Baboo Kalianee Devi, Chen Zhengyun, Zhang Xinmei
Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2019 Apr 25;48(2):142-147. doi: 10.3785/j.issn.1008-9292.2019.04.04.
Drug therapy plays an important role in alleviating the symptoms related to adenomyosis, improving the curative effect of surgery, delaying the progress of disease and promoting assisted reproduction. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first choice to control pain associated with adenomyosis, and are the only choice for patients with recent fertility requirements; steroid hormones, gonadotropin releasing hormone agonists and mifepristone can effectively relieve pain and control uterine bleeding, among which oral contraceptives, levonorgestrel-releasing intranterine system (Mirena) and dienogest are more effective and commonly used in clinic. Drug selection should be based on patient's age, symptoms, uterine size, fertility requirements and economical conditions. At present, there is no specific drug for adenomyosis, and symptoms are easy to recur after drug withdrawal, so the long-term drug use needs further study.
药物治疗在缓解子宫腺肌病相关症状、提高手术疗效、延缓疾病进展及促进辅助生殖方面发挥着重要作用。非甾体类抗炎药(NSAIDs)是控制子宫腺肌病相关疼痛的首选药物,也是近期有生育需求患者的唯一选择;甾体激素、促性腺激素释放激素激动剂及米非司酮可有效缓解疼痛并控制子宫出血,其中口服避孕药、左炔诺孕酮宫内缓释系统(曼月乐)及地诺孕素效果更佳且临床常用。药物选择应基于患者年龄、症状、子宫大小、生育需求及经济状况。目前,子宫腺肌病尚无特效药物,停药后症状易复发,因此长期用药尚需进一步研究。