Irvine G A, Campbell-Brown M B, Lumsden M A, Heikkilä A, Walker J J, Cameron I T
University of Glasgow Department of Obstetrics and Gynaecology, Glasgow Royal Infirmary NHS Trust.
Br J Obstet Gynaecol. 1998 Jun;105(6):592-8. doi: 10.1111/j.1471-0528.1998.tb10172.x.
To compare the efficacy and acceptability of the levonorgestrel intrauterine system and norethisterone for the treatment of idiopathic menorrhagia.
A randomised comparative parallel group study.
Gynaecology outpatient clinic in a teaching hospital.
Forty-four women with heavy regular periods and a measured menstrual blood loss exceeding 80 ml.
Twenty-two women had a levonorgestrel intrauterine system inserted within the first seven days of menses, and 22 women received norethisterone (5 mg three times daily) from day 5 to day 26 of the cycle for three cycles.
The main outcome measure was the change in objectively assessed menstrual blood loss after three months of treatment.
When menstrual blood loss at three months was expressed as a percentage of the control, the levonorgestrel intrauterine system reduced menstrual blood loss by 94% (median reduction 103 ml; range 70 to 733 ml), and oral norethisterone by 87% (median reduction 95 ml; range 56 to 212 ml). After three cycles of treatment 76% of the women in the levonorgestrel intrauterine system group wished to continue with the treatment, compared with only 22% of the norethisterone group.
Both the levonorgestrel intrauterine system and oral norethisterone in this regimen provided an effective treatment for menorrhagia in terms of reducing menstrual blood loss to within normal limits. The levonorgestrel intrauterine system was associated with higher rates of satisfaction and continuation with treatment, and thus offers an effective alternative to currently available medical and surgical treatments for menorrhagia.
比较左炔诺孕酮宫内节育系统与炔诺酮治疗特发性月经过多的疗效和可接受性。
随机对照平行组研究。
教学医院的妇科门诊。
44名月经规律且经量多、经量测量超过80毫升的女性。
22名女性在月经周期的前7天内放置左炔诺孕酮宫内节育系统，22名女性在月经周期的第5天至第26天每天服用3次炔诺酮（5毫克），共3个周期。
主要观察指标是治疗3个月后客观评估的经量变化。
以3个月时的经量作为对照的百分比，左炔诺孕酮宫内节育系统使经量减少了94%（中位数减少103毫升；范围70至733毫升），口服炔诺酮使经量减少了87%（中位数减少95毫升；范围56至212毫升）。治疗3个周期后，左炔诺孕酮宫内节育系统组76%的女性希望继续接受治疗，而炔诺酮组只有22%。
在将经量减少至正常范围内方面，左炔诺孕酮宫内节育系统和口服炔诺酮在本方案中均为月经过多提供了有效的治疗方法。左炔诺孕酮宫内节育系统的满意度和继续治疗率更高，因此为目前可用的月经过多的药物和手术治疗提供了一种有效的替代方法。
