Gregoriou O, Konidaris S, Vitoratos N, Papadias C, Papoulias I, Chryssicopoulos A
2nd Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece.
Int J Fertil Womens Med. 1997 Nov-Dec;42(6):406-11.
The aim of this study was to determine whether or not continuous combined HRT used with GnRH-a for the treatment of endometriosis can prevent hypoestrogenic side effects associated with GnRH-a.
Forty premenopausal women with laparoscopically proven endometriosis entered the study. The patients were randomized into two groups. Group I (n = 19) received 3.75 mg i.m. leuprolide acetate (LA) every 4 weeks for 24 weeks. Group II (n = 21) received 3.7 mg LA combined with 1.25 mg oral conjugated equine estrogen (CEE) and 5 mg oral medroxyprogesterone acetate (MA).
Total revised AFS score as well as total pelvic pain scores decreased significantly (P < .001) in both groups. However, a statistically significant difference of hot flushes and sweating was reported by women receiving LA + HRT as compared to those treated with LA alone (P < .001). Furthermore, the bone loss at the lumbar spine was 4.2% in group I compared to 0.9% in group II at the end of the study.
This study suggests that 1.25 mg CEE + 5 mg MA is effective in preventing hypoestrogenic side effects caused by GnRH-a, while the treatment of endometriosis is not impaired.
本研究旨在确定连续联合激素替代疗法（HRT）与促性腺激素释放激素激动剂（GnRH-a）联合使用治疗子宫内膜异位症时，能否预防与GnRH-a相关的低雌激素副作用。
40名经腹腔镜证实患有子宫内膜异位症的绝经前女性进入本研究。患者被随机分为两组。第一组（n = 19）每4周肌肉注射3.75 mg醋酸亮丙瑞林（LA），共24周。第二组（n = 21）接受3.7 mg LA联合1.25 mg口服结合马雌激素（CEE）和5 mg口服醋酸甲羟孕酮（MA）。
两组的总修正美国生育学会（AFS）评分以及总盆腔疼痛评分均显著降低（P < .001）。然而，与仅接受LA治疗的女性相比，接受LA + HRT治疗的女性潮热和出汗的差异具有统计学意义（P < .001）。此外，研究结束时，第一组腰椎骨量流失为4.2%，而第二组为0.9%。
本研究表明，1.25 mg CEE + 5 mg MA可有效预防GnRH-a引起的低雌激素副作用，同时不影响子宫内膜异位症的治疗。
