米非司酮与醋酸甲羟孕酮片对异常子宫出血患者子宫内膜厚度及生殖激素的影响
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摘要
目的 :探讨米非司酮与醋酸甲羟孕酮片联合用药对异常子宫出血患者子宫内膜厚度及相关生殖激素水平的影响。方法 :选取2014年9月～2015年9月我院收治的异常子宫出血患者100例,按照随机数字表法分为对照组与观察组,每组各50例。对照组给予醋酸甲羟孕酮片治疗,观察组在对照组基础上,给予米非司酮治疗。比较两组治疗效果;分别于治疗前、治疗3个月及治疗6个月检测两组患者子宫内膜厚度及生殖激素雌二醇(E2)、促卵泡生成素(FSH)、黄体生成素(LH)、孕酮(P)水平。结果 :治疗3个月后,对照组总有效率为78.00%;观察组总有效率为92.00%,两者比较差异有统计学意义。治疗前,两组患者子宫内膜厚度及生殖激素水平比较,差异无统计学意义。治疗3个月及治疗6个月,对照组和观察组患者子宫内膜厚度、血清中E2、FSH、LH及P水平均明显低于本组治疗前,且观察组患者子宫内膜厚度、血清中E2、FSH、LH及P水平明显低于对照组治疗后,差异均有统计学意义。两组患者治疗3个月及治疗6个月,子宫内膜厚度及各生殖激素水平比较,无统计学差异。结论 :米非司酮与醋酸甲羟孕酮片联合用药对异常子宫出血患者具有较好的临床疗效,可明显抑制子宫内膜增厚及生殖激素的释放。
Objective To investigate the effect of mifepristone combined with medroxyprogesterone acetate tablets on endometrial thickness and related reproductive hormones in patients with abnormal uterine bleeding. Methods 100 patients with abnormal uterine bleeding in our hospital from September 2014 to September 2015 were randomly divided into control group and observation group, 50 cases in each group. Patients in the control group were given treatment with medroxyprogesterone acetate tablets. Patients in the observation group were treated with mifepristone on the basis of the control group. The effect of the two groups were compared. The thickness of the endometrium and the levels of reproductive hormone estradiol(E2), follicle stimulating hormone(FSH), luteinizing hormone(LH) and progesterone(P) were measured before treatment, 3 months of treatment and 6 months of treatment in the two groups. Result After treatment, the total effective rate of the control group was 78%,and the total effective rate of the observation group was 92%, and the difference was statistically significant. Before treatment,there was no significant difference between the two groups of endometrium thickness and the level of reproductive hormone.After treated for 3 months and 6 months, the thickness of endometrium, E2, FSH, LH and P in the serum of the control group and the observation group were significantly lower than that of the group before the treatment. The thickness of endometrium,E2, FSH, LH and P in the serum of the observation group were significantly lower than that of the control group, the difference was statistically significant. The two groups were treated for 3 months and 6 months, and there was no significant difference in endometrial thickness and reproductive hormones levels. Conclusion Mifepristone combined with medroxyprogesterone acetate tablets has a good clinical effect on patients with abnormal uterine bleeding, and it can significantly inhibit endometrial thickening and reproductive hormone release.
Objective To investigate the effect of mifepristone combined with medroxyprogesterone acetate tablets on endometrial thickness and related reproductive hormones in patients with abnormal uterine bleeding. Methods 100 patients with abnormal uterine bleeding in our hospital from September 2014 to September 2015 were randomly divided into control group and observation group, 50 cases in each group. Patients in the control group were given treatment with medroxyprogesterone acetate tablets. Patients in the observation group were treated with mifepristone on the basis of the control group. The effect of the two groups were compared. The thickness of the endometrium and the levels of reproductive hormone estradiol(E2), follicle stimulating hormone(FSH), luteinizing hormone(LH) and progesterone(P) were measured before treatment, 3 months of treatment and 6 months of treatment in the two groups. Result After treatment, the total effective rate of the control group was 78%,and the total effective rate of the observation group was 92%, and the difference was statistically significant. Before treatment,there was no significant difference between the two groups of endometrium thickness and the level of reproductive hormone.After treated for 3 months and 6 months, the thickness of endometrium, E2, FSH, LH and P in the serum of the control group and the observation group were significantly lower than that of the group before the treatment. The thickness of endometrium,E2, FSH, LH and P in the serum of the observation group were significantly lower than that of the control group, the difference was statistically significant. The two groups were treated for 3 months and 6 months, and there was no significant difference in endometrial thickness and reproductive hormones levels. Conclusion Mifepristone combined with medroxyprogesterone acetate tablets has a good clinical effect on patients with abnormal uterine bleeding, and it can significantly inhibit endometrial thickening and reproductive hormone release.
引文
[1]Miller JD, Bonafede MM, Cai Q, et al. Economic Evaluation of Global Endometrial Ablation Versus Inpatient and Outpatient Hysterectomy for Treatment of Abnormal Uterine Bleeding:US Commercial and Medicaid Payer Perspectives[J]. Popul Health Manag, 2018, 21(S1):S1-S12.
[2]Grzechocinska B, Dabrowski FA, Chlebus M, et al. Expression of matrix metalloproteinase enzymes in endometrium of women with abnormal uterine bleeding[J]. Neuro Endocrinol Lett, 2018, 38(8):537-543.
[3]Sinha P, Yadav N, Gupta U. Use of Hysteroscopy in Abnormal Uterine Bleeding:An Edge Over Histopathological Examination[J]. J Obstet Gynaecol India, 2018, 68(1):45-50.
[4]Godha Z, Mohsin Z, Hakim S, et al. Comparative Study of Ormeloxifene and Medroxyprogesterone Acetate in Abnormal Uterine Bleeding[J]. J Obstet Gynaecol India, 2016, 66(Suppl 1):395-9.
[5]周密,王莉.曼月乐与安宫黄体酮治疗围绝经期异常子宫出血的临床疗效对比[J].中国计划生育学杂志, 2018, 26(02):107-110.
[6]Rezk M, Al-Halaby A, Emarh M, et al. Correlation between uterine artery Doppler indices and menstrual irregularities among levonorgestrel releasing intrauterine system and depot medroxyprogesterone acetate users:a prospective observational study. Eur J Contracept Reprod Health Care, 2017, 22(4):316-320.
[7]廖彬池,茅群霞.米非司酮治疗中国女性围绝经期异常子宫出血有效性的Meta分析[J].中国药房, 2017, 28(36):5101-5105.
[8]Farrukh JB, Towriss K, McKee N. Abnormal uterine bleeding:Taking the stress out of controlling the flow[J]. Can Fam Physician, 2015, 61(8):693-7.
[9]Spremovi?-Ra?enovi?S, Stefanovi?A, Kadija S, et al. Classification and the diagnostics of abnormal uterine bleeding in nongravid women of reproductive age:The PALM-COEIN classification system adopted by the International Federation of Gynecology and Obstetrics[J]. Vojnosanit Pregl, 201, 73(12):1154-9.
[10]徐晓琳,俞力微.醋酸甲羟基孕酮联合抗生素治疗子宫内膜炎的临床效果[J].中国当代医药, 2016, 23(05):83-85.
[11]孙雅平.戊酸雌二醇片联合醋酸甲羟孕酮片治疗青春期功能失调性子宫出血疗效观察[J].现代实用医学, 2014, 26(04):442-443.
[12]刘慧桢.醋酸甲羟孕酮与二联抗生素联合治疗子宫内膜异位症的临床观察[J].北方药学, 2017, 14(08):121-122.
[13] Wen X, Xie J, Zhou L, et al. The role of combining medroxyprogesterone17-acetate with human menopausal gonadotropin in mouse ovarian follicular development[J]. Sci Rep, 2018, 8(1):4439.
[14]高松裔.米非司酮治疗妇产科疾病的临床效果[J].中国药物经济学, 2016, 11(01):53-54.
[15]方庆霞,邹萍,李坤寅.针刺促排卵对多囊卵巢综合征患者卵泡发育及生殖激素的影响[J].北京中医药, 2016, 35(03):198-201.
[16]陈忠兰,梁小洁.宫血宁胶囊联合醋酸甲羟孕酮和戊酸雌二醇治疗青春期功能失调性子宫出血的疗效观察[J].现代药物与临床,2016, 31(7):1063-1066.
[17]张小金.小剂量米非司酮对围绝经期排卵障碍性异常子宫出血效果观察[J].中国计划生育学杂志, 2015, 23(06):395-398.
[2]Grzechocinska B, Dabrowski FA, Chlebus M, et al. Expression of matrix metalloproteinase enzymes in endometrium of women with abnormal uterine bleeding[J]. Neuro Endocrinol Lett, 2018, 38(8):537-543.
[3]Sinha P, Yadav N, Gupta U. Use of Hysteroscopy in Abnormal Uterine Bleeding:An Edge Over Histopathological Examination[J]. J Obstet Gynaecol India, 2018, 68(1):45-50.
[4]Godha Z, Mohsin Z, Hakim S, et al. Comparative Study of Ormeloxifene and Medroxyprogesterone Acetate in Abnormal Uterine Bleeding[J]. J Obstet Gynaecol India, 2016, 66(Suppl 1):395-9.
[5]周密,王莉.曼月乐与安宫黄体酮治疗围绝经期异常子宫出血的临床疗效对比[J].中国计划生育学杂志, 2018, 26(02):107-110.
[6]Rezk M, Al-Halaby A, Emarh M, et al. Correlation between uterine artery Doppler indices and menstrual irregularities among levonorgestrel releasing intrauterine system and depot medroxyprogesterone acetate users:a prospective observational study. Eur J Contracept Reprod Health Care, 2017, 22(4):316-320.
[7]廖彬池,茅群霞.米非司酮治疗中国女性围绝经期异常子宫出血有效性的Meta分析[J].中国药房, 2017, 28(36):5101-5105.
[8]Farrukh JB, Towriss K, McKee N. Abnormal uterine bleeding:Taking the stress out of controlling the flow[J]. Can Fam Physician, 2015, 61(8):693-7.
[9]Spremovi?-Ra?enovi?S, Stefanovi?A, Kadija S, et al. Classification and the diagnostics of abnormal uterine bleeding in nongravid women of reproductive age:The PALM-COEIN classification system adopted by the International Federation of Gynecology and Obstetrics[J]. Vojnosanit Pregl, 201, 73(12):1154-9.
[10]徐晓琳,俞力微.醋酸甲羟基孕酮联合抗生素治疗子宫内膜炎的临床效果[J].中国当代医药, 2016, 23(05):83-85.
[11]孙雅平.戊酸雌二醇片联合醋酸甲羟孕酮片治疗青春期功能失调性子宫出血疗效观察[J].现代实用医学, 2014, 26(04):442-443.
[12]刘慧桢.醋酸甲羟孕酮与二联抗生素联合治疗子宫内膜异位症的临床观察[J].北方药学, 2017, 14(08):121-122.
[13] Wen X, Xie J, Zhou L, et al. The role of combining medroxyprogesterone17-acetate with human menopausal gonadotropin in mouse ovarian follicular development[J]. Sci Rep, 2018, 8(1):4439.
[14]高松裔.米非司酮治疗妇产科疾病的临床效果[J].中国药物经济学, 2016, 11(01):53-54.
[15]方庆霞,邹萍,李坤寅.针刺促排卵对多囊卵巢综合征患者卵泡发育及生殖激素的影响[J].北京中医药, 2016, 35(03):198-201.
[16]陈忠兰,梁小洁.宫血宁胶囊联合醋酸甲羟孕酮和戊酸雌二醇治疗青春期功能失调性子宫出血的疗效观察[J].现代药物与临床,2016, 31(7):1063-1066.
[17]张小金.小剂量米非司酮对围绝经期排卵障碍性异常子宫出血效果观察[J].中国计划生育学杂志, 2015, 23(06):395-398.