他莫西芬联合孕三烯酮预防子宫内膜异位症术后复发的疗效观察  

Effect of Tamoxifen Combined with Gestrinone on the Prevention of Postoperative Recurrence of Endometriosis

作　　者：姚晶 孙静 刘素芹[2] YAO Jing;SUN Jing;LIU Su-qin(Department of gynecology and obstetrics in Taikang Xianlin Drum Tower Hospital,Jiangsu Nanjing 210000)

机构地区：[1]泰康仙林鼓楼医院妇科,江苏南京210000 [2]江苏省淮安市淮阴医院妇科,江苏淮安223000

出　　处：《医学临床研究》2020年第1期36-38,共3页Journal of Clinical Research

摘　　要：【目的】探讨他莫西芬联合孕三烯酮预防子宫内膜异位症术后复发的临床疗效。【方法】选取2016年1月至2017年1月在泰康仙林鼓楼医院和江苏省淮安市淮阴医院诊治的86例子宫内膜异位症患者,按照随机数表法分为观察组和对照组,对照组采用孕三烯酮治疗,观察组在对照组的基础上加用他莫西芬治疗。比较两组患者的临床效果、免疫功能、雌激素(E2)和卵泡刺激素(FSH)指标、副作用发生率。【结果】观察组总有效率显著高于对照组(97.7%vs 83.7%),复发率低于对照组(2.32%vs 16.28%),其差异有统计学意义(χ^2有效=5.109,P=0.024,χ^2复发=4.962,P=0.026)。治疗前,两组免疫功能指标和激素水平比较差异无统计学意义(P>0.05);治疗后,两组CD4^+、CD8^+、CD4^+/CD8^+水平均增高,且观察组增高更明显(P<0.05);E2、FSH水平均下降,且观察组下降更为明显,其差异均有统计学意义(P<0.05)。观察组不良反应发生率为2.3%(1/43),显著低于对照组的20.9%(9/43),其差异有统计学意义(P<0.05)。【结论】采用他莫西芬联合孕三烯酮预防子宫内膜异位症术后复发,疗效显著,改善患者免疫功能和激素水平,且安全性高,值得临床推广应用。【Objective】To explore the clinical effect of tamoxifen combined with gestrinone in the prevention of postoperative recurrence of endometriosis.【Methods】From January 2016 to January 2017,86 patients with endometriosis who were treated in Taikang Xianlin Gulou Hospital and Huaiyin Hospital of Huai'an City,Jiangsu Province were randomly divided into the observation group and the control group according to the random number table method.The control group was treated with gestrinone,and the observation group was treated with tamoxifen on the basis of the control group.The clinical effect,immune function,estrogen(E2)and follicle stimulating hormone(FSH)were compared between the two groups.【Results】The total effective rate of the observation group was significantly higher than that of the control group(97.7%vs 83.7%),and the recurrence rate was lower than that of the control group(2.32%vs 16.28%).The difference was statistically significant[χ^2(effective)=5.109,P=0.024;χ^2(recurrence)=4.962,P=0.026].Before treatment,there was no significant difference in immune function indexes and hormone levels between the two groups(P>0.05);after treatment,the levels of CD4^+CD8^+CD4^+/CD8^+ in the two groups were increased,and the increase was more obvious in the observation group(P<0.05);the levels of E2 and FSH were decreased,and the decrease was more obvious in the observation group,and the difference was statistically significant(P V0.05).The incidence of adverse reactions in the observation group was 2.3%(1/43),which was significantly lower than that in the control group 20.9%(9/43),and the difference was statistically significant(P<0.05).【Conclusion】Thmoxifen combined with gestrinone can prevent the recurrence of endometriosis after operation.It has a significant effect,improves the immune function and hormone level of patients,and has a high safety.It is worthy of clinical application.

关 键 词：子宫内膜异位症/外科学 子宫内膜异位症/药物疗法 他莫昔芬/药理学 孕三烯酮/药理学 

分 类 号：R711.71[医药卫生—妇产科学]