Franke H R, van de Weijer P H, Pennings T M, van der Mooren M J
Department of Obstetrics and Gynecology, Medisch Spectrum Twente Hospital Group, Enschede, The Netherlands.
Fertil Steril. 2000 Sep;74(3):534-9. doi: 10.1016/s0015-0282(00)00690-7.
To assess the effect of add-back therapy with continuous combined estrogen-progestin on the GnRH agonist-induced hypoestrogenic state and its effectiveness in healing of endometriotic lesions.
A prospective, randomized, placebo-controlled, double-blind trial.
Multiple centers in The Netherlands.
PATIENT(S): 41 premenopausal women with laparoscopically diagnosed endometriosis (revised American Fertility Society scores >/=2).
INTERVENTION(S): Patients were randomly assigned to receive a subcutaneous depot formulation of goserelin, 3. 6 mg, every 4 weeks, plus oral placebo or oral continuous combined estradiol-norethisterone acetate add-back therapy daily for 24 weeks.
MAIN OUTCOME MEASURE(S): Endometriosis response, bone mineral density, transvaginal ultrasonographic changes, endocrinologic effects, and subjective side effects.
RESULT(S): The number of endometriotic implants was significantly reduced in both groups. In the group that received GnRH agonist plus placebo, bone mineral density of the lumbar spine decreased by 5.02%.
CONCLUSION(S): The effectiveness of GnRH agonist treatment for endometriosis was not decreased by the addition of add-back continuous combined hormone replacement therapy. Bone mineral density of the lumbar spine was maintained and subjective side effects were diminished.
评估连续联合雌激素 - 孕激素的补充治疗对GnRH激动剂诱导的低雌激素状态的影响及其在子宫内膜异位症病灶愈合中的有效性。
一项前瞻性、随机、安慰剂对照、双盲试验。
荷兰的多个中心。
41名经腹腔镜诊断为子宫内膜异位症的绝经前女性（修订后的美国生育协会评分≥2）。
患者被随机分配接受每4周一次皮下注射戈舍瑞林3.6毫克，加口服安慰剂，或每日口服连续联合雌二醇 - 炔诺酮醋酸酯补充治疗，共24周。
子宫内膜异位症反应、骨矿物质密度、经阴道超声变化、内分泌效应和主观副作用。
两组的子宫内膜异位植入物数量均显著减少。在接受GnRH激动剂加安慰剂的组中，腰椎骨矿物质密度下降了5.02%。
添加补充连续联合激素替代治疗不会降低GnRH激动剂治疗子宫内膜异位症的有效性。腰椎骨矿物质密度得以维持，主观副作用减少。
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