Cirkel U, Ochs H, Schneider H P
Universitätsfrauenklinik Münster, Germany.
Eur J Obstet Gynecol Reprod Biol. 1995 Mar;59(1):61-9. doi: 10.1016/0028-2243(94)02016-8.
To compare treatment efficacy and safety parameters a total of 55 premenopausal women with histologically proven endometriosis (stage II-IV) were randomized to receive the LHRH-analogue depot triptorelin (n = 30) or the steroid danazol (n = 25) for a total of 24 weeks. Immediately after cessation of the endocrine therapy a second-look operation was performed. Four as well as 24 weeks after the end of treatment patients were seen for re-evaluation of clinical symptoms and safety parameters. Estradiol suppression was significantly more pronounced with triptorelin, while the free androgenic index rose with danazol. Both substances were equally effective in reducing endometriotic implants (58% and 51%, respectively). Dysmenorrhea was absent at the end of medical therapy in both treatment groups. Dyspareunia and pelvic pain decreased at least by 50%. Red blood count, thrombocytes, liver enzymes and the atherogenic index rose with danazol, while the urinary calcium/creatinine ratio showed a marked elevation with triptorelin. Adverse effects were mainly due to the hypoestrogenism of the LHRH analogue and the androgenic/anabolic properties of the steroid. Triptorelin and danazol are equally effective in treating endometriosis. Therefore, choice of treatment should be based on the patient's medical history and the pharmacological profile of each substance.
为比较治疗效果和安全性参数，将55例经组织学证实为子宫内膜异位症（II-IV期）的绝经前女性随机分为两组，分别接受促性腺激素释放激素（LHRH）类似物长效曲普瑞林治疗（n = 30）或甾体药物达那唑治疗（n = 25），疗程共24周。内分泌治疗结束后立即进行二次探查手术。治疗结束后4周及24周时，对患者进行临床症状和安全性参数的重新评估。曲普瑞林对雌二醇的抑制作用更为显著，而达那唑使游离雄激素指数升高。两种药物在减少子宫内膜异位植入物方面同样有效（分别为58%和51%）。两个治疗组在药物治疗结束时痛经均消失。性交困难和盆腔疼痛至少减轻了50%。达那唑使红细胞计数、血小板、肝酶和动脉粥样硬化指数升高，而曲普瑞林使尿钙/肌酐比值显著升高。不良反应主要归因于LHRH类似物的低雌激素作用和甾体药物的雄激素/同化特性。曲普瑞林和达那唑在治疗子宫内膜异位症方面同样有效。因此，治疗方案的选择应基于患者的病史和每种药物的药理学特征。
