Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai Medical College, 419 Fangxie Road, Shanghai, China.
Reprod Sci. 2010 Oct;17(10):904-12. doi: 10.1177/1933719110373807. Epub 2010 Jul 2.
Adenomyosis is a difficult disease to manage and currently there is no investigative drug for adenomyosis on the horizon. We have previously reported in a pilot study that valproic acid (VPA) appears to be effective in treating adenomyosis. In this case series, we further evaluated the efficacy of VPA, with or without a progestin-containing intrauterine device, in the treatment of patients with adenomyosis. We recruited 12 patients with confirmed adenomyosis who complained of dysmenorrehea and had enlarged uterus. All patients took VPA for 3 months, then randomly assigned to 2 groups, 1 receiving no further treatment and the other were inserted with a levonorgestrel-releasing intrauterine system (Mirena) and were followed up for an additional 3 months. The primary outcome measures were the severity of dysmenorrhea and uterine size. Both measures were evaluated prior to the drug treatment and 3 and 6 months after the drug treatment, respectively. We found that VPA treatment resulted in complete resolution of dysmenorrhea and an average reduction in uterine size by 26% 6 months after the treatment, regardless of whether Mirena was used or not. Moreover, the amount of menses decreased significantly. Thus, VPA appears to be well tolerated and a promising drug for treating adenomyosis.
子宫腺肌病是一种难以治疗的疾病，目前尚无针对该疾病的研究性药物。我们之前在一项初步研究中报告称，丙戊酸（VPA）似乎对治疗子宫腺肌病有效。在本病例系列研究中，我们进一步评估了 VPA 联合或不联合含孕激素的宫内节育器（LNG-IUS）在治疗子宫腺肌病患者中的疗效。我们招募了 12 名经证实患有子宫腺肌病且有痛经和子宫增大的患者。所有患者均服用 VPA 3 个月，然后随机分为两组，一组不进行进一步治疗，另一组则置入左炔诺孕酮释放宫内节育系统（Mirena），并随访 3 个月。主要的观察指标是痛经的严重程度和子宫大小。分别在药物治疗前、治疗后 3 个月和 6 个月评估这两个指标。我们发现，VPA 治疗可使痛经完全缓解，且治疗 6 个月后子宫平均缩小 26%，无论是否使用 Mirena。此外，月经量也显著减少。因此，VPA 似乎具有良好的耐受性，是治疗子宫腺肌病的一种有前途的药物。
