米非司酮联合孕三烯酮治疗子宫腺肌症效果及对PGF2α、β-EP及子宫恢复的影响

Effect of mifepristone combined with gestrinone for treating the patients with adenomyosis and its influence on the levels of prostaglandin f 2a andβendorphins and the uterine recovery of these patients

目的:探讨米非司酮联合孕三烯酮治疗子宫腺肌症效果及对前列素F-2a(PGF-2a)、β-内啡肽(β-EP)及子宫恢复的影响。方法:选择2020年1月-2022年1月本院治疗的子宫腺肌症患者105例,随机数表法分为观察组(n=53)和对照组(n=52),两组均给予孕三烯酮治疗,观察组加用米非司酮治疗。比较两组临床疗效、PGF2α、β-EP、子宫体积、子宫内膜厚度、月经量、痛经程度变化及不良反应发生情况。结果:治疗后观察组总有效率(94.3%)高于对照组(78.9%)(P<0.05),两组血清PGF-2a水平均降低且观察组(197.64±35.62 pg/ml)低于对照组(287.59±56.38 pg/ml),β-EP水平升高且观察组(189.95±25.14 ng/L)高于对照组(160.25±22.94 ng/L),两组子宫体积、子宫内膜厚度水平均降低且观察组(131.84±7.24 cm^(3)、8.30±1.21 mm)低于对照组(154.68±5.94 cm^(3)、9.56±1.07 mm),两组月经量、痛经程度评分均降低且观察组(51.52±5.97 ml、1.14±0.28分)低于对照组(68.64±6.63 ml、2.29±0.44分)(均P<0.05);两组不良反应主要为头晕、恶心、腹痛及乳房痛,总发生率观察组(5.7%)与对照组(13.5%)无差异(P>0.05)。结论:米非司酮联合孕三烯酮治疗子宫腺肌症可提高疗效,可能与有效改善患者血清PGF2α、β-EP水平及促进子宫恢复有关。

Objective:To study the efect of mifepristone combined with gestrinone for treating the patients with adeno-myosis,and to analyze its influence on the levels of prostaglandin f 2a(PGF 2a)and pendorphins(βEP),and the uter-ine recovery of these patients.Methods:105 patients with adenomyosis treated in hospital were selected and were di-vided into experimental group(n-53)and control group(n-52)by random number table method from January 2020 xo January 2022.The paticnts in the control group were treated with gestational trienone,and the patients in the exper-imental group were treated with gestational trienone combined with mifepristone.The clinical efficacy,the levels of PGF2a andβEP,the uterine volume,the endometrial thickness,the menstrual volume,the dysmenorrhea degrce,and the incidence of complications of the patients were compared between the two groups.Results:The total effective rate(94.3%)of the patients in the experimental group after treatment was significantly higher than that(78.9%)of the patients in the control group(P<0.05).The serum PGF 2a level of the patients in both groups after treatment had decreased significantly,and which(197.64±35.62 pg/ml)of the patients in the experimental group was significantly lower than that(287.59±56.38 pg/ml)of the patients in the control group.TheβEP level of the patients in both groups after treatment had increased significantly,and which(189.95±25.14 ng/L)of the patients in the experimental group was significantly lower than that(160.25±22.94 ng/L)of the patients in the control group.The uterine volume and the endometrial thickness of the patients in both groups after treatment had decreased significantly.and which(131.84±7.24cm^(3)and 8.30±1.21mm)of the patients in the experimental group were significantly lower than those(154.68±5.94cm^(3)and 9.56±1.07mm)of the patients in the control group.The menstrual volume and the dysmenor-rhea score of the patients in both groups after treatment had decreased significantly.and which(51.52±5.97ml and 1.14±0.28 points)of the patients in the experimental group were significantly lower than those(68.64±6.63ml and 2.29±0.44 points)of the patients in the control group(all P<0.05).The main complications of the patients in the two groups were diziness,nausca,abdominal pain,and breast pain.The total incidence of the complications(5.7%)of the patients in the experimental group had no significantly different from that(13.5%)of the patients in the control group(P>0.05).Conclusion:Mifepristone combined with getrienone for treating the patients with adenomyosis can improve the therapeutic efficacy,and which may related with the ffectively increase of the PGF2a andβEP levels and the uter-ine recovery of the patients.