戈舍瑞林联合左炔诺孕酮宫内缓释系统治疗子宫腺肌病对卵巢功能及性激素水平的影响

Effect of Goserelin combined with Levonorgestrel Releasing Intrauterine System on ovarian function and sex hormone levels in the treatment of adenomyosis

目的探讨戈舍瑞林联合左炔诺孕酮宫内缓释系统治疗子宫腺肌病对卵巢功能及性激素水平的影响。方法选取2022年9月至2023年11月同济大学附属东方医院胶州医院收治的86例子宫腺肌病患者作为研究对象,以随机数字表法分为A组(43例)与B组(43例)。A组采用左炔诺孕酮宫内缓释系统(LNG-IUS)治疗,B组采用戈舍瑞林联合LNG-IUS治疗。比较两组临床疗效、子宫体积及子宫内膜厚度、性激素水平、月经量及痛经程度、不良反应发生情况。结果B组临床总有效率高于A组(P<0.05)。治疗后,两组子宫体积均缩小,且B组小于A组;两组子宫内膜厚度均变薄,且B组薄于A组(P<0.05)。A组黄体生成素、雌二醇、卵泡刺激素、孕酮水平均降低,但B组水平高于A组(P<0.05)。两组月经失血图及视觉模拟评分法评分均降低,且B组评分低于A组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论戈舍瑞林联合LNG-IUS治疗子宫腺肌病有利于提高临床疗效,恢复子宫形态及内膜厚度,稳定性激素水平,减少月经量并降低痛经程度,且不增加不良反应。

Objective To investigate the effect of Goserelin combined with Levonorgestrel Releasing Intrauterine System on ovarian function and sex hormone levels in the treatment of adenomyosis.Methods A total of 86 patients with adenomyosis admitted to Jiaozhou Hospital,East Hospital Affiliated to Tongji University from September 2022 to November 2023 were selected as the study objects.All the patients were divided into the group A(43 cases)and the group B(43 cases)by the random number table method.The group A was treated with Levonorgestrel Releasing Intrauterine System(LNG-IUS),and the group B was treated with Goserelin combined with LNG-IUS.The clinical efficacy,uterine volume,endometrial thickness,sex hormone level,menstrual volume,dysmenorrhea degree,and incidence of adverse reactions of the two groups were compared.Results The total clinical effective rate of the group B was higher than that of the group A(P<0.05).After treatment,the uterine volume of both groups decreased,and that in the group B was smaller than that in the group A(P<0.05).The endometrial thickness in both groups decreased,and that in the group B was thinner than that in the group A(P<0.05).The levels of luteinizing hormone,estradiol,follicle stimulating hormone,and progesterone in the group A were all reduced,but the levels of the group B were higher than those of the group A(P<0.05).The scores of pictorial blood loss assessment chart and visual analogue scale in both groups decreased,and the scores of the group B were lower than those of the group A(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Goserelin combined with LNG-IUS in the treatment of adenomyosis is beneficial to improve the clinical efficiency,restore uterine shape and endometrial thickness,stabilize the level of sex hormone,reduce menstrual volume and dysmenorrhea degree,without increasing adverse reactions.