地屈孕酮与戊酸雌二醇联合治疗排卵障碍性异常子宫出血的临床效果及安全性评价

Clinical efficacy and safety evaluation of didrogesterone combined with estradiol valerate in the treatment of abnormal uterine bleeding due to ovulation disorder

目的探究排卵障碍性异常子宫出血(AUB-O)患者采用地屈孕酮联合戊酸雌二醇治疗的效果及安全性。方法选取86例AUB-0患者,采取随机数字表法将其分为对照组与研究组,每组43例。对照组单纯服用地屈孕酮治疗,研究组采用地屈孕酮联合戊酸雌二醇治疗。比较两组临床疗效、治疗前和治疗3个月经周期后的子宫内膜厚度、性激素水平及不良反应发生情况。结果研究组治疗总有效率为97.67%,高于对照组的81.40%,差异有统计学意义(P<0.05)。治疗前,两组促黄体生成素(LH)、卵泡刺激素(FSH)水平及子宫内膜厚度比较,差异无统计学意义(P>0.05);治疗3个月经周期后,两组LH、FSH水平均低于治疗前,子宫内膜厚度薄于治疗前,且研究组LH、FSH水平均低于对照组,子宫内膜厚度薄于对照组,差异有统计学意义(P<0.05)。研究组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论地屈孕酮联合戊酸雌二醇治疗AUB-O,可抑制子宫内膜异常增生,纠正性激素紊乱状态,保障用药安全性。

Objective To investigate the efficacy and safety of the combination of didroxyprogesterone and estradiol valerate in patients with abnormal uterine bleeding due to ovulation disorder(AUB-O). Methods 86 AUB-O patients were selected and divided into control group and study group by random number table method, with 43 cases in each group. The control group was treated with dydrogesterone alone, while the study group was treated with dydrogesterone combined with estradiol valerate. The clinical efficacy, endometrial thickness, sex hormone levels and the incidence of adverse reactions were compared between the two groups before treatment and after 3 menstrual cycles. Results The total effective rate of the study group was 97.67%, which was higher than that of the control group(81.40%), the difference was statistically significant(P<0.05). Before treatment, there were no significant differences in the levels of luteinizing hormone(LH) and follicle-stimulating hormone(FSH) and endometrial thickness between the two groups(P>0.05). After 3 menstrual cycles of treatment, LH and FSH levels in 2 groups were lower than before treatment, endometrial thickness was thinner than before treatment, LH and FSH levels in the research group were lower than control group, endometrial thickness was thinner than control group, the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the study group and the control group(P>0.05).Conclusion The treatment of AUB-O with didroxyprogesterone and estradiol valerate can inhibit the abnormal hyperplasia of endometrium, correct the disorder of uterine hormone, and ensure the safety of drug use.