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屈螺酮炔雌醇对中国健康女性的避孕效果及安全性:一项多中心随机对照试验

[Efficacy and safety of drospirenone-ethinylestradiol on contraception in healthy Chinese women: a multicenter randomized controlled trial].

作者信息

Fan Guang-sheng, Bian Mei-lu, Cheng Li-nan, Cao Xiao-ming, Huang Zi-rong, Han Zi-yan, Jing Xiao-ping, Li Jian, Wu Shu-ying, Xiong Cheng-liang, Xiong Zheng-ai, Yue Tian-fu

机构信息

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2009 Jan;44(1):38-44.

Abstract

OBJECTIVE

To evaluate the contraception efficacy, mode of bleeding, side effects and other positive effects of drospirenone-ethinylestradiol (Yasmin) in healthy Chinese women.

METHODS

This was a multicenter, randomized, control study of 768 healthy Chinese women who consulted about contraception. The subjects were randomized into Yasmin group (30 microg ethinylestradiol plus 3 mg drospirenone, 573 cases) or desogestrel group (30 microg ethinylestradiol plus 150 microg desogestrel, 195 cases) with the ratio of 3:1. Each individual was treated for 13 cycles. Further visits were required at cycle 4, cycle 7, cycle 10 and cycle 13 of treatment Weight, height, body mass index were evaluated at each visit. The menstrual distress questionnaire (MDQ) was given to the women at baseline, visit 3 (cycle 7) and visit 5 (after cycle 13).

RESULTS

The values of basal features were similar between two groups (P > 0.05). The Pearl index (method failure) of Yasmin was 0. 208/hundred women year which was lower than that of desogestrel (0. 601/hundred women year). The mode of bleeding was similar between two groups after trial without showing any significant difference. According to MDQ subscale, the improvement of water retention and increasing appetite during inter-menstrual period and water retention and general well-being during menstrual period in the Yasmin group (-0.297, -0.057, 0.033, 0.150 respectively) was more obvious than that in the desogestrel group (-0.108, 0.023, 0.231, -0.023 respectively) with a significant difference (P < 0.05). Some other values which improved in both two groups, especially the improvement of breast tenderness and pain and skin abnormality in Yasmin group (18.0%, 89/494; 12.6%, 62/494) was more distinct than that in desogestrel group (11.3%, 19/168; 5.4%, 9/168). The mean weight increased in desogestrel group (0.57 kg) while it decreased in Yasmin group (-0.28 kg) with a significant difference (P < 0.01).

CONCLUSIONS

Both Yasmin and desogestrel have good efficacy on contraception and similar modes of menstrual bleeding. Yasmin is better than desogestrel in terms of weight control and premenstrual syndrome of oral contraceptive.

摘要

目的

评估炔雌醇环丙孕酮片(优思明)在健康中国女性中的避孕效果、出血模式、副作用及其他积极作用。

方法

这是一项针对768名咨询避孕事宜的健康中国女性的多中心、随机对照研究。受试者按3:1的比例随机分为优思明组(30微克炔雌醇加3毫克屈螺酮,573例)或去氧孕烯组(30微克炔雌醇加150微克去氧孕烯,195例)。每人接受13个周期的治疗。在治疗的第4周期、第7周期、第10周期和第13周期需要进一步随访。每次随访时评估体重、身高、体重指数。在基线、第3次随访(第7周期)和第5次随访(第13周期后)向女性发放月经困扰问卷(MDQ)。

结果

两组的基础特征值相似(P>0.05)。优思明的Pearl指数(方法失败率)为0.208/百名女性年,低于去氧孕烯(0.601/百名女性年)。试验后两组的出血模式相似,无显著差异。根据MDQ子量表,优思明组在经间期的水潴留和食欲增加以及经期的水潴留和总体幸福感方面的改善(分别为-0.297、-0.057、0.033、0.150)比去氧孕烯组(分别为-0.108、0.023、0.231、-0.023)更明显,差异有统计学意义(P<0.05)。两组均有改善的其他一些指标,尤其是优思明组乳房压痛和疼痛以及皮肤异常的改善(18.0%,89/494;12.6%,62/494)比去氧孕烯组(11.3%,19/168;5.4%,9/168)更显著。去氧孕烯组平均体重增加(0.57千克),而优思明组平均体重下降(-0.28千克),差异有统计学意义(P<0.01)。

结论

优思明和去氧孕烯在避孕方面均有良好效果,月经出血模式相似。在体重控制和口服避孕药的经前综合征方面,优思明优于去氧孕烯。

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