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两种低剂量口服避孕药敏定偶和美欣乐在30岁以上女性中的临床比较。

Clinical comparison of two low-dose oral contraceptives, Minulet and Mercilon, in women over 30 years of age.

作者信息

Kirkman R J, Pedersen J H, Fioretti P, Roberts H E

机构信息

University of Manchester, Palatine Centre, England.

出版信息

Contraception. 1994 Jan;49(1):33-46. doi: 10.1016/0010-7824(94)90107-4.

Abstract

A comparative study of two low-dose oral contraceptives, gestodene (GES) 75 mcg/ethinyl oestradiol (EE) 30 mcg and desogestrel (DES) 150 mcg/EE 20 mcg, was conducted in women over 30 years of age. This randomised, open-label study was organised in Denmark, Italy, New Zealand and United Kingdom. A total of 505 women received GES/EE and 501 received DES/EE for 6 consecutive menstrual cycles. The two groups were comparable in terms of demographic and gynaecologic characteristics at baseline. However, the menstrual flow length was slightly longer in the GES/EE group before the start of the treatment. The mean age (+/- SD) was 35 +/- 4 years in the GES/EE group and 35 +/- 5 years in the DES/EE group. The subjects in the GES/EE group contributed data for a total of 2800 cycles and those in the DES/EE group, data for 2796 cycles. There were no pregnancies on medication with either preparation. The results showed that there were significantly more normal cycles in the GES/EE group for cycles 1 to 6. Irregular bleeding between withdrawal bleeds occurred in 10% of GES/EE and 18.5% of DES/EE cycles. Absence of all bleeding was reported in 29 (1%) and 63 (2%) cycles, respectively. The incidence of missed pills was low in both groups (11% of cycles). No significant differences were observed in cycle length or withdrawal bleeding episode length. Withdrawal bleeding mean intensity was statistically significantly greater with GES/EE. However, for both preparations, the mean intensity was close to light bleeding. No clinically significant differences were noted in weight, blood pressure, Papanicolaou smears or laboratory data. Sixty-eight (13.5%) subjects in the GES/EE group and 64 (12.8%) in the DES/EE group discontinued before the end of the study. Among them, 37 (7%) and 40 (8%) in the respective groups withdrew because of adverse reactions. There was no difference between groups in terms of primary reasons for withdrawal. The most frequently reported complaints that led to discontinuation in both groups were headache, nausea and metrorrhagia. Breast tenderness led to the discontinuation of 1 subject in the GES/EE group and 3 in the DES/EE group. These results show excellent cycle control, efficacy and very low rate of side effects with both GES/EE and DES/EE. These low-dose oral contraceptives could be well suited to healthy nonsmoking women requiring contraception up to the age of menopause.

摘要

一项针对两种低剂量口服避孕药的比较研究,即孕二烯酮(GES)75微克/炔雌醇(EE)30微克和去氧孕烯(DES)150微克/EE 20微克,在30岁以上女性中进行。这项随机、开放标签研究在丹麦、意大利、新西兰和英国开展。共有505名女性接受GES/EE,501名女性接受DES/EE,连续服用6个月经周期。两组在基线时的人口统计学和妇科特征方面具有可比性。然而,在治疗开始前,GES/EE组的月经持续时间略长。GES/EE组的平均年龄(±标准差)为35±4岁,DES/EE组为35±5岁。GES/EE组的受试者共贡献了2800个周期的数据,DES/EE组的受试者贡献了2796个周期的数据。服用任何一种制剂期间均未怀孕。结果显示,在第1至6个周期中,GES/EE组的正常周期明显更多。撤退性出血之间的不规则出血在GES/EE组的周期中占10%,在DES/EE组的周期中占18.5%。分别有29个(1%)和63个(2%)周期报告无出血。两组的漏服率均较低(周期的11%)。在周期长度或撤退性出血发作长度方面未观察到显著差异。GES/EE的撤退性出血平均强度在统计学上显著更高。然而,对于两种制剂,平均强度均接近轻度出血。在体重、血压、巴氏涂片或实验室数据方面未发现临床显著差异。GES/EE组有68名(13.5%)受试者和DES/EE组有64名(12.8%)受试者在研究结束前停药。其中,各自组中有37名(7%)和40名(8%)因不良反应停药。两组在停药的主要原因方面没有差异。两组中导致停药的最常见报告的不适症状是头痛、恶心和子宫出血。乳房压痛导致GES/EE组有1名受试者停药,DES/EE组有3名受试者停药。这些结果表明,GES/EE和DES/EE在周期控制、疗效和副作用发生率极低方面表现出色。这些低剂量口服避孕药可能非常适合需要避孕直至绝经年龄的健康非吸烟女性。

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