摘要
目的:探讨子宫内膜异位症患者保守性手术后使用促性腺激素释放激素激动剂(GnRH-a)的最佳方案。方法:选择行腹腔镜下或开腹行保守性手术的子宫内膜异位症患者148例,术后随机分成3组:A组(反向添加疗法组)51例,B组(延长间隔给药疗法组)48例,C组(对照组)49例,分析比较3种不同疗法的症状缓解率和复发率,用药后体内的激素水平及药物的不良反应。结果:(1)3组患者的症状都得到明显的缓解,A组完全缓解45例,完全缓解率为88.24%,B组完全缓解42例,完全缓解率为87.50%,C组完全缓解45例,完全缓解率为91.84%,3组患者完全缓解率无统计学差异(P>0.05)。至用药后2年,A组共复发3例,累计复发率为5.88%,B组共复发3例,累计复发率为6.25%,C组共复发2例,累计复发率为4.08%。3组比较无统计学差异(P>0.05)。(2)用药后6个月,患者体内激素水平明显下降,达基础水平。A组和B组的血清E2水平高于C组,有统计学意义(P<0.05)。A组和B组的血清E2水平差异无显著性(P>0.05)。(3)A组和B组的不良反应发生率明显低于C组,有统计学意义(P<0.05)。(4)3组患者用药后2年骨密度基本恢复到用药前。A组患者用药6个月后骨密度与用药前相比无明显下降(P>0.05)。B组和C组患者用药后6个月骨密度明显下降,与用药前相比,有统计学意义(P<0.05)。结论:与对照组相比,反向添加疗法和延长间隔给药疗法没有降低疗效,而且可以减少药物不良反应,但延长间隔给药疗法不能防止骨质丢失。
OBJECFIVE To discuss the best therapy option with gonadotropin releasing hormone agonist （GnRH-a） for patients of endometriosis after conservative surgery. METHODS Choosing 148 patients after conservative laparoscopic or open surgery for endometriosis from July 2005 to December 2007 in our hospital-line,which were randomly divided into 3 groups：A （add back therapy group） 51 cases, B group （extended interval-dosing regimen group） 48 cases,C group （control group） 49 cases. Analyze and compare the situation after different treatment,concluding recurrence rate of,symptomatic relief, hormones lew el after treatment and drug side effects. RESULTS （1）Symptoms were relieved obviously for all patienls,Symptoms were relieved completely in 45 patients of A group,42 patients of B group and 45 patients of C group. There was no significant difference between the three groups（P〉0. 05）. Two years after treatments, there was no significant difference in recurrence rate between three groups（P〉0. 05）, A group had 3 cases of recurrence, the cumulative recurrence rate was 5. 88% ,B group had 3 cases of recurrence, the cumulative recurrence rate was 6. 25 %,C group had 2 cases of recurrence, the cumulative recurrence rate was 4. 08%. （2）6 months after treatments, hormone levels were significantly decreased, reaching the baseline level. The level of serum E2 of A group and B group were higher than C group, which was statistically significant （P〈0. 05）. The serum E2 levels were not significantly different between A group and B group （P〉0. 05）. （3）Incidence of side effects of A group and/3 group was significantly lower than C group, which was statistically significant （P〈0. 05）. （4）The bone mineral density of all patients had recovered 2 years after treatment. The bone mineral density of patients of A group had not decreased significantly 6 months after treatments . But that of B group and C group had decreased significantly, comparing with before treatment, there was statistically difference （P〈0. 05）. CONCLUSION Compared with the control group,add back therapy and extended-interval dosing regimen did not reduce the efficacy of drug delivery, and can reduce drug side effects, but extended-interval dosing regimen did not prevent bone loss.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2011年第4期305-308,共4页
Chinese Journal of Hospital Pharmacy
