Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USA.
Fertil Steril. 2011 Oct;96(4):939-42. doi: 10.1016/j.fertnstert.2011.07.1136. Epub 2011 Aug 24.
To evaluate the use of an aromatase inhibitor for the treatment of endometriosis-related chronic pelvic pain.
Retrospective analysis.
Academic medical center outpatient reproductive endocrinology clinic.
PATIENT(S): Sixteen patients with endometriosis and chronic pelvic pain who previously failed conventional medical and/or surgical therapy.
INTERVENTION(S): Treatment with the aromatase inhibitor letrozole (2.5 mg/d) plus a gonadotropin suppressor (norethindrone acetate, 2.5 mg/d, or a combination oral contraceptive [OC]) for an average of 6 months.
MAIN OUTCOME MEASURE(S): Pain scores were reported at each visit using a visual analogue scale from 0 to 10 (0: no pain, 10: maximum pain).
RESULT(S): Sixteen patients were treated with an aromatase inhibitor for 180 ± 31 days. The median pain score at the start of therapy was 7, and at the end of therapy it was 1.5. In the nine patients who were evaluated after discontinuing therapy, pain scores returned to pretreatment levels. We did not find any correlation between the length of treatment and the overall improvement in pain score.
CONCLUSION(S): Letrozole plus a gonadotropin suppressor substantially improved pain symptoms in patients with endometriosis refractory to conventional therapies; however, pain recurred after treatment was completed.
评估芳香化酶抑制剂治疗子宫内膜异位症相关慢性盆腔痛的效果。
回顾性分析。
学术医疗中心门诊生殖内分泌诊所。
16 例子宫内膜异位症和慢性盆腔痛患者，这些患者先前接受过常规药物和/或手术治疗，但效果不佳。
接受芳香化酶抑制剂来曲唑（2.5mg/d）联合促性腺激素抑制剂（醋酸炔诺酮，2.5mg/d，或复方口服避孕药[OC]）治疗，平均治疗 6 个月。
使用视觉模拟评分法（0 到 10 分，0 分：无痛，10 分：最痛）在每次就诊时报告疼痛评分。
16 例患者接受了芳香化酶抑制剂治疗，平均治疗时间为 180±31 天。治疗开始时的中位数疼痛评分为 7 分，治疗结束时为 1.5 分。在停止治疗后接受评估的 9 例患者中，疼痛评分恢复到治疗前水平。我们未发现治疗时间长短与疼痛评分总体改善之间存在相关性。
来曲唑联合促性腺激素抑制剂可显著改善对常规治疗无效的子宫内膜异位症患者的疼痛症状；然而，治疗结束后疼痛会复发。
