Fedele Luigi, Bianchi Stefano, Frontino Giada
Fondazione Policlinico, Mangiagalli e Regina Elena, Clinica Ostetrica e Ginecologica II, Università di Milano, Istituto Luigi Mangiagalli, Via della Commenda 12, 20122 Milano, Italy.
Best Pract Res Clin Obstet Gynaecol. 2008 Apr;22(2):333-9. doi: 10.1016/j.bpobgyn.2007.07.006. Epub 2007 Aug 30.
Like endometriosis and uterine myomas, adenomyosis presents the typical characteristics of oestrogen-dependent diseases. The medical treatment of adenomyosis is based on the hormonal dependency of the disease and its strongly debated similarities with endometriosis. Infact, despite the evident differences between the two conditions, the therapies that treat endometriosis effectively have also been successful for the treatment of adenomyosis. Although the two diseases have distinct epidemiological features, they have the same 'target tissue' for hormonal therapy, namely ectopic endometrium. Recognized approaches are systemic hormonal treatments, which are generally used for endometriosis and are capable of suppressing the oestrogenic induction of the disease, and local hormonal treatment that targets the ectopic endometrium directly. Gonadotropin-releasing hormone agonists, danazol and intrauterine levonorgestrel- or danazol-releasing devices have been used in the treatment of adenomyosis. Despite the solid rational basis for its hormonal treatment, few studies have been performed on medical therapy for adenomyosis.
与子宫内膜异位症和子宫肌瘤一样，子宫腺肌病具有雌激素依赖性疾病的典型特征。子宫腺肌病的药物治疗基于该疾病的激素依赖性及其与子宫内膜异位症备受争议的相似性。事实上，尽管这两种病症存在明显差异，但有效治疗子宫内膜异位症的疗法对子宫腺肌病的治疗也取得了成功。虽然这两种疾病具有不同的流行病学特征，但它们激素治疗的“靶组织”相同，即异位子宫内膜。公认的方法是全身激素治疗，通常用于子宫内膜异位症，能够抑制该疾病的雌激素诱导作用，以及直接针对异位子宫内膜的局部激素治疗。促性腺激素释放激素激动剂、达那唑以及宫内左炔诺孕酮或达那唑释放装置已用于子宫腺肌病的治疗。尽管其激素治疗有坚实的理论基础，但针对子宫腺肌病药物治疗的研究却很少。
