米非司酮2种用药方案治疗围绝经期功能障碍性子宫出血临床疗效对比

Clinical effect of two different therapies of mifepristone in the treatment of dysfunctional uterine bleeding in peri-menopausal period

目的:探讨米非司酮连续给药与改良短周期疗法治疗围绝经期功能障碍性子宫出血临床疗效差异。方法:选取我院2013-01~2014-12围绝经期功能障碍性子宫出血患者共130例,采用随机数字表法分为A组(65例)和B组(65例),分别采用米非司酮连续给药疗法和改良短周期疗法;比较两组月经周期恢复正常率、绝经率、治疗前后血红蛋白水平、子宫内膜厚度、卵泡生成激素(FSH)、黄体生成激素(LH)、雌二醇(E2)、孕酮(P)等性激素水平及远期复发率等。结果:B组月经周期恢复正常率显著高于A组,差异有统计学意义(P<0.05);B组治疗后血红蛋白水平显著优于A组、治疗前,差异有统计学意义(P<0.05);两组治疗后子宫内膜厚度和性激素水平显著优于治疗前,差异有统计学意义(P<0.05);两组患者远期复发率比较差异无统计学意义(P>0.05)。结论:米非司酮短周期疗法治疗围绝经期功能障碍性子宫出血可有效促进正常月经周期恢复,改善血红蛋白水平,且在预防远期复发方面效果确切,优于米非司酮连续给药疗法。

Objective:To investigate clinical differene between continuous therapy and short-cycle therapy of mifepristone in the treatment of dysfunctional uterine bleeding in peri-menopausal period.Methods:A total of 130 patients with dysfunctional uterine bleeding in peri menopausal period hospitalized from Jan.2013 to Dec.2014 in our hospital were selected and randomly divided into group A who received continuous therapy of mifepristone and group B who received short-cycle therapy of mifepristone(65cases in each group).Recovery rate of menstrual cycle,menopause rate,hemoglobin levels,endometrial thickness,sex hormones such as FSH,LH,E2 and P before and after the treatment,and the long-term recurrence rate of all patients were detected.Results:The recovery rate of menstrual cycle was significantly higher in group B than that in group A(P<0.05).The hemoglobin level was significantly higher in group B after the treatment than that in group A and before treatment(P<0.05).The endometrial thickness and levels of sex hormones were significantly higher after the treatment than those before treatment(P<0.05).There was no significant difference in the long-term recurrence rate between the two groups(P>0.05).Conclusion:Compared with continuous therapy of mifepristone,short-cycle therapy of mifepristone can not only efficiently promote the recovery of normal menstrual cycle and improve hemoglobin level,but also can prevent the long-term recurrence in the treatment of dysfunctional uterine bleeding in peri-menopausal period.