噻唑烷二酮类药物治疗子宫内膜异位症：病例系列。
Thiazolidinediones as therapy for endometriosis: a case series.
机构信息
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich. USA.
出版信息
Gynecol Obstet Invest. 2009;68(3):167-70. doi: 10.1159/000230713. Epub 2009 Jul 30.
BACKGROUND
Current medical therapies for endometriosis result in delayed conception and have not been shown to provide any fertile benefit subsequent to treatment. Thiazolidinediones (TZDs) do not impede conception and have been shown to reduce endometriotic lesions in animal models; however, no studies have been performed in humans. The aim of this study was to provide preliminary data about the effectiveness of a TZD in treating endometriosis-related pain.
METHODS
Case series of women with endometriosis recruited from the University of Michigan as part of an open-label prospective phase 2a clinical trial. Participants were given rosiglitazone, 4 mg daily, for 6 months. Subjective endometriosis symptoms were assessed using a modified Biberoglu and Behrman symptom severity scale and the McGill pain questionnaire.
RESULTS
Two of the 3 patients exhibited improvement in severity of symptoms and pain levels with a concurrent decrease in pain medication, while 1 experienced no change. Rosiglitazone was well tolerated by all patients.
CONCLUSIONS
Combined with data gathered from studies in rats and nonhuman primates, the results from this study offer positive justification for using TZDs as a well-tolerated treatment for endometriosis that can address pain without impeding ovulation and without the need for add-back therapy.
背景
目前治疗子宫内膜异位症的医学疗法会延迟受孕，且治疗后并不能提供任何生育益处。噻唑烷二酮类药物（TZDs）不影响受孕，并且已在动物模型中显示出可减少子宫内膜异位症病变；然而，尚未在人类中进行研究。本研究旨在提供 TZD 治疗子宫内膜异位症相关疼痛的有效性的初步数据。
方法
密歇根大学作为开放标签前瞻性 2a 期临床试验的一部分，从招募的子宫内膜异位症女性中进行病例系列研究。参与者每天服用 4 毫克罗格列酮，持续 6 个月。使用改良的 Biberoglu 和 Behrman 症状严重程度量表和 McGill 疼痛问卷评估主观子宫内膜异位症症状。
结果
3 名患者中的 2 名在症状严重程度和疼痛水平上有所改善，同时疼痛药物用量减少，而 1 名患者没有变化。所有患者均耐受罗格列酮。
结论
结合在大鼠和非人类灵长类动物中进行的研究收集的数据，本研究的结果为将 TZDs 作为一种耐受性良好的子宫内膜异位症治疗方法提供了积极的依据，该方法可以解决疼痛问题，而不会干扰排卵，也不需要添加激素替代治疗。
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