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目的探讨戊酸雌二醇及地屈孕酮治疗子宫内膜异位症效果及安全性,为临床用药提供参考。方法选择2012年1月-2014年1月80例子宫内膜异位症患者,按照数字表法随机分为观察组与对照组,每组各40例。对照组患者使用促性腺激素释放激素激动剂(GnRH-a)皮下注射治疗,观察组在对照组基础上联合戊酸雌二醇及地屈孕酮治疗。对比两组患者生殖激素水平、疼痛视觉模拟评分VAS、改良Kupperman评分、简明健康量表SF-36评分、绝经期症状等临床指标。结果观察组治疗后FSH、LH、E2分别为(5.14±1.05)U/L、(2.69±0.59)U/L、(97.76±8.67)pmol/L,均优于对照组(P<0.05);观察组治疗后VAS评分、改良Kupperman评分、简明健康量表SF-36评分分别为1.78±0.32、16.26±3.36、86.49±14.29,均优于对照组(P<0.05);观察组左股骨颈、左髋部、腰椎L1~4骨丢失率分别为(-1.24±0.23)%、(-0.72±0.21)%、(-0.51±0.14)%,左髋部、腰椎L1~4骨丢失率明显低于对照组(t=26.334,P<0.01;t=19.812,P<0.01);观察组潮热发生27例(67.50%),明显低于对照组(χ2=9.928,P<0.01)。结论戊酸雌二醇及地屈孕酮联合GnRH-a治疗子宫内膜异位症临床效果好,利于缓解患者临床症状,减轻GnRH-a造成的低雌激素症状。
Objective To investigate the efficacy and safety of estradiol valerate and dydrogesterone in the treatment of endometriosis and provide reference for clinical use. Methods Eighty patients with endometriosis from January 2012 to January 2014 were randomly divided into observation group and control group according to digital table method, 40 cases in each group. Patients in the control group were treated with subcutaneous injection of GnRH-a. The observation group was treated with estradiol valerate and dydrogesterone on the basis of the control group. Reproductive hormone levels, pain visual analogue scale VAS, modified Kupperman score, SF-36 concise health scale and clinical symptoms of menopause were compared between the two groups. Results The FSH, LH and E2 in the observation group were (5.14 ± 1.05) U / L, (2.69 ± 0.59) U / L and 97.76 ± 8.67 pmol / L, respectively, which were better than those in the control group (P <0.05) The scores of VAS, Kupperman and SF-36 in the observation group were 1.78 ± 0.32, 16.26 ± 3.36 and 86.49 ± 14.29, respectively, which were better than those in the control group (P <0.05). The left femoral neck, The loss rates of L1 ~ 4 in the left hip and lumbar spine were (-1.24 ± 0.23)%, (-0.72 ± 0.21)% and (-0.51 ± 0.14)%, respectively. The loss rate of L1 ~ 4 in the left hip and lumbar spine was significantly lower (T = 26.334, P <0.01; t = 19.812, P <0.01). The incidence of hot flashes in the observation group was 27 cases (67.50%) which was significantly lower than that of the control group (χ2 = 9.928, P <0.01). Conclusions Estradiol valerate and dydrogesterone combined with GnRH-a have a good clinical effect in treating endometriosis, which will help to alleviate the clinical symptoms and reduce the symptoms of low estrogen caused by GnRH-a.