左炔诺孕酮宫内缓释系统以及优思明治疗子宫内膜异位性疾病的效果对比
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摘要
目的:探究左炔诺孕酮宫内缓释系统(LNG-IUS)以及优思明(屈螺酮炔雌醇片)治疗子宫内膜异位性疾病的效果。方法:回顾分析2016年8月-2017年10月本院住院以及门诊就诊患者中通过B超或者腹腔镜检查提示为子宫内膜异位性疾病70例的临床资料。其中40例子宫腺肌症患者设为A组,将A组分为A_1组和A_2组,各20例,A_1组给予单纯LNG-IUS治疗,A_2组给予单纯优思明治疗;其中30例子宫内膜异位症患者设为B组,将B组分为B_1组和B_2组,各15例,B_1组给予腹腔镜保守性手术后+LNG-IUS治疗,B_2组给予腹腔镜保守手术后+优思明治疗。对比患者月经量、BMI指数、VAS评分等指标。结果:与治疗前对比,A_1组和A_2组治疗3、6、12个月后子宫腺肌病患者月经量、出血天数、月经周期、BMI指数均得到显著改善(P<0.05)。与治疗前比较,A_1组和A_2组治疗3、6、12个月后的痛经评分均有所降低,且A_1组均显著优于A_2组(P<0.05);子宫体积均有所减小,且A_1组均显著优于A_2组(P<0.05);血清CA125水平均有所降低,且A_1组均显著优于A_2组(P<0.05)。与治疗前比较,两组子宫腺肌病患者治疗3、6、12个月后的痛经评分、血清CA125水平均有所降低,且B_2组均显著优于B_1组,差异均有统计学意义(P<0.05)。A组子宫腺肌症患者均无复发,B_2组复发率虽低于B_1组,但差异无统计学意义(P>0.05)。结论:左炔诺孕酮宫内缓释系统以及优思明治疗子宫内膜异位性疾病均可取得显著效果,又各有优点。左炔诺孕酮宫内缓释系统更为经济方便,但对于较大的子宫其容易脱落,而优思明可以弥补这一缺点。单纯左炔诺孕酮宫内缓释系统治疗子宫腺肌症在改善痛经评分、血清CA125水平及子宫体积方面具有优势,优思明在改善子宫内膜异位症患者痛经评分及血清CA125方面具有优势。因此,应当全面考虑患者病情选取科学的最佳治疗方案。
Objective:To investigate the efficacy of levonorgestrel-releasing intrauterine system(LNG-IUS)and Yasmin in the treatment of endometriosis.Method:The clinical data of 70 cases of endometriosis in our hospital from August 2016 to October 2017 were analyzed retrospectively by ultrasonography or laparoscopy.40 cases of adenomyosis of uterus were divided into group A_1 and group A_2,20 cases in each group,group A_1 were treated with LNG-IUS alone and group A_2 was treated with simple Yasmin.Among them,30 patients with endometriosis were assigned to group B,and B was divided into group B_1 and group B_2,15 cases in each group,group B1 was treated with LNG-IUS after laparoscopic conservative surgery,group B_2 was treated with hypersensitive therapy after laparoscopic conservative operation.The menstrual volume,BMI index,VAS score and other indicators were compared.Result:Compared with those before treatment,after treatment 3,6,12 months,the menstrual volume,bleeding days and BMI index of adenomyosis were significantly improved in group A_1 and group A_2(P<0.05).Compared with before treatment,after treatment 3,6,12 months,the dysmenorrhea score of group A_1 and group A_2 were decreased,and the group A_1 was significantly lower than that of group A_2(P<0.05),the volume of uterus decreased,and the group A_1 was significantly better than that of group A_2(P<0.05),the levels of serum CA125 were decreased,and in group A_1 was lower than that in group A_2(P<0.05).Compared with that before treatment,dysmenorrhea score and serum CA125 level of patients with adenomyosis were decreased after treatment 3,6 and 12 months,and both group B_2 were significantly superior to group B_1,with statistically significant differences(P<0.05).No recurrence of adenomyosis in group A,the recurrence rate of group B_2 was lower than that of group B_1,but there was no significant difference(P>0.05).Conclusion:LNG-IUS and Yasmin in the treatment of endometriosis can achieve significant results,but each has its own advantages.LNG-IUS is more economical and convenient,but it is easy to fall off for larger uterus,which can be remedied by Yosmin.The treatment of uterine adenomyosis with LNG-IUS alone has advantages in improving dysmenorrhea score,serum CA125 level and uterine volume,Yasmin has advantages in improving dysmenorrhea score and serum CA125 in patients with endometriosis.Therefore,the best treatment plan should be considered comprehensively.
Objective:To investigate the efficacy of levonorgestrel-releasing intrauterine system(LNG-IUS)and Yasmin in the treatment of endometriosis.Method:The clinical data of 70 cases of endometriosis in our hospital from August 2016 to October 2017 were analyzed retrospectively by ultrasonography or laparoscopy.40 cases of adenomyosis of uterus were divided into group A_1 and group A_2,20 cases in each group,group A_1 were treated with LNG-IUS alone and group A_2 was treated with simple Yasmin.Among them,30 patients with endometriosis were assigned to group B,and B was divided into group B_1 and group B_2,15 cases in each group,group B1 was treated with LNG-IUS after laparoscopic conservative surgery,group B_2 was treated with hypersensitive therapy after laparoscopic conservative operation.The menstrual volume,BMI index,VAS score and other indicators were compared.Result:Compared with those before treatment,after treatment 3,6,12 months,the menstrual volume,bleeding days and BMI index of adenomyosis were significantly improved in group A_1 and group A_2(P<0.05).Compared with before treatment,after treatment 3,6,12 months,the dysmenorrhea score of group A_1 and group A_2 were decreased,and the group A_1 was significantly lower than that of group A_2(P<0.05),the volume of uterus decreased,and the group A_1 was significantly better than that of group A_2(P<0.05),the levels of serum CA125 were decreased,and in group A_1 was lower than that in group A_2(P<0.05).Compared with that before treatment,dysmenorrhea score and serum CA125 level of patients with adenomyosis were decreased after treatment 3,6 and 12 months,and both group B_2 were significantly superior to group B_1,with statistically significant differences(P<0.05).No recurrence of adenomyosis in group A,the recurrence rate of group B_2 was lower than that of group B_1,but there was no significant difference(P>0.05).Conclusion:LNG-IUS and Yasmin in the treatment of endometriosis can achieve significant results,but each has its own advantages.LNG-IUS is more economical and convenient,but it is easy to fall off for larger uterus,which can be remedied by Yosmin.The treatment of uterine adenomyosis with LNG-IUS alone has advantages in improving dysmenorrhea score,serum CA125 level and uterine volume,Yasmin has advantages in improving dysmenorrhea score and serum CA125 in patients with endometriosis.Therefore,the best treatment plan should be considered comprehensively.
引文
[1]崔欠欠,程玲慧,曹云霞,等.左炔诺孕酮宫内缓释系统治疗子宫内膜异位性疾病的临床观察[J].中国临床保健杂志,2015,18(1):76-78.
[2]胡利辉,陈梅莲,顾立芳.左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的临床疗效分析[J].北方药学,2016,7(1):83.
[3]吴红娟,刘广珍,孔敏莉.子宫内膜异位症保守性手术联合药物巩固后复发者应用左炔诺孕酮宫内缓释系统的疗效观察[J].中国当代医药,2016,23(10):105-107.
[4]陈萍,王芬娟,龚巧丽,等.左炔诺孕酮宫内缓释系统用于卵巢子宫内膜异位囊肿手术后巩固治疗30例[J].医药导报,2012,31(6):708-710.
[5]刘冬梅.左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的临床效果观察[J].中国妇幼卫生杂志,2013,8(1):34.
[6]李晓红,陈志芳,丁岩.左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的临床疗效[J].中国临床药理学杂志,2014,8(7):571-574.
[7]蔡克影,李芹,索虹蔚,等.左炔诺孕酮宫内缓释系统治疗腹腔镜术后复发性卵巢子宫内膜异位症患者的临床研究[J].中国内镜杂志,2013,19(3):288-290.
[8]李萍.左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的疗效观察[J].药物流行病学杂志,2014,8(2):83-85.
[9]陈琳,任琛琛,杨立,等.左炔诺孕酮宫内缓释系统在临床应用中的研究[J].河南医学研究,2014,23(3):37-39.
[10]李翠梅,江震钦.左炔诺孕酮宫内缓释系统辅助宫腔镜子宫内膜息肉切除术治疗子宫内膜息肉临床分析[J].中国妇幼保健,2015,30(8):1289-1291.
[11]刘琛姝,王永莉,尹淑杰.左炔诺孕酮宫内缓释系统治疗子宫内膜息肉临床分析[J].中国医学创新,2014,11(12):69-71.
[12]王珏.LNG-IUS联合优思明治疗顽固性围绝经期功能失调性子宫出血临床疗效观察[J].贵州医药,2017,41(7):754-755.
[13]李冰莹.子宫内膜异位症应用左炔诺孕酮宫内缓释系统治疗的可行性研究[J/OL].临床医药文献杂志:电子版,2016,3(22):4422-4423.
[14]廖灿,吴杰儒.左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的临床疗效及安全性分析[J].当代医学,2016,22(33):158-159.
[15]文璞,崔伟.左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的长期安全性[J].中外医疗,2015,34(30):136-137.
[16]张明芳,戴红春.左炔诺孕酮宫内缓释系统和复方口服避孕药用于卵巢子宫内膜异位症患者复发后的治疗效果[J].中国当代医药,2016,23(26):58-60.
[17]钟志华.左炔诺孕酮宫内缓释系统用于子宫内膜异位症保守性手术后复发的治疗效果观察[J/OL].中国保健营养,2015(7):15.
[18]杭悦霞,李娟.左炔诺孕酮宫内缓释系统预防子宫内膜异位症保守性手术后复发的疗效观察[J].中国妇产科临床杂志,2016,7(2):160-162.
[19]王玉,杨清,顾雪桥.左炔诺孕酮宫内缓释系统预防子宫内膜异位症术后复发的疗效[J].中国医科大学学报,2017,46(9):812-815.
[20]李晓红,卿松,丁岩.LNG-IUS对子宫内膜异位症月经模式影响的临床观察[J].中国医学创新,2014,11(15):16-19.
[2]胡利辉,陈梅莲,顾立芳.左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的临床疗效分析[J].北方药学,2016,7(1):83.
[3]吴红娟,刘广珍,孔敏莉.子宫内膜异位症保守性手术联合药物巩固后复发者应用左炔诺孕酮宫内缓释系统的疗效观察[J].中国当代医药,2016,23(10):105-107.
[4]陈萍,王芬娟,龚巧丽,等.左炔诺孕酮宫内缓释系统用于卵巢子宫内膜异位囊肿手术后巩固治疗30例[J].医药导报,2012,31(6):708-710.
[5]刘冬梅.左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的临床效果观察[J].中国妇幼卫生杂志,2013,8(1):34.
[6]李晓红,陈志芳,丁岩.左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的临床疗效[J].中国临床药理学杂志,2014,8(7):571-574.
[7]蔡克影,李芹,索虹蔚,等.左炔诺孕酮宫内缓释系统治疗腹腔镜术后复发性卵巢子宫内膜异位症患者的临床研究[J].中国内镜杂志,2013,19(3):288-290.
[8]李萍.左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的疗效观察[J].药物流行病学杂志,2014,8(2):83-85.
[9]陈琳,任琛琛,杨立,等.左炔诺孕酮宫内缓释系统在临床应用中的研究[J].河南医学研究,2014,23(3):37-39.
[10]李翠梅,江震钦.左炔诺孕酮宫内缓释系统辅助宫腔镜子宫内膜息肉切除术治疗子宫内膜息肉临床分析[J].中国妇幼保健,2015,30(8):1289-1291.
[11]刘琛姝,王永莉,尹淑杰.左炔诺孕酮宫内缓释系统治疗子宫内膜息肉临床分析[J].中国医学创新,2014,11(12):69-71.
[12]王珏.LNG-IUS联合优思明治疗顽固性围绝经期功能失调性子宫出血临床疗效观察[J].贵州医药,2017,41(7):754-755.
[13]李冰莹.子宫内膜异位症应用左炔诺孕酮宫内缓释系统治疗的可行性研究[J/OL].临床医药文献杂志:电子版,2016,3(22):4422-4423.
[14]廖灿,吴杰儒.左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的临床疗效及安全性分析[J].当代医学,2016,22(33):158-159.
[15]文璞,崔伟.左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的长期安全性[J].中外医疗,2015,34(30):136-137.
[16]张明芳,戴红春.左炔诺孕酮宫内缓释系统和复方口服避孕药用于卵巢子宫内膜异位症患者复发后的治疗效果[J].中国当代医药,2016,23(26):58-60.
[17]钟志华.左炔诺孕酮宫内缓释系统用于子宫内膜异位症保守性手术后复发的治疗效果观察[J/OL].中国保健营养,2015(7):15.
[18]杭悦霞,李娟.左炔诺孕酮宫内缓释系统预防子宫内膜异位症保守性手术后复发的疗效观察[J].中国妇产科临床杂志,2016,7(2):160-162.
[19]王玉,杨清,顾雪桥.左炔诺孕酮宫内缓释系统预防子宫内膜异位症术后复发的疗效[J].中国医科大学学报,2017,46(9):812-815.
[20]李晓红,卿松,丁岩.LNG-IUS对子宫内膜异位症月经模式影响的临床观察[J].中国医学创新,2014,11(15):16-19.
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