中國醫(yī)學(xué)創(chuàng)新目次不同劑量米非司酮聯(lián)合去氧孕烯炔雌醇治療圍絕經(jīng)期功能失調(diào)性子宮出血

寧杰

【摘要】 目的：探究不同劑量的米非司酮聯(lián)合去氧孕烯炔雌醇對治療圍絕經(jīng)期功能失調(diào)性子宮出血的臨床療效。方法：選取本院2014-2017年收治的圍絕經(jīng)期功能失調(diào)性子宮出血患者153例，按照隨機(jī)數(shù)字表法將其分為A、B、C組，各51例。A組給予5 mg米非司酮+去氧孕烯炔雌醇治療，B組給予10 mg米非司酮+去氧孕烯炔雌醇治療，C組給予15 mg米非司酮+去氧孕烯炔雌醇治療，比較三組臨床療效，子宮內(nèi)膜厚度，血紅蛋白水平（Hb），性激素[促卵泡刺激素（FSH）、促黃體生成素（LH）、雌二醇（E2）、孕酮（P）]水平，控制出血時(shí)間以及完全止血時(shí)間，不良反應(yīng)發(fā)生情況等。結(jié)果：C組治療有效率（94.12%）與B組（90.19%）均高于A組（70.58%），差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，三組的FSH、LH、E2及P水平均有所降低，B、C組較A組更為顯著，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；三組子宮內(nèi)膜厚度均有所減少，血紅蛋白水平均有所升高，C組子宮內(nèi)膜厚度及血紅蛋白水平的改善較A、B組更加顯著，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；B組不良反應(yīng)發(fā)生率（7.84%）低于A組（9.80%）和C組（11.76%），差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：15 mg米非司酮聯(lián)合去氧孕烯炔雌醇治療圍絕經(jīng)期功能失調(diào)性子宮出血臨床療效更加顯著，在臨床上可優(yōu)先使用。

【關(guān)鍵詞】 圍絕經(jīng)期功能失調(diào)性子宮出血； 米非司酮； 去氧孕烯炔雌醇； 不同劑量

【Abstract】 Objective：To investigate the clinical effect of different doses of Mifepristone combined with Desogestrel Ethinylestradiol in the treatment of perimenopausal dysfunction uterine bleeding.Method：53 cases of perimenopausal dysfunctional uterine bleeding were selected in the hospital from 2014 to 2017，according to the random number table method，they were divided into A，B and C group，51 cases in each group.A group was given 5 mg of Mifepristone+Desogestrel Ethinylestradiol，B group was given 10 mg of Mifepristone+Desogestrel Ethinylestradiol，C group was given 15 mg of Mifepristone+Desogestrel Ethinylestradiol，the clinical curative effect，endometrial thickness，hemoglobin（Hb），the sex hormones of follicle-stimulating hormone（FSH），luteinizing hormone（LH），estradiol（E2）and progesterone（P），control the bleeding time and complete hemostasis time，adverse reactions occur were compared among three groups.Result：The effective rate of treatment in C group（94.12%） and B group（90.19%） were significantly higher than those of A group（70.58%），the differences were statistically significant（P<0.05）.After treatment，F(xiàn)SH，LH，E2 and P levels of three groups were decreased，B group and C group were more significant than those of A group，the differences were statistically significant（P<0.05）.The endometrium thickness of three groups were decreased，the hemoglobin levels were increased，and the endometrial thickness and hemoglobin levels in C group improved more significantly than those of A group and B group（P<0.05）.The incidence of adverse events in B group（7.84%） was significantly lower than that of A group（9.80%） and C group（11.76%），the differences were statistically significant（P<0.05）.Conclusion：The clinical efficacy of 15 mg Mifepristone combined with Desogestrel Ethinylestradiol in the treatment of perimenopausal dysfunctional uterine bleeding is more remarkable and can be given priority in clinical practice.endprint

【Key words】 Perimenopausal dysfunctional uterine bleeding； Mifepristone； Desogestrel Ethinylestradiol； Different doses

First-authors address：Guangzhou City Panyu District Second Peoples Hospital，Guangzhou 511430，China

doi：10.3969/j.issn.1674-4985.2017.29.014

圍絕經(jīng)期功能失調(diào)性子宮出血（dysfunctional uterine bleeding during perimeno-pause，P-DUB）簡稱圍絕經(jīng)期功血，圍絕經(jīng)期指婦女絕經(jīng)前后的一段時(shí)期，也就是卵巢功能開始衰退一直持續(xù)到最后一次月經(jīng)后1年，此期主要以無排卵功能失調(diào)性子宮出血為主。圍絕經(jīng)期婦女在經(jīng)歷一段月經(jīng)不規(guī)則的絕經(jīng)過渡期后月經(jīng)終止[1]。本研究通過探究不同劑量的米非司酮聯(lián)合去氧孕烯炔雌醇對治療圍絕經(jīng)期功能失調(diào)性子宮出血的臨床療效，為臨床提供更有效的治療方案，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料 選取本院2014-2017年收治的圍絕經(jīng)期功能失調(diào)子宮出血患者153例，根據(jù)隨機(jī)數(shù)字表法將其分為A、B、C組，各51例。其中，A組年齡45～56歲，平均（49.16±1.47）歲，病程6個(gè)月～4年，平均（2.23±1.08）年，體重54～67 kg，平均（60.12±2.06）kg；B組年齡44～56歲，平均（48.16±1.20）歲，病程8個(gè)月～4年，平均