LE微球+DRSP/EE+LNG-IUS治疗子宫内膜异位症的疗效观察  

Effect of LNG-IUS+DRSP/EE+LE Microspheres on Endometriosis

作　　者：陈霖[1] 蒋晓芳[1] 孙静[1] 罗莉[1] CHEN Lin;JIANG Xiaofang;SUN Jing;LUO Li(Department of Obstetrics and Gynecology,Taizhou Hospital of Traditional Chinese Medicine,Taizhou,Jiangsu 225300,China)

机构地区：[1]江苏省泰州市中医院妇产科,江苏泰州225300

出　　处：《转化医学杂志》2024年第5期811-815,共5页Translational Medicine Journal

摘　　要：目的探讨皮下注射醋酸亮丙瑞林(LE)微球联合口服屈螺酮炔雌醇(DRSP/EE)和宫腔内放置左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫内膜异位症(endometriosis,EMs)的疗效。方法选择2019年10月至2022年1月于江苏省泰州市中医院就诊的76例EMs患者为研究对象,采用随机数字表法分为观察组和对照组。观察组38例,采用LE微球+DRSP/EE+LNG-IUS治疗;对照组38例,采用LE微球治疗。分别于DRSP/EE+LE治疗前、治疗结束后对比2组月经期疼痛治疗效果、性激素水平、子宫内膜厚度。LNG-IUS治疗结束后观察并比较2组妊娠情况和复发情况。结果观察组经期疼痛总有效率为97.37%,对照组为76.32%,观察组明显高于对照组(P<0.05)。2组治疗后血清卵泡刺激素(FSH)、雌二醇(E_(2))和黄体生成激素(LH)水平均较治疗前明显降低,且观察组较对照组更低(P<0.05)。2组子宫内膜厚度、行经期均较治疗前下降,且观察组均低于对照组(P<0.05)。观察组的妊娠率高于对照组,而复发率低于对照组(P<0.05)。结论LE微球+DRSP/EE+LNG-IUS治疗EMs有明显疗效,能有效降低性激素水平,减小子宫内膜厚度,缩短行经期,在提高妊娠率的同时,降低复发率,具有较为理想的疗效。Objective To explore the effect of the levonorgestrel intrauterine sustained-release system(LNG-IUS)combined with oral drospirenone and ethinylestradiol(DRSP/EE)along with subcutaneous leuprolide acetate(LE)microspheres in the treatment of endometriosis(EMs).Methods Seventy-six patients with EMs treated in our hospital from October 2019 to January 2022 were randomly divided into an experimental group(n=38)and a control group(n=38)using the random number table method.The experimental group received LNG-IUS+DRSP/EE+LE microspheres,while the control group received LE microspheres alone.Treatment effects,hormone levels,endometrial thickness,and menstrual indicators were compared before and after treatment.After treatment,patients were followed up for 12 months to observe and compare pregnancy and recurrence rates between the two groups.Results The total effective rate of the experimental group was 97.37%,significantly higher than that of the control group(76.32%,P<0.05).After treatment,serum follicle-stimulating hormone(FSH),estradiol(E_(2)),and luteinizing hormone(LH)levels in both groups decreased significantly compared to pre-treatment levels,with the experimental group showing lower post-treatment hormone levels than the control group(P<0.05).Both groups showed reductions in endometrial thickness,menstrual period,and menstrual cycle length,but the experimental group experienced significantly greater reductions than the control group(P<0.05).At 12 months after treatment,the pregnancy rate in the experimental group was higher,while the recurrence rate was lower than in the control group(P<0.05).Conclusion LNG-IUS+DRSP/EE+LE microspheres demonstrated significant efficacy in treating EMs,effectively reducing sex hormone levels,endometrial thickness,and menstrual duration,improving pregnancy rates,and reducing recurrence rates with good safety.

关 键 词：左炔诺孕酮宫内缓释系统 屈螺酮炔雌醇 醋酸亮丙瑞林 子宫内膜异位症 性激素水平 

分 类 号：R711.71[医药卫生—妇产科学]