雌孕激素反向添加疗法联合GnRHa治疗子宫内膜异位症患者的效果  

Effects of estrogen and progesterone add-back therapy combined with GnRHa on patients with endometriosis

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作  者:邢向茹 贾纪云 XING Xiangru;JIA Jiyun(Department of Gynecology of Xuchang People’s Hospital,Xuchang 461000 Henan,China)

机构地区:[1]许昌市人民医院妇科,河南许昌461000

出  处:《中国民康医学》2022年第23期52-55,共4页Medical Journal of Chinese People’s Health

摘  要:目的:观察雌孕激素反向添加疗法联合促性腺激素释放激素激动剂(GnRHa)治疗子宫内膜异位症患者的效果。方法:回顾性分析2019年1—10月该院收治的98例子宫内膜异位症患者的临床资料,按照治疗方法不同分为对照组和观察组各49例,对照组采取GnRHa治疗,观察组在对照组基础上联合雌孕激素反向添加疗法治疗。比较两组治疗前后雌激素指标[黄体生成素(LH)、卵泡刺激素(FSH)、孕酮(P)、雌二醇(E_(2))]水平、第1~4腰椎骨密度水平、低雌激素症状(Kupperman改良评分)、生命质量[子宫内膜异位症健康相关生活质量问卷(EHP-5)]评分、不良反应发生率、随访1年复发率和妊娠率。结果:治疗后,两组LH、FSH、P、E_(2)水平均低于治疗前,但观察组FSH、P、E_(2)水平均高于对照组,差异有统计学意义(P<0.05);两组LH水平和第1~4腰椎骨密度水平比较,差异均无统计学意义(P>0.05);两组EHP-5评分均高于治疗前,且观察组高于对照组,两组Kupperman改良评分均高于治疗前,但观察组低于对照组,差异均有统计学意义(P<0.05);观察组1年妊娠率高于对照组,差异有统计学意义(P<0.05);两组1年复发率比较,差异无统计学意义(P>0.05);观察组潮热盗汗、焦虑、头痛发生率均低于对照组,差异有统计学意义(P<0.05)。结论:雌孕激素反向添加疗法联合GnRHa治疗子宫内膜异位症患者,可提高生命质量评分和妊娠率,改善雌激素指标水平,降低Kupperman改良评分和不良反应发生率,效果优于单纯GnRHa治疗。Objective:To observe effects of estrogen and progesterone add-back therapy combined with gonadotropin releasing hormone agonist(GnRHa)in treatment of patients with endometriosis.Methods:The clinical data of 98 patients with endometriosis admitted to this hospital from January to October 2019 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,49 cases in each.The control group was treated with GnRHa,while the observation group was treated with estrogen and progesterone add-back therapy on the basis of that of the control group.The levels of estrogen indexes[luteinizing hormone(LH),follicle stimulating hormone(FSH),progesterone(P),estradiol(E_(2))],the bone mineral density of the first to fourth lumbar vertebrae,the low estrogen symptoms(modified Kupperman score),the quality of life[endometriosis health-related quality of life questionnaire(EHP-5)]score,the incidence of adverse reactions,and the recurrence rate and the pregnancy rate after 1 year of follow-up were compared between the two groups before and after the treatment.Results:After the treatment,the levels of LH,FSH,P and E_(2) in the two groups were lower than those before the treatment;but the levels of FSH,P and E_(2) were higher than those in control group;anf the differences were statistically significant(P<0.05).There were no significant differences in the LH level and the bone mineral densities of the first to fourth lumbar vertebrae between the two groups(P>0.05).The EHP-5 scores of the two groups were higher than those before the treatment,and that of the observation group was higher than that of the control group;the modified Kupperman score scores of the two groups were higher than those before the treatment,but that of the observation group was lower than that of the control group;and the differences were statistically significant(P<0.05).The 1-year pregnancy rate of the observation group was higher than that of the control group,and the difference was statistically s

关 键 词:子宫内膜异位症 促性腺激素释放激素激动剂 雌孕激素反向添加疗法 生命质量 妊娠率 雌激素 Kupperman改良评分 

分 类 号:R711.71[医药卫生—妇产科学]

 

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