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子宫内膜异位症患者的生活质量和临床因素,地诺孕素与雌孕激素/地诺孕素随时间变化的作用:一项单中心研究。

Quality of life and clinical factors in women with endometriosis, the role of dienogest vs EE/dienogest over time: a single-center study.

机构信息

Gynaecologic and Obstetric Unit, ARNAS Civico Di Cristina Fatebenefratelli, Piazza Nicola Leotta 4, 90127, Palermo, Italy.

Institute of Translational Pharmacology (IFT), National Research Council of Italy, Via Fosso del Cavaliere 100, 00133, Rome, Italy.

出版信息

Arch Gynecol Obstet. 2023 May;307(5):1503-1512. doi: 10.1007/s00404-023-06942-9. Epub 2023 Feb 4.

Abstract

PURPOSE

The aims of this observational study were: to assess the relationship between psychological variables, pain, Duration Untreated Endometriosis (DUE) in a sample of women with Endometriosis; and to assess the effect of dienogest 2 mg/daily (DNG) and dienogest/ethinylestradiol 0.03 mg/daily (EE/DNG) on Symptoms, QoL, HRQoL, pain and sexual satisfaction, over time.

METHODS

64 women constituted the study group; (56%) took DNG and (44%) took EE/DNG. VAS, SF-36, EHP-30 and ISS were used to assess endometriosis-associated pelvic pain, QoL, HRQoL and sexual satisfaction, respectively. The study included one follow-up at 18 months.

RESULTS

At T0, a longer period of DUE was related both to worst HRQoL and Physical QoL. At T1, a correlation was found between longer DUE and worst HRQoL. At T0, a negative correlation was found between VAS and PCS and between VAS and EHP-30. At T1, the same above correlation was found between VAS and PCS/MCS and VAS and EHP-30 scale. There was a correlation between ISS and VAS. ANOVA showed a reduction in dysmenorrhea, in general pain level and an improvement in emotional wellbeing, relationship with medical profession, and PCS over time, regardless to type of treatment. Moreover, a significant time × treatment group interaction for dysmenorrhea was found.

CONCLUSION

DUE and pain are important variables related to psychological aspects of women with endometriosis. Treatment with both DNG and EE/DNG may have positive effects on the QoL, HRQoL and symptoms. Moreover, DNG seems to have a greater effect than EE/DNG on dyspareunia reduction over time.

摘要

目的

本观察性研究的目的是:评估心理变量、疼痛与未治疗的子宫内膜异位症持续时间(DUE)之间的关系,研究对象为患有子宫内膜异位症的女性;并评估地诺孕素 2mg/天(DNG)和地诺孕素/炔雌醇 0.03mg/天(EE/DNG)对症状、生活质量(QoL)、健康相关生活质量(HRQoL)、疼痛和性满意度的影响,随时间推移而变化。

方法

64 名女性组成研究组;56%服用 DNG,44%服用 EE/DNG。使用视觉模拟评分法(VAS)、36 项简短健康调查问卷(SF-36)、欧洲健康调查问卷-30 项(EHP-30)和女性性满意度量表(ISS)评估与子宫内膜异位症相关的盆腔疼痛、QoL、HRQoL 和性满意度。研究包括 18 个月的一次随访。

结果

T0 时,DUE 时间较长与最差的 HRQoL 和躯体 QoL 相关。T1 时,DUE 时间较长与最差的 HRQoL 之间存在相关性。T0 时,VAS 与躯体成分总分(PCS)和 VAS 与 EHP-30 之间呈负相关。T1 时,VAS 与 PCS/躯体功能总分(MCS)和 VAS 与 EHP-30 量表之间也存在上述相关性。ISS 与 VAS 相关。方差分析显示,无论治疗类型如何,随时间推移,痛经、一般疼痛水平以及情绪健康、与医疗专业人员的关系和 PCS 均得到改善。此外,还发现痛经在时间×治疗组间存在交互作用。

结论

DUE 和疼痛是与子宫内膜异位症女性心理方面相关的重要变量。DNG 和 EE/DNG 治疗可能对 QoL、HRQoL 和症状产生积极影响。此外,DNG 似乎比 EE/DNG 更能随时间改善性交痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd2f/10110631/0b2c91ddfd06/404_2023_6942_Fig1_HTML.jpg

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