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目的探讨子宫内膜异位症患者保守性手术术后使用甲羟孕酮/达菲林疗效对比观察。方法将120例患者随机分为A、B两组(各60例),术后分别给予甲羟孕酮150 mg、达菲林3.75 mg肌注,每28 d一次,连续用六次。研究持续12个月,包括6个月的药物治疗和6个月的随访。结果两组用药前后血清(follicle-stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、血清雌二醇(estradiol,E2)、CA125水平变化明显(P<0.05)。两组用药前血清FSH、LH、E2、CA125差异无统计学意义(P>0.05);用药后除CA125外,差异有统计学意义(P<0.05)。两组治疗前后视觉模拟评分(visual analogue scale,VAS)差异有统计学意义(P<0.05);A组与B组治疗前后疼痛评分差异无统计学意义(P>0.05)。观察至停药时,甲羟孕酮组与达菲林组完全缓解率分别为85.1%、94.7%,观察至停药6个月累计复发率分别为11.1%、8.9%,两组疗效疗效差异无统计学意义(χ2=2.602,P=0.626)。两组患者不规则阴道流血发生率、围绝经期症状发生率差异有统计学意义(χ2分别为21.823,53.218,P均=0.000)。结论甲羟孕酮和达菲林用药后对患者血清性激素、CA125数值均有明显影响,其中达菲林影响较大。两药在子宫内膜异位症保守性手术术后治疗上,总有效率、累计复发率相似,副作用各有侧重。甲羟孕酮针剂值得临床推广。
Objective To investigate the effect of medroxyprogesterone and dafampin after conservative surgery in patients with endometriosis. Methods 120 patients were randomly divided into A and B groups (60 cases each). Medroxyprogesterone 150 mg and dipyridamole 3.75 mg were injected intramuscularly once a day for 28 consecutive days, six times in a row. The study lasted 12 months, including 6 months of medication and 6 months of follow-up. Results The levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and CA125 in the two groups changed significantly (P <0.05) before and after treatment. There was no significant difference in FSH, LH, E2, CA125 levels between the two groups before treatment (P> 0.05). There was significant difference between the two groups except CA125 (P <0.05). There were significant differences in visual analogue scale (VAS) between the two groups before and after treatment (P <0.05). There was no significant difference in pain score between the two groups before and after treatment (P> 0.05). Observed to withdrawal, the complete remission rate of medroxyprogesterone group and the Tamiflu group were 85.1% and 94.7% respectively. The cumulative recurrence rates after 6 months of withdrawal from treatment were 11.1% and 8.9% respectively, with no significant difference between the two groups Statistical significance (χ2 = 2.602, P = 0.626). The incidence of irregular vaginal bleeding and the incidence of perimenopausal symptoms in both groups were statistically significant (χ2 = 21.823, 53.218, P = 0.000). Conclusions Both medroxyprogesterone and dafenlin exert a significant influence on serum sex hormones and CA125 values after dosing with medroxyprogesterone and diphenhydramine, among which dafening is more influential. Two drugs in conservative treatment of endometriosis postoperative treatment, the total effective rate, the cumulative recurrence rate is similar, side effects have different emphases. Medroxyprogesterone injection is worthy of clinical promotion.