子宫内膜异位症术后小剂量米非司酮辅助治疗临床分析  

Clinical analysis on small dose mifepristone auxiliary treatment of postoperative endometriosis

作　　者：贾君容[1] 温岩[1] 贾云霄[1] 徐跃[1] 

机构地区：[1]吉林大学第一医院妇产科,吉林长春130021

出　　处：《中国妇幼保健》2008年第21期2960-2962,共3页Maternal and Child Health Care of China

摘　　要：目的：探讨子宫内膜异位症手术后服用小剂量米非司酮治疗子宫内膜异位症（内异症）的临床疗效。方法：米非司酮组（M组）37例，米非司酮10mg口服，每日1次；达那唑组（D组）35例，达那唑200mg口服，每日2～3次。均连续用药3个月，观察两组症状、体征改善情况，用药后的副反应及用药3个月时性激素水平生化指标的变化。结果：两组症状、体征缓解率相似。米非司酮组潮热、阴道出血、腰背疼痛、体重增加、痤疮等副反应发生率显著低于达那唑组（P〈0．05）。米非司酮组雌二醇（E2）为（204．9±45．3）pmol／L，保持在卵泡期水平，达那唑组为（94．3±33．0）pmol／L，为绝经后水平，两组比较，差异有极显著性（P〈0．01）。停药13～15天，米非司酮组E2水平为（1221．6±384．2）pmol／L，较用药前（排卵期）下降，但差异无显著性（P〉0．05），达那唑组为（815．1±376．0）pmol／L，较用药前（排卵期）明显下降（P〈0．05）。米非司酮组停药后基础体温上升和月经复潮时间较达那唑组为短。结论：手术后加用米非司酮可明显改善患者症状和体征，疗效与达那唑类似，但副反应明显减少。10mg／d米非司酮3个月治疗可使血清E：保持在卵泡期水平。Objective： To compare the efficacy and safety of mifepfistone and danazol in the treatment of patients with endometfiosis after conservative surgery. Methods： 72 patients with endometrlosis after conservative surgery were treated orally either with mifepristone 10 mg/d （ group M, n = 37） or danazo1200 mg 2 ～3 times/d （ group D, n = 35） for 3 months. Changes of symptoms and signs, serum sex hormone levels as well as side effects were assessed before and at the end of the therapy. Results： During the treatment, the symptoms and signs were remarkably relieved in both groups. Side effects including hot flushes, irregular vaginal bleeding, back pain, weight gain and acne, were less commonly seen in group M as compared with group D. After 3 months＇treatment, serum estradlol （ E2 ） levels in group M [ （204.9±45.3 ） pmol/L], but serum E2 levels declined to postmenopausal level in group D [ （94.3±33.0） pmol/ L] . About two weeks after discontinuation of the therapy, serum E2 levels [ （ 1 221.6±384.2） pmol/L] was not significantly different from the normal ovulatory range in group M, but significantly lower in group D [ （815.1±376.0） pmo/L, P 〈0. 05 ]. After discontinuation of the therapy, either basal body temperature raised or menstruation recovered sooner in group M. Conclusion： Mifepristone is equally effective to danazol when combined with conservative surgery in the management of endometriosis with fewer side effects. Serum E2 levels remained in the range of follicular phase after 3 months＇therapy with mifepristone 10 mg/d.

关 键 词：米非司酮 达那唑 子宫内膜异位症 

分 类 号：R711.71[医药卫生—妇产科学]