Mettler L, Semm K
Postgrad Med J. 1979;55 Suppl 5:27-32.
Based on "second look" pelviscopic control in 438 cases of pelvic endometrosis, additional hormonal antigonadotrophin therapy with danazol represents the most effective treatment for endometriosis. The rationale is well explained by Dmowski and Scommegna (1976). As endocrine treatment alone cannot control severe cases of endometriosis, in recent years a combined 3-step surgical-endocrine-surgical therapy, with thermocoagulation of endometriotic foci, cyst wall resection of endometriomas and consecutive thermocoagulation has proved to be the optimal therapy for endometriosis in general and especially in cases of sterilty. While additional progestogen therapy resulted in a 60% rate of remission of the symptoms of endometriosis, danazol gave a 90% success rate in the 3-step therapy. This 3-step therapy avoids many cases of radical surgery during the reproductive age in women with endometriosis. The pregnancy rate of 312 patients treated between 1976 and 1978 with danazol amounted to 45% compared with a pregnancy rate of 32% treated with lynestrenol and laparoscopy.
基于对438例盆腔子宫内膜异位症患者进行的“二次探查”腹腔镜检查控制情况，采用达那唑进行额外的激素抗促性腺激素治疗是子宫内膜异位症最有效的治疗方法。Dmowski和Scommegna（1976年）对此原理进行了很好的解释。由于单纯内分泌治疗无法控制重度子宫内膜异位症病例，近年来，一种联合的三步手术-内分泌-手术治疗方法，即对子宫内膜异位病灶进行热凝、切除子宫内膜瘤的囊肿壁并连续进行热凝，已被证明是一般子宫内膜异位症尤其是不育病例的最佳治疗方法。虽然额外的孕激素治疗使子宫内膜异位症症状缓解率达到60%，但在三步治疗中达那唑的成功率为90%。这种三步治疗避免了许多患有子宫内膜异位症的育龄妇女进行根治性手术的情况。1976年至1978年期间用达那唑治疗的312例患者的妊娠率为45%，而用炔诺孕酮和腹腔镜检查治疗的患者妊娠率为32%。
