Morotti Matteo, Remorgida Valentino, Venturini Pier Luigi, Ferrero Simone
Department of Obstetrics and Gynaecology, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Largo R. Benzi 1 16132 Genoa, Italy.
Department of Obstetrics and Gynaecology, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Largo R. Benzi 1 16132 Genoa, Italy.
Eur J Obstet Gynecol Reprod Biol. 2014 Aug;179:63-8. doi: 10.1016/j.ejogrb.2014.05.016. Epub 2014 Jun 2.
Evaluate patient satisfaction at 6-month treatment in women with symptomatic rectovaginal endometriosis and migraine without aura with (progestogen-only contraceptive pill, POP versus sequential combined oral contraceptives, COC) STUDY DESIGN: A patient preference trial including 144 women (82 in the group COC and 62 in the group POP). Main outcome measure was the degree of patient satisfaction by using a Likert scale. Secondary objectives were to evaluate differences in endometriosis-related pain and changes in migraine features during the treatment.
In group POP, 38/62 women (61.2%) were satisfied or very satisfied after treatment, compared to 31/82 women (37.8%) in group COC (p=0.005). The intensity of chronic pelvic pain and dyspareunia significantly decreased at 6-month treatment in both the groups. At 6-month treatment, the number of migraine attacks was lower than at baseline in group POP (p=0.002), while it was not reduced in group COC (p=0.521). The intensity of migraine attacks was significantly different between baseline and 6-month treatment in group POP (p<0.001) but not in group COC (p=0.078).
POP is better tolerated than COC and it seems to ameliorate migraine attacks compared to COC in symptomatic patients with rectovaginal endometriosis and migraine without aura. Both drugs efficaciously relieve endometriosis-related pain symptoms. This study supports the use of the POP in women with rectovaginal endometriosis and coexisting migraine without aura.
评估有症状的直肠阴道子宫内膜异位症合并无先兆偏头痛的女性在接受6个月治疗（使用仅含孕激素的避孕药，即 POP，与序贯复方口服避孕药，即 COC）时的患者满意度。
一项患者偏好试验，纳入144名女性（COC组82名，POP组62名）。主要结局指标是使用李克特量表评估患者满意度。次要目标是评估治疗期间子宫内膜异位症相关疼痛的差异以及偏头痛特征的变化。
POP组中，38/62名女性（61.2%）治疗后满意或非常满意，而COC组为31/82名女性（37.8%）（p = 0.005）。两组在6个月治疗时慢性盆腔疼痛和性交困难的强度均显著降低。在6个月治疗时，POP组偏头痛发作次数低于基线（p = 0.002），而COC组未减少（p = 0.521）。POP组基线与6个月治疗时偏头痛发作强度有显著差异（p < 0.001），而COC组无差异（p = 0.078）。
在有症状的直肠阴道子宫内膜异位症合并无先兆偏头痛的患者中，POP比COC耐受性更好，且与COC相比似乎能改善偏头痛发作。两种药物均能有效缓解子宫内膜异位症相关疼痛症状。本研究支持在有直肠阴道子宫内膜异位症并存无先兆偏头痛的女性中使用POP。
