左炔诺孕酮宫内节育系统及电刺激治疗子宫内膜异位症盆腔疼痛的疗效观察
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摘要
目的:探讨左炔诺孕酮宫内节育系统(曼月乐)及电刺激对子宫内膜异位症引起盆腔疼痛的疗效观察。方法:选择子宫内膜异位症以盆腔疼痛为主要症状的患者84例,分为电刺激组、曼月乐组、综合治疗组(曼月乐及电刺激综合治疗)。治疗后1个月和3个月后复诊,观察治疗前后3组患者盆腔疼痛程度(VAS)、CA125水平的变化。结果:治疗1个月后,电刺激组及综合治疗组评分较治疗前明显下降(均P<0.05)。治疗3个月后,3组VAS评分及CA125水平均较治疗前明显下降(均P<0.05)。综合治疗组VAS评分及CA125水平低于曼月乐组,曼月乐组低于电刺激组(均P<0.05)。治疗3个月后,综合治疗组完全缓解率高于曼月乐组,曼月乐组高于电刺激组(均P<0.05)。结论:左炔诺孕酮宫内节育系统联合电刺激治疗子宫内膜异位症引起的盆腔疼痛效果明显,值得在临床上推广应用。
Objective: To investigate the effectiveness of levonorgestrel intrauterine birth control system( LNG-IUS,Mirena) and electrical stimulation on pelvic pain caused by endometriosis. Methods: Eighty-four patients with pelvic pain caused by endometriosis were divided into electrical stimulation group,Mirena group,and the comprehensive treatment group( electrical stimulation combined with Mirena). The abdominal pain measured by VAS and CA125 levels was evaluated 1 and 3 month( s) after treatment. Results: After 1-month treatment,the score of VAS in the electrical stimulation group and comprehensive treatment group decreased significantly( P < 0. 05). After 3-month treatment,the VAS scores and CA125 levels in the comprehensive treatment group were lowest in three groups and those in the Mirena group were lower than in the electrical stimulation group( P < 0. 05). After 3-month treatment,the complete remission rate in the comprehensive treatment group was significantly higher than that in the Mirena group,and that in the Mirena group was significantly higher than that in the electrical stimulation group( P < 0. 05). Conclusion: Levonorgestrel intrauterine system combined with electrical stimulation could relief the pelvic pain caused by endometriosis and is worth of clinical application.
Objective: To investigate the effectiveness of levonorgestrel intrauterine birth control system( LNG-IUS,Mirena) and electrical stimulation on pelvic pain caused by endometriosis. Methods: Eighty-four patients with pelvic pain caused by endometriosis were divided into electrical stimulation group,Mirena group,and the comprehensive treatment group( electrical stimulation combined with Mirena). The abdominal pain measured by VAS and CA125 levels was evaluated 1 and 3 month( s) after treatment. Results: After 1-month treatment,the score of VAS in the electrical stimulation group and comprehensive treatment group decreased significantly( P < 0. 05). After 3-month treatment,the VAS scores and CA125 levels in the comprehensive treatment group were lowest in three groups and those in the Mirena group were lower than in the electrical stimulation group( P < 0. 05). After 3-month treatment,the complete remission rate in the comprehensive treatment group was significantly higher than that in the Mirena group,and that in the Mirena group was significantly higher than that in the electrical stimulation group( P < 0. 05). Conclusion: Levonorgestrel intrauterine system combined with electrical stimulation could relief the pelvic pain caused by endometriosis and is worth of clinical application.
引文
[1]李雷,冷金花.子宫内膜异位症及其治疗对女性生育影响的研究进展[J].中国实用妇科与产科杂志,2013,29(5):393-396.
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[5]Janssen EB,Rijkers ACM,Hoppenbrouwers K,et al.Prevalence of endometriosis diagnosed by laparoscopy in adolescents with dysmenorrhea or chronic pelvic pain:a systematic review[J].Hum Reprod Update,2013,19(5):570-582.
[6]Morelli M,Rocca ML,Venturella R,et al.Improvement in chronic pelvic pain after gonadotropin releasing hormone analogue(Gn RH-a)administration in premenopausal women suffering from adenomyosis or endometriosis:a retrospective study[J].Gynecol Endocrinol.2013,29(4):305-308.
[7]张鹏,姚吉龙.子宫内膜异位症相关疼痛发病机制的研究进展[J].肿瘤预防与治疗,2015,28(3):179-182.
[8]金莹,郭红燕,贺豪杰.电刺激疗法治疗慢性盆腔痛及痛经[J].中国微创外科杂志,2014,5(5):461-463.
[9]Sato KL,Sanada LS,Rakel BA,et al.Increasing intensity of TENS prevents analgesic tolerance in rats[J].J Pain,2012,13(9):884-890.
[10]Alesh I,Kayali F,Stein PD.Catheter-directed thrombolysis(intrathrombus injection)in treatment of deep venous thrombosis:a systematic review[J].Catheter Cardiovasc Interv,2007,70(1):143-148.
[11]赵惠杰.曼月乐对不愿手术的子宫内膜异位症患者的疗效观察[J].中国当代医药,2014,21(8):177-179.
[12]陈燕,林莺莺,郑瑜宏,等.血清HE4、CA125和ROMA指数评估卵巢癌风险性的初步评价[J].中国免疫学杂志,2013,29(2):168-174.
[2]陈京亭.子宫内膜异位症患者盆腔疼痛与病灶特点的相关性分析[J].安徽医学,2012,33(7):833-835.
[3]谢幸,苟文丽.妇产科学[M].第8版.北京:人民卫生出版社,2013:268-275.
[4]Schliep KC,Mumford SL,Peterson CM,etal.Pain typology and incident endometriosis[J].Human reproduction,2015,30(10):2427-2438.
[5]Janssen EB,Rijkers ACM,Hoppenbrouwers K,et al.Prevalence of endometriosis diagnosed by laparoscopy in adolescents with dysmenorrhea or chronic pelvic pain:a systematic review[J].Hum Reprod Update,2013,19(5):570-582.
[6]Morelli M,Rocca ML,Venturella R,et al.Improvement in chronic pelvic pain after gonadotropin releasing hormone analogue(Gn RH-a)administration in premenopausal women suffering from adenomyosis or endometriosis:a retrospective study[J].Gynecol Endocrinol.2013,29(4):305-308.
[7]张鹏,姚吉龙.子宫内膜异位症相关疼痛发病机制的研究进展[J].肿瘤预防与治疗,2015,28(3):179-182.
[8]金莹,郭红燕,贺豪杰.电刺激疗法治疗慢性盆腔痛及痛经[J].中国微创外科杂志,2014,5(5):461-463.
[9]Sato KL,Sanada LS,Rakel BA,et al.Increasing intensity of TENS prevents analgesic tolerance in rats[J].J Pain,2012,13(9):884-890.
[10]Alesh I,Kayali F,Stein PD.Catheter-directed thrombolysis(intrathrombus injection)in treatment of deep venous thrombosis:a systematic review[J].Catheter Cardiovasc Interv,2007,70(1):143-148.
[11]赵惠杰.曼月乐对不愿手术的子宫内膜异位症患者的疗效观察[J].中国当代医药,2014,21(8):177-179.
[12]陈燕,林莺莺,郑瑜宏,等.血清HE4、CA125和ROMA指数评估卵巢癌风险性的初步评价[J].中国免疫学杂志,2013,29(2):168-174.