Baxter Niki, Black Jean, Duffy S
University Department of Obstetrics and Gynaecology, St James's University Hospital, Leeds, UK.
J Obstet Gynaecol. 2004 Jan;24(1):64-6. doi: 10.1080/01443610310001620323.
One of the most common gynaecological causes of chronic pelvic pain is endometriosis. A lack of correlation between laparoscopic findings and pelvic pain has been reported. As endometriotic lesions are under hormonal influence, the effects of the gonadotrophin-releasing hormone (GnRH) analogues cause shrinkage of the deposits, reducing symptoms caused by them. We carried out a longitudinal, interventional pilot study, examining the effect of leuprorelin acetate 3.75 mg (Prostap SR, Wyeth) on pelvic pain prospectively. Preliminary data shows a decrease in pain scores from before to after treatment which is statistically significant (P<0.0001) as well as a general improvement in other symptoms. Laparoscopy showed that symptom intensity is not always related to severity of endometriosis and the worst symptoms may not necessarily be due to pathology. Therefore, it is beneficial to treat women with CPP with GnRH analogues as first-line management to relieve painful symptoms, avoid surgical risks and save money.
慢性盆腔疼痛最常见的妇科病因之一是子宫内膜异位症。据报道，腹腔镜检查结果与盆腔疼痛之间缺乏相关性。由于子宫内膜异位病变受激素影响，促性腺激素释放激素（GnRH）类似物的作用会使沉积物缩小，减轻由它们引起的症状。我们进行了一项纵向干预性初步研究，前瞻性地考察3.75毫克醋酸亮丙瑞林（抑那通缓释剂，惠氏公司）对盆腔疼痛的影响。初步数据显示，治疗前后疼痛评分降低，具有统计学显著性（P<0.0001），其他症状也普遍有所改善。腹腔镜检查表明，症状强度并不总是与子宫内膜异位症的严重程度相关，最严重的症状不一定是由病变引起的。因此，将GnRH类似物作为一线治疗方法来治疗慢性盆腔疼痛的女性，以缓解疼痛症状、避免手术风险并节省费用是有益的。
