恶拉戈利治疗中重度子宫内膜异位症疼痛效果及外周血疼痛应激因子变化

Efficacy of elagolix for alleviating pain of women with moderate or severe endometriosis and its influence on their peripheral blood pain stress factors levels

目的:观察恶拉戈利治疗中、重度子宫内膜异位症(EMT)疼痛疗效及对患者外周血疼痛应激因子的影响。方法:纳入本院2020年1月-12月收治的中、重度EMT相关性疼痛患者80例,随机分为观察组(n=39)与对照组(n=41),分别应用恶拉戈利和安慰剂治疗3个月。比较两组治疗前后痛经、非经期盆腔痛、性交痛及数字模拟量表(NRS)评分,测量腰椎L1-4和股骨颈的骨密度(BMD),检测血清疼痛应激因子前列腺素E;(PGE;)和神经生长因子(NGF)水平。结果:治疗3个月后,观察组痛经(1.44±0.38分)、非经期盆腔痛(1.25±0.33分)、性交痛(1.19±0.39分)和NRS评分(3.12±0.72分)均低于对照组(1.81±0.41分、1.44±0.46分、1.41±0.42分、5.01±1.01分),且临床意义减痛率均高于对照组(P<0.05);两组血清PGE;和NGF水平均降低且观察组(249.71±33.05 pg/ml、167.43±51.27 pg/ml)低于对照组(589.92±132.51 pg/ml、301.43±90.23 pg/ml)(P<0.05),两组BMD均无明显变化(P>0.05)。观察组的潮热发生率(25.6%)及不良反应总发生率(84.6%)高于对照组(7.3%、56.1%)(P<0.05)。结论:恶拉戈利治疗中、重度EMT相关性疼痛疗效显著,尤其可缓解痛经及非经期盆腔痛,降低血清疼痛应激因子水平,且对骨密度影响较小。

Objective: To observe the curative effect of elagolix for alleviating pain of women with moderate or severe endometriosis, and to study its influence on the peripheral blood pain stress factors levels of the women. Methods: 80 women with moderate or severe pain related endometriosis were selected and were randomly divided into two groups from January to December 2020. 39 women in the observation group had received elagoli treatment for 3 months, and 41 women in the observation group had received placebo for 3 months. The scores of dysmenorrhea, non-menstrual pelvic pain, pain during intercourse, and digital analog scale(NRS) of the women before and after treatment were compared between the two groups. The value of bone mineral density(BMD) of lumbar spine L1-4 and femoral neck of the women in the two groups were measured, and the levels of serum pain stress factor prostaglandin E;(PGE;) and nerve growth factor(NGF) of the women in the two groups were detected. Results: After 3 months of treatment, the scores of dysmenorrhea(1.44±0.38 points), non-menstrual pelvic pain(1.25±0.33 points), and pain during intercourse(1.19±0.39 points), and NRS(3.12±0.72 points) of the women in the observation group were significantly lower than those(1.81±0.41 points, 1.44±0.46 points, 1.41±0.42 points, and 5.01±1.01 points) of the women in the control group, and the rate of pain reduction with clinical significance of the women in the observation group was significantly higher than that of the women in the control group(P<0.05). The levels of PGE;and NGF of the women in the two groups had decreased significantly, and which(249.71±33.05 pg/ml and 167.43±51.27 pg/ml) of the women in the observation group were significantly lower than those(589.92±132.51 pg/ml and 301.43±90.23 pg/ml) of the women in the control group(P<0.05).The BMD value of the women in the two groups after treatment had no significant different from that before treatment(P>0.05).The incidences of hot flashes(25.6%)and total incidence(84.6%)of the women in the observation group were significantly higher than those(7.3%and 56.1%)of the women in the control group(P<0.05).Conclusion:Elagolix for alleviating pain of women with moderate or severe endometriosis has significant effectiveness,especially for alleviating their dysmenorrhea and non-menstrual pelvic pain,and which can reduce the levels of serum pain stress factors with less adverse influence on the BMD value of these women.