differences in serum PRL and E_(2)levels between the combined group and the control group(P>0.05),after treatment,serum PRL and E_(2)levels in combined group and control group were decreased,and those in combined group were lower than those in control group(P<0.05);before treatment,there was no significant difference in uterine smooth muscle function between the combined group and the control group(P>0.05),after treatment,the systolic frequency and amplitude of both groups were increased,and the combined group was higher than the control group(P<0.05);before treatment,there were no significant differences in FSH,P,LH levels and endometrial thickness between the combined group and the control group(P>0.05),after treatment,the FSH,P,LH levels and endometrial thickness in the combined group and the control group were decreased,and the combined group was lower than the control group(P<0.05).The time of blood control and hemostasis in combined group was significantly earlier than those in control group(P<0.05).The incidence of adverse reactions between the two groups were 10.71%and 12.73%respectively,and the difference was not statistically significant(P>0.05).Conclusion:Low dose Mifepristone combined with Compound Norethindrone has a significant effect on patients with dysfunction uterine bleeding,which may be related to the effective improvement of serum PRL,E_(2)levels and uterine smooth muscle function.