地诺孕素联合醋酸亮丙瑞林缓释微球应用于卵巢子宫内膜异位囊肿术后治疗的临床效果

Clinical effect of dienogest combined with leuprorelin acetate microspheres sustained release in the treatment of ovarian endometriosis cyst after surgery

目的观察地诺孕素联合醋酸亮丙瑞林缓释微球应用于卵巢子宫内膜异位囊肿(EMA)术后治疗的临床效果。方法选取2020年1月—2023年12月福建中医药大学附属人民医院收治的EMA手术治疗患者80例为研究对象。采用抽签法,按1∶1的配比分为联合组和亮丙瑞林组,各40例。亮丙瑞林组予醋酸亮丙瑞林缓释微球治疗,联合组在亮丙瑞林组基础上联合地诺孕素治疗。比较2组疗效、卵巢储备功能[血清抗苗勒氏管激素(AMH)、卵巢窦状卵泡数量(AFC)]、肿瘤标志物[糖类抗原125(CA125)、糖类抗原199(CA199)]、术后停经恢复情况、生活质量[世界卫生组织生存质量量表(WHOQOL-100)评分]及不良反应。结果联合组总有效率(95.00%)高于亮丙瑞林组(77.50%)(χ^(2)=5.165,P=0.023)。与治疗前比较,治疗后,2组AMH水平及AFC降低或减少,CA125、CA199水平下降,WHOQOL-100评分升高,且联合组变化程度大于亮丙瑞林组(P<0.05或P<0.01);术后2个月,联合组月经恢复率为95.83%(23/24),高于亮丙瑞林组的69.57%(16/23)(χ^(2)=5.738,P=0.017)。联合组与亮丙瑞林组不良反应总发生率比较无统计学差异(5.00%vs.2.50%,P=1.000)。结论地诺孕素联合醋酸亮丙瑞林缓释微球进行EMA患者的术后治疗,取得良好效果,有助于促进卵巢储备功能改善,降低血清肿瘤标志物水平,促使月经恢复,且具有较高安全性,可提升患者生活质量。

Objective To observe the clinical effect of dienogest combined with leuprorelin acetate microspheres sustained release in the treatment of ovarian endometriosis cyst(EMA) after surgery.Methods A total of 80 patients with EMA treated in the People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2020 to December 2023 were selected as the research objects.Using the lottery method,the subjects were randomly assigned in a 1∶1 ratio to the combined group and the leuprorelin group,with 40 cases in each group.The leuprorelin group was treated with leuprorelin acetate microspheres sustained release,and the combination group was treated with dienogest on the basis of leuprorelin group.The efficacy,ovarian reserve function(AMH,AFC),tumor markers(CA125,CA199),postoperative menopause recovery,quality of life score(WHOQOL-100 score) and adverse reactions were compared between the two groups.Results The total effective rate in the combination group(95.00%) was higher than that in the leuprorelin group(77.50%)(χ^(2)=5.165,P=0.023).Compared with before treatment,after treatment,the levels of AMH and AFC decreased,the levels of CA125 and CA199 decreased,and the WHOQOL-100 scores increased in the two groups,and the degree of changes in the combined group were greater than those in the leuprorelin group(P<0.05 or P<0.01).Two months after operation,the menstrual recovery rate in the combination group was 95.83%,which was higher than 69.57% in the leuprorelin group(χ^(2)=5.738,P=0.017).There was no significant difference in the total incidence of adverse reactions between the combination group and leuprorelin group(5.00% vs.2.50%,P=1.000).Conclusion Dienogest combined with leuprorelin acetate microspheres sustained release for the postoperative treatment of EMA patients has achieved good results,which helps to improve ovarian reserve function,reduce the level of serum tumor markers,promote menstruation recovery,and has high safety,and can improve the quality of life of patients.