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米非司酮在子宫内膜异位症不同治疗方法中的作用。

Effect of mifepristone in the different treatments of endometriosis.

作者信息

Zhang Y X

出版信息

Clin Exp Obstet Gynecol. 2016;43(3):350-3.

Abstract

OBJECTIVE

To observe the effect of small-dose mifepristone conservative treatment and laparoscopic combined with mifepristone in the treatment of endometriosis.

MATERIALS AND METHODS

Sixty-five endometriosis cases were given small-dose mifepristone conservative treatment and were assessed for the effect of this treatment; 92 cases were randomly divided into control group (taking gestrinone) and observation group (mifepristone), FSH, P, PRL and E2 levels were compared before and after treatment, and pregnancy investigation and each sex hormone level monitoring were followed-up at one year after drug withdrawal.

RESULTS

Using mifepristone, FSH, P, E2, and LH levels all significantly changed six months after treatment and recovered 12 months after drug withdrawal; when comparing the pelvic symptoms, endometrial thickness showed that mifepristone was significantly effective (p < 0.01), and the pregnancy rate was 27.69%. Comparing the two groups, none of the total effective rate, pregnancy rate one year of follow-up, and recurrence rates were significantly different; hormone levels in the both groups were significantly decreased or increased (p < 0.05) after treatment. The two groups had no significant difference (p > 0.05), but 12 months after drug withdrawal, in the control group (not in the observation group), LH level was still significantly different (p < 0.05) compared pre-treatment.

CONCLUSIONS

In the conservative treatment, mifepristone can safely improve the hormone levels, reduce the thickness of the endometrium, alleviate symptoms. With laparoscopic minimally invasive combined drug therapy, mifepristone has a significant effect, with a more followed-up pregnancy rate, less recurrence, and no drug accumulation side-effects, hence it is worthy of clinical application.

摘要

目的

观察小剂量米非司酮保守治疗及腹腔镜联合米非司酮治疗子宫内膜异位症的效果。

材料与方法

65例子宫内膜异位症患者接受小剂量米非司酮保守治疗并评估疗效;92例患者随机分为对照组(服用孕三烯酮)和观察组(服用米非司酮),比较治疗前后促卵泡生成素(FSH)、孕酮(P)、泌乳素(PRL)及雌二醇(E2)水平,并在停药1年后进行妊娠情况调查及各性激素水平监测。

结果

使用米非司酮治疗6个月后,FSH、P、E2及促黄体生成素(LH)水平均有显著变化,停药12个月后恢复;比较盆腔症状及子宫内膜厚度显示米非司酮疗效显著(p<0.01),妊娠率为27.69%。两组比较,总有效率、随访1年妊娠率及复发率均无显著差异;两组治疗后激素水平均显著下降或上升(p<0.05),两组间无显著差异(p>0.05),但停药12个月后,对照组(观察组未出现)LH水平与治疗前相比仍有显著差异(p<0.05)。

结论

在保守治疗中,米非司酮可安全改善激素水平,减少子宫内膜厚度,缓解症状。腹腔镜微创联合药物治疗时,米非司酮效果显著,随访妊娠率更高,复发更少,且无药物蓄积副作用,值得临床应用。

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