激素序贯疗法与去氧孕烯炔雌醇片口服治疗青春期功能失调性子宫出血的疗效及安全性对比
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摘要
目的探讨激素序贯疗法与去氧孕烯炔雌醇片在青春期功能失调性子宫出血治疗中的应用价值。方法选取2015年3月～2017年9月收治的青春期功能失调性子宫出血患者188例为研究对象,以随机数字表法分为A组94例,B组94例,A组给予去氧孕烯炔雌醇片治疗,B组给予激素序贯疗法治疗,观察两组治疗效果,止血情况,治疗前、治疗3个月后性激素水平、子宫内膜厚度变化及不良反应发生情况。结果 A组治疗总有效率为95.74%,同B组80.85%对比,差异有统计学意义(P<0.05),A组出血控制时间、出血停止时间及血红蛋白复常时间同B组对比,明显较短,差异有统计学意义(P<0.05),治疗前两组宫内膜厚度、性激素水平差异无统计学意义(P>0.05),A组治疗3个月后子宫内膜厚度与同期B组对比,明显较小,血清促卵泡激素(FSH)、雌二醇(E2)水平与同期B组对比,明显较低,差异有统计学意义(P<0.05);A组用药期间不良反应发生率为8.51%,同B组25.53%对比,差异有统计学意义(P<0.05)。结论相比于激素序贯疗法,去氧孕烯炔雌醇片治疗青春期功能失调性子宫出血,止血更为迅速,对性激素及子宫内膜改善作用更明显,疗效确切,安全性高,值得推广。
Objective To investigate the value of hormone sequential therapy and desogestrel therapy in the treatment of dysfunctional uterine bleeding in adolescents.Methods Select 188 patients with adolescent dysfunctional uterine bleeding from March 2015 to September 2017 as study subjects.The random number table method was used to classify 94 cases in group A and 94 cases in group B.Group A was treated with desogestrel ethinyl estradiol tablets,and Group B was treated with hormone sequential therapy.Observed the effects of treatment,hemostasis,pre-treatment,sex hormone levels,endometrial thickness changes,and occurrence of adverse reactions.Results The total effective rate in group A was 95.74%,which was significantly higher than that in group B(80.85%).The difference was statistically significant(P<0.05).The bleeding control time,bleeding stop time,and hemoglobin recovery time in group A were significantly shorter than those in group B,and the difference was statistically significant(P<0.05).There were no significant difference in endometrial thickness and sex hormone levels between the two groups before treatment(P>0.05).Endometrial thickness was significantly smaller in group A after 3 months of treatment compared with group B in the same period.Serum follicle-stimulating hormone(FSH),the level of estradiol(E2) were significantly lower than that of group B during the same period,and the difference was statistically significant(P<0.05).The incidence of adverse reactions during group A medication was 8.51%,compared with 25.53% in group B,the difference was statistically significant(P<0.05).Conclusion Compared to sequential hormone therapy,desogestrel therapy is effective in the treatment of dysfunctional uterine bleeding during puberty,hemostasis is more rapid,and the effects of sex hormones and endometrial improvement are more pronounced,the efficacy is definite,and the safety is high.It is worth promoting.
Objective To investigate the value of hormone sequential therapy and desogestrel therapy in the treatment of dysfunctional uterine bleeding in adolescents.Methods Select 188 patients with adolescent dysfunctional uterine bleeding from March 2015 to September 2017 as study subjects.The random number table method was used to classify 94 cases in group A and 94 cases in group B.Group A was treated with desogestrel ethinyl estradiol tablets,and Group B was treated with hormone sequential therapy.Observed the effects of treatment,hemostasis,pre-treatment,sex hormone levels,endometrial thickness changes,and occurrence of adverse reactions.Results The total effective rate in group A was 95.74%,which was significantly higher than that in group B(80.85%).The difference was statistically significant(P<0.05).The bleeding control time,bleeding stop time,and hemoglobin recovery time in group A were significantly shorter than those in group B,and the difference was statistically significant(P<0.05).There were no significant difference in endometrial thickness and sex hormone levels between the two groups before treatment(P>0.05).Endometrial thickness was significantly smaller in group A after 3 months of treatment compared with group B in the same period.Serum follicle-stimulating hormone(FSH),the level of estradiol(E2) were significantly lower than that of group B during the same period,and the difference was statistically significant(P<0.05).The incidence of adverse reactions during group A medication was 8.51%,compared with 25.53% in group B,the difference was statistically significant(P<0.05).Conclusion Compared to sequential hormone therapy,desogestrel therapy is effective in the treatment of dysfunctional uterine bleeding during puberty,hemostasis is more rapid,and the effects of sex hormones and endometrial improvement are more pronounced,the efficacy is definite,and the safety is high.It is worth promoting.
引文
[1] 张岩,罗婷.性激素治疗青春期功能性子宫出血临床治疗观察[J].临床和实验医学杂志,2013,12(17):1418-1419.
[2] Seravalli V,Linari S,Peruzzi E,et al. Prevalence of hemostatic disorders in adolescents with abnormal uterine bleeding[J]. J Pediatr Adolesc Gynecol,2013,26(5):285-289.
[3 ] 中华医学会妇产科学分会妇科内分泌学组.异常子宫出血诊断与治疗指南[J].中华妇产科杂志,2014,49(11):801-806.
[4] 中华医学会妇产科学分会内分泌学组中华医学会妇产科学分会绝经学组.功能失调性子宫出血临床诊断治疗指南(草案)[J].中华妇产科杂志,2009,44(3):234-236.
[5] 于蕾,马晓晋.戊酸雌二醇联合黄体酮序贯治疗功能失调性子宫出血的临床研究[J].中国临床药理学杂志,2016,32(19):1756-1758.
[6] Deligeoroglou E,Karountzos V,Creatsas G. Abnormal uterine bleeding and dysfunctional uterine bleeding in pediatric and adolescent gynecology.[J]. Gynecological Endocrinology, 2013,29(1):74-78.
[7] 张涛,杨海澜.口服妈富隆与雌孕激素序贯疗法治疗青春期功能失调性子宫出血的疗效分析[J].山西医科大学学报,2012,43(7):523-525.
[8] 辛宇红,韩仰东.雌孕激素序贯疗法与妈富隆治疗青春期功血的临床疗效对比[J].陕西医学杂志,2016,45(9):1206-1207.
[9] 简凤萍,陈昂,周萍,等.戊酸雌二醇与去氧孕烯炔雌醇治疗青春期功能性子宫出血的疗效比较[J].医学综述,2015,21(8):1506-1508.
[10] 朱静.去氧孕烯炔雌醇片治疗围绝经期功能失调性子宫出血的疗效评价[J].实用临床医药杂志,2013,17(11):108-109.
[11] 李寅苏,方志红.去氧孕烯炔雌醇片治疗青春期功能失调性子宫出血的疗效及安全性研究[J].中国性科学,2013,22(7):17-19.
[12] 欧阳焰.妈富隆治疗青春期功能失调性子宫出血的临床疗效研究[J].中国医药导刊,2013,15(12):2052-2053.
[13] 梁栋,洪顺家,李维茹,等.妈富隆对绝经过渡期功能失调性子宫出血患者血清性激素水平的影响[J].中国妇幼保健,2014,29(2):265-267.
[14] 宋娟.不同方法治疗青春期功能失调性子宫出血对子宫内膜厚度的影响及临床疗效观察[J].中华保健医学杂志,2016,18(2):160-161,163.
[15] 杜清玲,王晓红,郝汇平,等.青春期功能失调性子宫出血行测量子宫内膜厚度在不同治疗方法中的疗效[J].中国妇幼保健,2015,30(18):2952-2953.
[2] Seravalli V,Linari S,Peruzzi E,et al. Prevalence of hemostatic disorders in adolescents with abnormal uterine bleeding[J]. J Pediatr Adolesc Gynecol,2013,26(5):285-289.
[3 ] 中华医学会妇产科学分会妇科内分泌学组.异常子宫出血诊断与治疗指南[J].中华妇产科杂志,2014,49(11):801-806.
[4] 中华医学会妇产科学分会内分泌学组中华医学会妇产科学分会绝经学组.功能失调性子宫出血临床诊断治疗指南(草案)[J].中华妇产科杂志,2009,44(3):234-236.
[5] 于蕾,马晓晋.戊酸雌二醇联合黄体酮序贯治疗功能失调性子宫出血的临床研究[J].中国临床药理学杂志,2016,32(19):1756-1758.
[6] Deligeoroglou E,Karountzos V,Creatsas G. Abnormal uterine bleeding and dysfunctional uterine bleeding in pediatric and adolescent gynecology.[J]. Gynecological Endocrinology, 2013,29(1):74-78.
[7] 张涛,杨海澜.口服妈富隆与雌孕激素序贯疗法治疗青春期功能失调性子宫出血的疗效分析[J].山西医科大学学报,2012,43(7):523-525.
[8] 辛宇红,韩仰东.雌孕激素序贯疗法与妈富隆治疗青春期功血的临床疗效对比[J].陕西医学杂志,2016,45(9):1206-1207.
[9] 简凤萍,陈昂,周萍,等.戊酸雌二醇与去氧孕烯炔雌醇治疗青春期功能性子宫出血的疗效比较[J].医学综述,2015,21(8):1506-1508.
[10] 朱静.去氧孕烯炔雌醇片治疗围绝经期功能失调性子宫出血的疗效评价[J].实用临床医药杂志,2013,17(11):108-109.
[11] 李寅苏,方志红.去氧孕烯炔雌醇片治疗青春期功能失调性子宫出血的疗效及安全性研究[J].中国性科学,2013,22(7):17-19.
[12] 欧阳焰.妈富隆治疗青春期功能失调性子宫出血的临床疗效研究[J].中国医药导刊,2013,15(12):2052-2053.
[13] 梁栋,洪顺家,李维茹,等.妈富隆对绝经过渡期功能失调性子宫出血患者血清性激素水平的影响[J].中国妇幼保健,2014,29(2):265-267.
[14] 宋娟.不同方法治疗青春期功能失调性子宫出血对子宫内膜厚度的影响及临床疗效观察[J].中华保健医学杂志,2016,18(2):160-161,163.
[15] 杜清玲,王晓红,郝汇平,等.青春期功能失调性子宫出血行测量子宫内膜厚度在不同治疗方法中的疗效[J].中国妇幼保健,2015,30(18):2952-2953.