地诺孕素、左炔诺孕酮宫内节育系统治疗子宫腺肌病的临床对比研究  

The Clinical Comparative Study of Dienogest and Levonorgestrel Intrauterine Contraceptive System in the Treatment of Adenomyosis

作　　者：区瑾华 麦小珊 胡道琴[1] 裴雪梅[1] 何思敏 陈素珍 QU Jinhua;MAI Xiaoshan;HU Daoqin;PEI Xuemei;HE Simin;CHEN Suzhen(Jiangmen Maternal and Child Health Hospital,Jiangmen,Guangdong Province,529020 China)

机构地区：[1]江门市妇幼保健院,广东江门529020

出　　处：《中外医疗》2021年第29期117-120,共4页China & Foreign Medical Treatment

基　　金：地诺孕素、左炔诺孕酮宫内节育系统治疗子宫腺肌病的临床对比研究。

摘　　要：目的浅析地诺孕素、左炔诺孕酮宫内节育系统(LNG-IUS)治疗子宫腺肌病的临床对比。方法随机选取该院于2020年3月—2021年2月间收治的80例子宫腺肌病患者作为研究样本,采用随机数字表法分为两组,各40例,A组给予LNG-IUS治疗,B组给予地诺孕素治疗,评价两组治疗效果。结果治疗6个月后,两组患者月经失血图(PBAC)评分、疼痛评分、子宫内膜厚度均低于治疗前、子宫体积小于治疗前,差异有统计学意义(P<0.05)。且A组月经失血图(PBAC)评分(23.12±1.10)分、疼痛评分(1.00±0.30)分、子宫内膜厚度(5.00±1.05)mm均低于B组,A组子宫体积(119.36±3.65)cm3均小于B组,两组比较,差异有统计学意义(t=15.126、17.191、8.817、17.981,P<0.05)。两组乳房胀痛、盆腔、腹腔痛、阴道点滴出血、闭经等不良反应发生率比较,差异无统计学意义(P>0.05)。两组治疗前CA-125(糖类抗原125)水平值比较,差异无统计学意义(P>0.05);A组治疗3个月、6个月时CA-125水平分别为(48.13±4.21)、(30.19±2.11)IU/L,均明显低于B组,差异有统计学意义(t=8.657、14.876,P<0.05)。且A组40例患者中要求保留曼月乐环占比为30例,B组中要求转放置曼月乐环者15例。结论子宫腺肌病应用LNG-IUS治疗效果优于地诺孕素,用药安全性高。Objective To analyze the clinical comparison between dienogest and levonorgestrel intrauterine contraceptive system(LNG-IUS)in the treatment of adenomyosis.Methods A total of 80 patients with adenomyosis admitted to the hospital between March 2020 to February 2021 were conveniently selected as research samples.They were divided into 2 groups with 40 cases by random number table method.Group A was treated with LNG-IUS,and group B was treated with LNG-IUS.The group was treated with dienogest,and the treatment effect of the two groups was evaluated.Results After 6 months of treatment,the menstrual blood loss chart(PBAC)score,pain score,and endometrial thickness of the two groups were lower than before treatment,and the uterine volume was smaller than before treatment.The difference was statistically significant(P<0.05).And the menstrual blood loss chart(PBAC)score of group A(23.12±1.10)points,pain score(1.00±0.30)points,and endometrial thickness(5.00±1.05)mm were all lower than those of group B.The uterine volume of group A was(119.36±3.65)m3 was smaller than that of group B,and the difference between the two groups was statistically significant(t=15.126,17.191,8.817,17.981,P<0.05).There was no significant difference in the incidence of adverse reactions such as breast pain,pelvic pain,abdominal pain,vaginal spotting,and amenorrhea between the two groups(P>0.05).The comparison of the levels of CA-125(carbohydrate antigen 125)between the two groups before treatment was not statistically significant(P>0.05);the levels of CA-125 in group A were(48.13±4.21)IU/L and(30.19±2.11)IU/L was significantly lower than that of group B,the difference was statistically significant(t=8.657,14.876,P<0.05).And the proportion of the 40 patients in group A who requested to keep the Mirena was 30 cases,and in group B,15 cases were requested to be transferred to the Mirena.Conclusion The therapeutic effect of LNG-IUS for adenomyosis is better than that of dienogest,and the medication is safer.

关 键 词：地诺孕素 左炔诺孕酮 子宫腺肌病 不良反应 

分 类 号：R711[医药卫生—妇产科学]