去氧孕烯炔雌醇联合戊酸雌二醇治疗青春期功血的疗效及对性激素水平的影响
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摘要
为探讨去氧孕烯炔雌醇联合戊酸雌二醇治疗青春期功血的疗效及对性激素水平的影响,本研究选取了2015年1月至2016年6月收治的60例青春期功能失调性子宫出血患者作为研究对象,根据患者治疗方案不同随机分为2组,每组各有患者30例。观察组为去氧孕烯炔雌醇联合戊酸雌二醇疗法,对照组为戊酸雌二醇疗法。记录并对比2组患者控制出血时间、完全止血时间、临床治疗效果、子宫内膜厚度以及血清性激素水平。观察组控制出血时间和完全止血时间显著小于对照组,差异有统计学意义(p<0.05)。第一疗程结束后,观察组基础体温双向者、排卵者以及月经周期规律者和对照度相差不大。在第二以及第三疗程结束后,观察组基础体温双向者、排卵者以及月经周期规律者显著多于对照组,差异有统计学意义(p<0.05)。治疗后2组子宫内膜厚度(观察组(5.4±0.6) mm,对照组(5.6±0.9) mm)显著小于治疗前,差异具有统计学意义(p<0.05),而两组之间差异并不明显。治疗后观察组LH和FSH水平显著低于对照组,差异具有统计学意义(p<0.05),E2水平在2组治疗前后则无显著变化。观察组不良反应率显著低于对照组(p<0.05)。去氧孕烯炔雌醇联合戊酸雌二醇对治疗青春期功血具有显著的效果,可大大缩短病人控制止血的时间和完全止血的时间,并且对月经周期和性激素水平具有调节作用。
To explored the effect of marvelon and estrogen combined with pentanoic acid estradiol on treating puberty dysfunctional uterine bleeding and its influence on serum sex hormone, 60 cases of adolescent dysfunctional uterine bleeding from January 2015 to June 2016 were randomly selected and divided into two groups, with 30 cases in each group. Marvelon and estrogen combined with pentanoic acid estradiol treated patients were selected as the observation group and pentanoic acid oestrogen treated patients were selected as the control group. Records were made on control bleeding time and complete hemostasis time. The control bleeding time and complete hemostasis time of the observation group were significantly lower than the control group(p<0.05). After the first course of treatment, the basal body temperature two-way, ovulation and menstruation cycles and the intensity of illumination in the two groups were not different. We also found that after the end of the second and the third period of treatment, the basal body temperature two-way, ovulation and menstruation cycle in observation group were significantly more than the control group. In addition, the endometrial thickness in two groups after treatment(observation group:(5.4±0.6) mm, control group:(5.6±0.9) mm) is significantly less than those before treatment(p<0.05). However, there was no obvious difference between the two groups. Our results showed that the levels of LH and FSH in observation group after treatment were significantly lower than the control group(p<0.05) and the level of E2 was not significantly different in the two groups before and after treatment. Marvelon and estrogen combined with pentanoic acid estradiol exert significant effect on treatment for puberty dysfunctional, which can greatly shorten control bleeding time and complete hemostasis time and have a regulatory role on menstrual cycles and sex hormone levels.
To explored the effect of marvelon and estrogen combined with pentanoic acid estradiol on treating puberty dysfunctional uterine bleeding and its influence on serum sex hormone, 60 cases of adolescent dysfunctional uterine bleeding from January 2015 to June 2016 were randomly selected and divided into two groups, with 30 cases in each group. Marvelon and estrogen combined with pentanoic acid estradiol treated patients were selected as the observation group and pentanoic acid oestrogen treated patients were selected as the control group. Records were made on control bleeding time and complete hemostasis time. The control bleeding time and complete hemostasis time of the observation group were significantly lower than the control group(p<0.05). After the first course of treatment, the basal body temperature two-way, ovulation and menstruation cycles and the intensity of illumination in the two groups were not different. We also found that after the end of the second and the third period of treatment, the basal body temperature two-way, ovulation and menstruation cycle in observation group were significantly more than the control group. In addition, the endometrial thickness in two groups after treatment(observation group:(5.4±0.6) mm, control group:(5.6±0.9) mm) is significantly less than those before treatment(p<0.05). However, there was no obvious difference between the two groups. Our results showed that the levels of LH and FSH in observation group after treatment were significantly lower than the control group(p<0.05) and the level of E2 was not significantly different in the two groups before and after treatment. Marvelon and estrogen combined with pentanoic acid estradiol exert significant effect on treatment for puberty dysfunctional, which can greatly shorten control bleeding time and complete hemostasis time and have a regulatory role on menstrual cycles and sex hormone levels.
引文
Agarwal A.,and Venkat A.,2009,Questionnaire study on menstrual disorders in adolescent girls in Singapore,J.Pediatr Adolesc Gynecol.,22(6):365-371
American College of Obstetricians and Gynecologists,A.C.O.,2013,ACOG committee opinion no.557:Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women,Obstet.Gynecol.,121(4):891-896
Apter D.,Viinikka L.,and Vihko R.,1978,Hormonal pattern of adolescent menstrual cycles,J.Clin.Endocrinol.Metab,47(5):944-954
Cowan B.D.,and Morrison J.C.,1991,Management of abnormal genital bleeding in girls and women,N.Engl.J.Med.,324(24):1710-1715
Gu Z.Q.,Zhou Y.,and Cai R.,2015,The clinical effects of gestodene-ethinylestradiol in the treatment of adolescent dysfunctional uterine bleeding,Linchuang Heli Yongyao Zazhi(Chinese Journal of Clinical Rational Drug Use),8(9C):86-87(顾志群,周晔,蔡蓉,2015,去氧孕烯炔雌醇治疗青春期功能性子宫出血的临床疗效,临床合理用药杂志,8(9C):86-87)
Qu Q.H.,Tan S.Q.,and Tang X.H.,2008,Two kinds of endometrial atrophy therapy in the treatment of dysfunctional uterine bleeding in adolescent patients,Shiyong Fuchanke Zazhi(Journal of Practical Obstetrics and Gynecology),24(8):479-481(屈清华,谭世桥,唐晓红,2008,两种子宫内膜萎缩疗法治疗青春期功血的随机临床对照研究,实用妇产科杂志,24(8):479-481)
Terry M.B.,and Tehranifar P.,2013,Hormone replacement therapy and breast cancer risk:more evidence for risk stratification?J.Natl.Cancer Inst.,105(18):1342
Yang J.,Xu W.,Zhu Y.,and Lu M.,2014,A meta-analysis of treatment of puberty dysfunctional uterine bleeding with Marvelon,Zhongguo Jihua Shengyuxue Zazhi(Chinese Journal of Family Planning),22(5):292-295(杨静,徐雯,朱垚,陆明,2014,妈富隆治疗青春期功能失调性子宫出血的meta分析,中国计划生育学杂志,22(5):292-295)
American College of Obstetricians and Gynecologists,A.C.O.,2013,ACOG committee opinion no.557:Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women,Obstet.Gynecol.,121(4):891-896
Apter D.,Viinikka L.,and Vihko R.,1978,Hormonal pattern of adolescent menstrual cycles,J.Clin.Endocrinol.Metab,47(5):944-954
Cowan B.D.,and Morrison J.C.,1991,Management of abnormal genital bleeding in girls and women,N.Engl.J.Med.,324(24):1710-1715
Gu Z.Q.,Zhou Y.,and Cai R.,2015,The clinical effects of gestodene-ethinylestradiol in the treatment of adolescent dysfunctional uterine bleeding,Linchuang Heli Yongyao Zazhi(Chinese Journal of Clinical Rational Drug Use),8(9C):86-87(顾志群,周晔,蔡蓉,2015,去氧孕烯炔雌醇治疗青春期功能性子宫出血的临床疗效,临床合理用药杂志,8(9C):86-87)
Qu Q.H.,Tan S.Q.,and Tang X.H.,2008,Two kinds of endometrial atrophy therapy in the treatment of dysfunctional uterine bleeding in adolescent patients,Shiyong Fuchanke Zazhi(Journal of Practical Obstetrics and Gynecology),24(8):479-481(屈清华,谭世桥,唐晓红,2008,两种子宫内膜萎缩疗法治疗青春期功血的随机临床对照研究,实用妇产科杂志,24(8):479-481)
Terry M.B.,and Tehranifar P.,2013,Hormone replacement therapy and breast cancer risk:more evidence for risk stratification?J.Natl.Cancer Inst.,105(18):1342
Yang J.,Xu W.,Zhu Y.,and Lu M.,2014,A meta-analysis of treatment of puberty dysfunctional uterine bleeding with Marvelon,Zhongguo Jihua Shengyuxue Zazhi(Chinese Journal of Family Planning),22(5):292-295(杨静,徐雯,朱垚,陆明,2014,妈富隆治疗青春期功能失调性子宫出血的meta分析,中国计划生育学杂志,22(5):292-295)