地诺孕素用于中重度子宫内膜异位症术后补充治疗的疗效评价

Evaluation of the Effect of Dienogest on Postoperative Supplementary Treatment of Moderate or Severe Endometriosis

目的分析地诺孕素在中重度子宫内膜异位症患者术后补充治疗中的应用效果。方法选取2020年4月至2022年1月江西省妇幼保健院收治的94例中重度子宫内膜异位症手术患者为研究对象,按随机数字表法分为两组,各47例。两组均手术治疗,对照组术后常规药物治疗,观察组加用地诺孕素治疗,持续治疗3个月,并随访6个月。对比两组临床疗效、激素水平、疼痛评分、生活质量、复发率及不良反应发生率。结果观察组治疗总有效率95.72%,高于对照组的82.98%,差异有统计学意义(P<0.05)。治疗前两组性激素水平比较,差异无统计学意义(P>0.05);治疗后观察组血清雌二醇(E2)水平、黄体生成素(LH)、促卵泡生成素(FSH)、孕酮(P)低于对照组,差异有统计学意义(P<0.05)。治疗前两组疼痛评分比较,差异无统计学意义(P>0.05);治疗后两组腹痛评分、性交疼痛评分、痛经评分低于对照组,差异有统计学意义(P<0.05)。治疗前两组生活质量比较,差异无统计学意义(P>0.05);治疗后观察组用生活质量综合评定问卷(GQOLI-74)中的心理功能评分、躯体功能评分、社会功能评分、物质生活评分高于对照组。观察组复发率2.13%低于对照组17.02%,差异有统计学差异(P<0.05)。组间不良反应比较,差异无统计学意义(P>0.05)。结论地诺孕素能有效增强中重度子宫内膜异位症手术患者临床治疗效果,降低性激素水平,促进病情恢复,从而降低疾病复发率,且不良反应少。

Objective To investigate the effect of dienogest in the postoperative supplementary treatment of patients with moderate or severe endometriosis.Methods 94 patients with moderate or severe endometriosis who were admitted to Jiangxi Maternal and Child Health Hospital from April 2020 to January 2022 were selected.Patients were divided into two groups according to the random number table method,with 47 patients in each group.Both groups were treated with surgery,the control group was treated with conventional medicine after operation,and the observation group was treated with dienogest based on control group,all treated for 3 months,follow-up was 6 months.The clinical efficacy,hormone level,pain score,quality of life,recurrence rate and adverse reaction rate of the two groups were compared.Results The total effective rate of the observation group was 95.72%,which was higher than 82.98%of the control group(P<0.05).There was no significant difference between the two groups in sex hormone levels before treatment(P>0.05);after treatment,the levels of serum estradiol(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH),progesterone(P)in the observation group were lower than those in the control group,with statistical differences(P<0.05).There was no significant difference in pain scores between the two groups before treatment(P>0.05);after treatment,the scores of abdominal pain,sexual intercourse pain and dysmenorrhea in the two groups were lower than those in the control group(P<0.05).There was no significant difference in quality of life between the two groups before treatment(P>0.05);after treatment,the scores of psychological function,physical function,social function,and material life in the observation group were higher than those in the control group with the comprehensive quality of life assessment questionnaire(GQOLI-74).The observation group recurrence rate was 2.13%,which was lower than 17.02%in the control group,there was statistical difference(P<0.05);there was no significant difference in adverse reactions between groups(P>0.05).Conclusion Dienogest can effectively enhance the clinical treatment effect of patients with endometriosis,reduce the level of sex hormones,promote the recovery of the disease,thereby reducing the recurrence rate of the disease,and have fewer adverse reactions.