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目的:观察针对无排卵型月经失调患者采用不同剂量孕酮进行治疗的临床效果。方法:选取2016年3月至2017年3月于广东省湛江吴川市妇幼保健计划生育服务中心就诊治疗的无排卵型月经失调患者280例,按就诊时间以随机数字表法均分为甲、乙、丙、丁4组,每组各70例。均采用孕酮进行治疗,甲组100 mg·d~(-1)、乙组200 mg·d~(-1)、丙组300 mg·d~(-1)、丁组400 mg·d~(-1)。对比各组治疗效果。结果:甲、乙、丙、丁四组治疗后组间阴道流血量评分、阴道流血时间比较,差异均无统计学意义(P>0.05);甲、乙、丁三组治疗后子宫内膜厚度与治疗前比较,差异均无统计学意义(P>0.05);丙组治疗后子宫内膜厚度与治疗前比较明显变薄,差异具有统计学意义(P<0.05);甲、乙、丁三组治疗后子宫内膜厚度比较,差异均无统计学意义(P>0.05),与丙组比较均相对较厚,差异具有统计学意义(P<0.05);甲、乙、丙三组治疗后不良反应发生率比较,差异均无统计学意义(P>0.05),与丁组比较明显较低,差异具有统计学意义(P<0.05)。结论:不同剂量孕酮治疗无排卵型月经失调均效果较佳,但其中300 mg·d~(-1)剂量疗法可明显减少患者子宫内膜厚度,且低剂量孕酮疗法患者不良反应率较低,可作为无排卵型月经失调的首选推荐疗法。
Objective: To observe the clinical effect of different doses of progesterone in patients with anovulatory menstruation. Methods: From March 2016 to March 2017, 280 cases of anovulatory menstrual disorder treated in MCH center of Wuchuan City, Zhanjiang, Guangdong Province were selected and randomly divided into A and B , C, D 4 groups, each group of 70 cases. All the patients were treated with progesterone, 100 mg · d -1 in group A, 200 mg · d -1 in group B, 300 mg · d -1 in group C and 400 mg · d ~ (-1). Compare the treatment effect of each group. Results: There was no significant difference in vaginal bleeding volume and vaginal bleeding time between the four groups after treatment (P> 0.05). The thickness of endometrium in groups A, B and C after treatment Compared with those before treatment, the differences were not statistically significant (P> 0.05); the thickness of endometrium in group C was significantly thinner than that before treatment, the difference was statistically significant (P <0.05); A, B and D There was no significant difference in endometrial thickness between the two groups after treatment (P> 0.05), but the difference was statistically significant (P <0.05) There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05), but the difference was statistically significant (P <0.05). Conclusion: Different doses of progesterone treatment of anovulatory menstrual disorders are better, but 300 mg · d ~ (-1) dose therapy can significantly reduce the thickness of the endometrium, and patients with low dose progesterone treatment adverse reaction rate Low, can be used as the first choice for anovulatory menstrual disorders recommended therapy.