曼月乐环联合屈螺酮炔雌醇片治疗围绝经期功能失调性子宫出血的疗效观察
Effect of Mirena combined with yasmin in the treatment of perimenopausal dysfunctional uterine bleeding
-
摘要: 目的：探讨曼月乐环联合屈螺酮炔雌醇片治疗围绝经期功能失调性子宫出血的疗效。方法：选取围绝经期功能失调性子宫出血病人178例，依据随机数表法分为联合组和对照组，每组89例。对照组病人在诊刮术后5 d给予12.5 mg米非司酮口服治疗，在此基础上，联合组病人在诊刮术后5 d给予30 μg口服屈螺酮炔雌醇片联合曼月乐环治疗，采用酶联免疫吸附法检测血浆卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）水平，随访6个月，记录出血停止时间、疗效和治疗前后血浆FSH、LH、E2水平，比较治疗前和治疗后2、4、6个月的子宫内膜厚度及不良反应发生情况。结果：联合组病人治疗后出血停止时间（13.07±2.71）d，明显低于对照组的（15.78±3.24）d（P<0.01），联合组治疗有效率高于对照组（P<0.05）；联合组病人治疗后血浆FSH、LH、E2水平均明显低于对照组（P<0.01）；联合组病人治疗后2、4、6个月的子宫内膜厚度均明显低于对照组（P<0.01）；联合组和对照组病人不良反应发生率差异无统计学意义（P>0.05）。结论：曼月乐环联合屈螺酮炔雌醇片治疗可有效提高围绝经期功能失调性子宫出血病人的治疗疗效，改善病人子宫内分泌环境和降低子宫内膜厚度，且无增加病人不良反应发生的风险，值得临床进一步推广。Abstract: Objective:To investigate the effects of the Mirena combined with yasmin in the treatment of perimenopausal dysfunctional uterine bleeding.Methods:One hundred and seventy-eight patients with perimenopausal dysfunctional uterine bleeding were divided into the joint group and control group according to the random number table(78 cases each group).After 5 d of diagnostic curettage,the control group was treated with 12.5 mg of mifepristone,and the joint group was additionally treated with 30 μg of yasmin combined with mirena by oral based on control group.The serum levels of follicle hormone assay,luteinizing hormone(LH) and estradiol(E2) in two groups were detected using enzyme-linked immunosorbent assay.Two groups were followed up for 6 months.The amount of bleeding and menstruation,and serum levels of FSH,LH and E2 in two groups before and after treatment were recorded.The endometrial thickness and incidence rate of adverse reactions in two groups before and after 2,4 and 6 months of treatment were observed.Results:After treatment,the haemorrhage stopping time in joint group[(13.07±2.71)d] was significantly lower than that in control group[(15.78±3.24)d](P<0.01),and the treatment efficiency in joint group was higher than that in control group(P<0.05).After treatment,and the serum levels of FSH,LH and E2 in joint group were higher than those in control group(P<0.01).After 2,4 and 6 months of treatment,the endometrial thickness in joint group were significantly lower than that in control group(P<0.01).The difference of the incidence rate of adverse reactions between two groups was not statistically significant(P>0.05).Conclusions:The treatment of Mirena combined with yasmin can effectively improve the perimenopausal dysfunctional uterine bleeding and uterine endocrine environment,reduce the endometrial thickness,and do not increase the incidence of adverse reaction,which is worthy of further promotion.
-
Key words:
- dysfunctional uterine bleeding /
- perimenopause /
- Mirena /
- yasmin
-
[1] 张宁宁,赵成志,杨清.宫腔镜子宫内膜射频消融术与内膜电切术治疗围绝经期功血疗效比较研究[J].中国实用妇科与产科杂志,2015,31(4):342. [2] GOPIMOHAN R,CHANDRAN A,JACOB J,et al.A clinical study assessing the efficacy of a new variant of the levonorgestrel intrauterine system for abnormal uterine bleeding[J].Int J Gynaeeol Obstet,2015,129(2):114. [3] 谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013:118. [4] 詹海珠.米非司酮与曼月乐用于围绝经期功能失调性子宫出血治疗的疗效对比.[J].中国妇幼保健,2014,29(17):2800. [5] 刘建国,刘莉丽,谷春蓉,等.妈富隆与左炔诺孕酮宫内缓释系统治疗围绝经期功能失调性子宫出血的临床疗效比较[J].中外医疗,2015,34(3):13. [6] KELEKCI SL,KELEKCI KH,YILMAZ B.Effects of levonorgestrel releasing intra uterine system and T380A intrauterine copper device on dysmenorrhea and days of bleeding in women with and without adenomyosis[J].Contraception,2012,86(5):458. [7] 贾冬梅.围绝经期功能失调性子宫出血治疗中应用孕激素的疗效评价[J/CD].实用妇科内分泌杂志(电子版),2015,2(1):17. [8] SHAW AB,MARLIN ES,IKEDA DS,et al.Ventriculoperitoneal shunt infection following uterine instrumentation for dysfunc-tional uterine bleeding[J].J Clin Neurosci,2014,21(8):1462. [9] 道寿丽,王丹.王辉,等.左炔诺孕酮宫内缓释系统治疗子宫腺肌病的临床观察分析[J].中国伤残医学,2012,20(4):12. [10] KHROUF M,TERRAS K.Diagnosis and management of formerly called' dysfunctional uterine bleeding' according to PALM-COEIN FIGO classification and the new guidelines[J].J Obstet Gynaecol India,2014,64(6):388. [11] TIFFANY B,MATTHEW FR,BRIANNA R,et al.Duration of use of a levonorgestre IUS amongst nulliparous and adolescent women[J].Contraception,2011,84(5):e5. [12] 李海霞.曼月乐联合达英-35治疗无排卵性异常子宫出血的长期疗效观察[J/CD].实用妇科内分泌杂志(电子版),2015,2(11):129. [13] SOARES SR,MART NEZ-VAREA A,HIDALGO-MORA JJ,et al.Pharmacologic therapies in endometriosis:a systematic review[J].Fertility and Sterility,2012,98(3):529. [14] 麻翠玲.米非司酮与去氧孕烯炔雌醇片治疗围绝经期功能性子宫出血病人效果及对子宫内膜厚度影响的对比研究[J].中国妇幼保健,2015,30(5):698. [15] 李雪萍,罗菊玉.去氧孕烯炔雌醇联合米非司酮治疗围绝经期无排卵型功能失调性子宫出血的临床观察[J].中国药房,2016,27(14):1981. [16] LAGANA AS,BARBARO L,PIZZO A.Evaluation of ovarian function and metabolic factors in women affected by polycystic ovary syndrome after treatment with D-Chiro-Inositol[J].Arch Gynecol Obstet,2015,291(5):1181. [17] 王敏华,陈丽萍,谢榕.米非司酮与左炔诺孕酮对功能失调性子宫出血病人的疗效与安全性评价[J].中国临床药理学杂志,2015,31(6):453. [18] BEHNAMFAR F,GHAHIRI A,TAVAKOLI M.Levonorgestrel-releasing intrauterine system (Mirena) in compare to medroxyprogesterone acetate as a therapy for endometrial hyperplasia[J].J Res Med Sci,2014,19(8):686. [19] 季红珍,黄红燕,应翩,等.米非司酮与去氧孕烯炔雌醇片对围绝经期功能件子官出血病人子宫内膜厚度的影响及疗效观察[J].中国性科学,2014,15(8):27. [20] 曲波,刘红,杜盟盟,等.曼月乐和安宫黄体酮在围绝经期异常子宫出血治疗中的疗效分析[J].生殖与避孕,2016,36(1):65. -
点击查看大图
计量
- 文章访问数: 5770
- HTML全文浏览量: 752
- PDF下载量: 67
- 被引次数: 0
下载:
