Lindsay P C, Shaw R W, Bennink H J, Kicovic P
Royal Free Hospital School of Medicine, London, United Kingdom.
Fertil Steril. 1996 Feb;65(2):342-8. doi: 10.1016/s0015-0282(16)58096-0.
To assess whether tibolone can prevent the bone loss and symptomatic side effects normally associated with GnRH agonist (GnRH-a) use and whether tibolone modifies the effect of GnRH-a on endometriosis.
Prospective, double-blind, placebo-controlled, group comparative study.
Gynecological research unit in a London teaching hospital.
Twenty-nine patients with endometriosis and two with fibroids.
Six months of treatment with 3.75 mg/mo IM triptorelin combined with daily tablets of either placebo or 2.5 mg tibolone.
Daily symptom diary for hot flushes and bleeding episodes, laparoscopic scoring of endometriosis, endocrine and biochemical changes, and bone mineral density scans.
Lumbar spine bone mineral density decreased significantly from baseline in the placebo group (-5.1%) but not in the tibolone group (-1.1%). The frequency of hot flushes and sweating episodes was reduced significantly by tibolone. There was no difference between the two treatment groups with regard to the endometriosis scores.
The addition of tibolone to GnRH-a treatment reduces the bone loss and vasomotor symptoms that normally occur with GnRH-a, thus making long-term treatment with GnRH-a safer and more acceptable. It does not negate the therapeutic effect of GnRH-a on endometriosis.
评估替勃龙是否能预防通常与促性腺激素释放激素激动剂（GnRH-a）使用相关的骨质流失和有症状的副作用，以及替勃龙是否会改变GnRH-a对子宫内膜异位症的作用。
前瞻性、双盲、安慰剂对照、组间比较研究。
伦敦一家教学医院的妇科研究单位。
29例子宫内膜异位症患者和2例子宫肌瘤患者。
3.75mg/月的注射用曲普瑞林联合每日口服安慰剂或2.5mg替勃龙治疗6个月。
潮热和出血发作的每日症状日记、子宫内膜异位症的腹腔镜评分、内分泌和生化变化以及骨密度扫描。
安慰剂组腰椎骨密度较基线显著下降（-5.1%），而替勃龙组未下降（-1.1%）。替勃龙显著降低了潮热和出汗发作的频率。两组治疗组在子宫内膜异位症评分方面无差异。
在GnRH-a治疗中添加替勃龙可减少GnRH-a通常引起的骨质流失和血管舒缩症状，从而使GnRH-a的长期治疗更安全、更易接受。它不会抵消GnRH-a对子宫内膜异位症的治疗效果。
