Almassinokiani Fariba, Khodaverdi Sepideh, Solaymani-Dodaran Masoud, Akbari Peyman, Pazouki Abdolreza
Department of Obstetrics and Gynecology, Fellowship of Laparoscopy, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Department of Obstetrics and Gynecology, Fellowship of Laparoscopy, Endometriosis Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Med Sci Monit. 2016 Dec 17;22:4960-4966. doi: 10.12659/msm.901838.
BACKGROUND Endometriosis is a disabling disease of reproductive-age women. Dysmenorrhea, dyspareunia, and pelvic pain are the main symptoms of endometriosis. Its etiology is not clear. Endometriosis may have various causes, including vitamin D deficiency, but its effect is controversial. MATERIAL AND METHODS In this double-blind clinical trial, we enrolled patients with endometriosis diagnosed and treated by laparoscopy, with scores of at least 3 for of dysmenorrhea and/or pelvic pain at 8 weeks after surgical treatment. They were randomly prescribed vitamin D (50 000 IU weekly for 12 weeks) or placebo. Severity of pain in the 2 groups (placebo and treatment) was compared by VAS test at 24 weeks after surgical treatment. RESULTS There were 19 patients in the vitamin D group and 20 in the placebo group. Baseline characteristics in the 2 groups were similar. Following the treatment with vitamin D or placebo, we did not find significant differences in severity of pelvic pain (p=0.24) and dysmenorrhea (p=0.45) between the 2 groups. Mean pelvic pain at 24 weeks after laparoscopy in the vitamin D group was 0.84±1.74 and in placebo group it was 0.68±1.70 (p=0.513). Mean dysmenorrhea was 2.10±2.33 in the vitamin D group and 2.73±2.84 in the placebo group (p=0.45). CONCLUSIONS After ablative surgery for endometriosis, vitamin D treatment did not have a significant effect in reducing dysmenorrhea and/or pelvic pain.
子宫内膜异位症是一种困扰育龄期女性的疾病。痛经、性交困难和盆腔疼痛是子宫内膜异位症的主要症状。其病因尚不清楚。子宫内膜异位症可能有多种病因,包括维生素D缺乏,但其影响存在争议。
在这项双盲临床试验中,我们纳入了经腹腔镜诊断和治疗的子宫内膜异位症患者,这些患者在手术治疗8周后痛经和/或盆腔疼痛评分至少为3分。他们被随机分配服用维生素D(每周50000国际单位,共12周)或安慰剂。在手术治疗24周后,通过视觉模拟评分法(VAS)比较两组(安慰剂组和治疗组)的疼痛严重程度。
维生素D组有19名患者,安慰剂组有20名患者。两组的基线特征相似。在服用维生素D或安慰剂治疗后,我们发现两组之间在盆腔疼痛严重程度(p = 0.24)和痛经严重程度(p = 0.45)方面没有显著差异。腹腔镜检查24周后,维生素D组的平均盆腔疼痛评分为0.84±1.74,安慰剂组为0.68±1.70(p = 0.513)。维生素D组的平均痛经评分为2.10±2.33,安慰剂组为2.73±2.84(p = 0.45)。
子宫内膜异位症消融手术后,维生素D治疗在减轻痛经和/或盆腔疼痛方面没有显著效果。