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目的:比较促性腺激素释放激素激动剂(GnRH-a)联合与不联合激素反加疗法治疗子宫内膜异位症的疗效及安全性。方法:将32例确诊为子宫内膜异位症随机分成两组,A组16例,Goserelin 3.6mp,皮下注射,4周1次;B组16例,Goserelin同A组+倍美力0.3mg每日口服1次+安宫黄体酮5mg每日口服1次,疗程12或24周,比较两组治疗前后症状、体征、血激素水平及骨密度变化。结果:A组总主观症状评分于治疗12周后下降了82.6%,24周后下降了93.5%(P<0.01),卵巢子宫内膜异位囊肿于12周后缩小了42%,24周后缩小了71%(P<0.01);B组总主观症状评分于12、24周后分别下降了79.1%、93.4%。卵巢内膜异位囊肿分别缩小了44%、82%(P<0.01)。两组血雌二醇均降至绝经期水平,A组比B组下降更明显(P<0.05)。潮热等副反应,A组8.75%,B组仅25%(P<0.01);A组于治疗24周腰椎、股骨颈骨丢失率分别为4.32%和2.97%,B组分别为2.35%和1.76%。结论:GnRH-a联合激素反加疗法与GnRH-a一样有效,且能降低GnRH-a所致骨密度下降及潮热等副反应,为长期和反复治疗提供一个良好的方案。
Objective: To compare the efficacy and safety of gonadotropin-releasing hormone agonist (GnRH-a) with and without hormone-anti-hyperthermia in the treatment of endometriosis. Methods: Thirty-two cases of endometriosis were randomly divided into two groups: group A (16 cases), Goserelin 3.6mp (subcutaneously), once a week for 4 weeks, group B (16 cases), Goserelin Oral daily oral administration of An Cheng progesterone 5mg daily oral 1, treatment of 12 or 24 weeks, compared the two groups before and after treatment of symptoms and signs, blood hormone levels and bone mineral density changes. Results: The subjective symptom score of group A decreased by 82.6% after 12 weeks of treatment and decreased by 93.5% after 24 weeks (P <0.01), and the ovarian endometriosis decreased by 42% after 12 weeks. After 24 weeks (P <0.01). The subjective symptom scores of group B decreased by 79.1% and 93.4% respectively after 12 and 24 weeks. Ovarian endometriotic cysts were reduced by 44%, 82% (P <0.01). Serum estradiol in both groups decreased to menopause, while in group A, the decrease was more significant than that in group B (P <0.05). Hot flashes and other side effects. The bone loss rate of group A was 8.75% and that of group B was only 25% (P <0.01). The bone loss rates of group A and group B were 4.32% and 2.97% 1.76%. CONCLUSIONS: GnRH-a combined with anti-hormone therapy is as effective as GnRH-a and can reduce the bone mineral density and hot flashes and other side effects caused by GnRH-a, providing a good solution for long-term and repeated treatment.