Liu Xia, Zhang Hong-xia, Wang Li-ping, Fu Wei-ping
Department of Centre for Reproductive Medicine & Infertility, Jiaxing, China.
Zhonghua Yi Xue Za Zhi. 2013 Jan 15;93(3):208-11.
To evaluate the efficacy and adverse effects of half-dose depot long-acting triptorelin in the therapy of endometriosis.
The efficacy and adverse effects of routine-dose or half-dose triptorelin in postoperative endometriosis patients were prospectively observed. A total of 186 postoperative patients with moderate or severe endometriosis received an intramuscular injection of triptorelin every 28 days for 6 times. They were randomly divided into 3 groups, i.e. half-dose group (n = 99): 1.875 mg each time; "draw-back" group (n = 52): 3.75 mg first time, then 1.875 mg each time; and routine-dose group (n = 35): 3.75 mg each time.
Amenorrhea was effectively induced in all patients after the second injection. There was no significant difference in the rate of serum E2 level at Day 28 of every injection below the upper limit of "estrogen threshold (110 - 146 pmol/L)" not stimulating ectopic endometrium proliferation among half-dose group, "draw-back" group and routine-dose group (99% vs 100% and 99.0%, P > 0.05), the percentage of E2 < 37 pmol/L in E2 < 110 pmol/L in half-dose group was significantly lower than that in "draw-back" and routine-dose groups after 2-5(th) injection (69% vs 79% and 85%, P < 0.01), but there was no significant difference after first half-dose and routine-dose injection (71% vs 73%, P > 0.05). No significant difference existed in the rate of pelvic pain relief during the first returning menstruation and the recurrence rate of endometriosis within 1 year postoperation among three groups (both P > 0.05). However, the incidences of menopausal syndrome and severe menopausal syndrome in half-dose group were significantly lower than those in "draw-back" and routine-dose groups (both P < 0.01). And the incompletion rate of six-time drug for severe menopause syndrome was also significantly lower (P < 0.05) while the completion rate of six-time drug use in half-dose group was significantly higher (P < 0.05).
As a postoperative adjuvant, half-dose depot triptorelin therapy is efficacious for endometriosis. It reduces menopausal syndrome and treatment cost and enhances patient compliance.
评估半量长效曲普瑞林治疗子宫内膜异位症的疗效及不良反应。
前瞻性观察常规剂量或半量曲普瑞林对子宫内膜异位症术后患者的疗效及不良反应。共186例中重度子宫内膜异位症术后患者，每28天肌肉注射曲普瑞林1次，共6次。随机分为3组，即半量组（n = 99）：每次1.875 mg；“递减”组（n = 52）：首次3.75 mg，之后每次1.875 mg；常规剂量组（n = 35）：每次3.75 mg。
所有患者在第二次注射后均有效诱导闭经。半量组、“递减”组和常规剂量组在每次注射第28天时血清E2水平低于不刺激异位内膜增殖的“雌激素阈值（110 - 146 pmol/L）”上限的比例无显著差异（99%对100%和99.0%，P > 0.05），在第2 - 5次注射后半量组E2 < 110 pmol/L中E2 < 37 pmol/L的比例显著低于“递减”组和常规剂量组（69%对79%和85%，P < 0.01），但在首次半量和常规剂量注射后无显著差异（71%对73%，P > 0.05）。三组在首次月经复潮时盆腔疼痛缓解率及术后1年内子宫内膜异位症复发率方面均无显著差异（均P > 0.05）。然而，半量组的更年期综合征及严重更年期综合征发生率显著低于“递减”组和常规剂量组（均P < 0.01）。且严重更年期综合征的六次用药未完成率也显著更低（P < 0.05），而半量组六次用药完成率显著更高（P < 0.05）。
作为术后辅助治疗，半量长效曲普瑞林治疗子宫内膜异位症有效。它可减轻更年期综合征，降低治疗成本，并提高患者依从性。
