摘要
目的对比地诺孕素与左炔诺孕酮宫内节育系统(LNG-IUS)对子宫内膜异位症治疗的效果。方法选择河源市妇幼保健院2023年7月至2024年6月收治的100例子宫内膜异位症患者。根据治疗方式分为手术组和非手术组,每组再随机分为对照组和观察组。手术组中,对照组(n=30,戈舍瑞林+LNG-IUS治疗)和观察组(n=30,戈舍瑞林+地诺孕素片治疗)。非手术组中,对照组(n=20,戈舍瑞林+LNG-IUS治疗)和观察组(n=20,戈舍瑞林+地诺孕素片治疗),手术组和非手术组均持续用药治疗6个月。对比各组治疗前后疼痛程度、临床疗效、子宫体积、月经量、血红蛋白、血清糖类抗原125(CA125)、内膜厚度以及不良反应。结果在非手术组以及手术组中,各观察组治疗总有效率分别为95.00%、93.33%均高于对照组,差异有统计学意义(P<0.05)。在非手术组以及手术组中,各观察组治疗后疼痛程度评分分别为(2.02±0.11)分、(2.06±0.18)分,均低于对照组,差异有统计学意义(P<0.05)。在非手术组以及手术组中,治疗后,各观察组月经量分别为(30.25±2.74)mL、(30.15±2.14)mL,均少于对照组;血红蛋白水平分别为(129.47±11.89)g/L、(129.41±11.09)g/L,均高于对照组;血清CA125水平分别为(15.28±2.47)U/mL、(15.88±2.27)U/mL,均低于对照组,差异有统计学意义(P<0.05)。在非手术组以及手术组中,治疗后,各观察组子宫大小分别为(71.55±4.54)mm^(3)、(71.25±4.04)mm^(3),内膜厚度分别为(4.17±0.89)mm、(4.15±0.81)mm,均小于对照组,差异有统计学意义(P<0.05)。在非手术组以及手术组中,各组不良反应比较,差异均无统计学意义(P>0.05)。结论无论是手术联合治疗还是非手术治疗,相较于戈舍瑞林+LNG-IUS治疗,戈舍瑞林+地诺孕素片治疗能够有效减轻子宫内膜异位症患者的疼痛程度,改善月经量、血红蛋白、血清CA125,缩小子宫体积,减轻子宫内膜厚度,且安全性较高。
Objective To compare the therapeutic effects of dienogest and the levonorgestrel-releasing intrauterine system(LNG-IUS)on endometriosis.Methods A total of 100 patients with endometriosis admitted to Heyuan Maternal and Child Health Hospital from July 2023 to June 2024 were selected.Based on the treatment approach,they were divided into the surgical group and the non-surgical group,with each group further randomized into a control group and an observation group.In the surgical group,the control group(n=30,treated with goserelin+LNG-IUS)and the observation group(n=30,treated with goserelin+dienogest tablets)were compared.In the non-surgical group,the control group(n=20,treated with goserelin+LNG-IUS)and the observation group(n=20,treated with goserelin+dienogest tablets)were evaluated.Both groups received treatment for 6 months.Pain levels,clinical efficacy,uterine volume,menstrual blood loss,hemoglobin levels,serum carbohydrate antigen125(CA125)levels,endometrial thickness,and adverse reactions were compared before and after treatment.Results In both the non-surgical and surgical groups,the total treatment effectiveness rates in each observation group were 95.00%and 93.33%,respectively,significantly higher than those in the control group,with a statistically significant difference(P<0.05).In both the non-surgical and surgical groups,the post-treatment pain scores in the observation groups were(2.02±0.11)points and(2.06±0.18)points,respectively,significantly lower than those in the control group,with a statistically significant difference(P<0.05).In both the non-surgical and surgical groups,the post-treatment menstrual volumes in the observation groups were(30.25±2.74)mL and(30.15±2.14)mL,respectively,significantly less than those in the control group,while the hemoglobin levels were(129.47±11.89)g/L and(129.41±11.09)g/L,respectively,significantly higher than those in the control group.The serum CA125 levels were(15.28±2.47)U/mL and(15.88±2.27)U/mL,respectively,significantly lower than those in the control group,with statistically significant differences(P<0.05).In both the non-surgical and surgical groups,the post-treatment uterine sizes in the observation groups were(71.55±4.54)mm^(3) and(71.25±4.04)mm^(3),respectively,and the endometrial thicknesses were(4.17±0.89)mm and(4.15±0.81)mm,respectively,all significantly smaller than those in the control group,with statistically significant differences(P<0.05).In both the non-surgical and surgical groups,there were no statistically significant differences in adverse reactions among the groups(P>0.05).Conclusion Whether combined with surgery or used as non-surgical treatment,goserelin+dienogest tablet therapy is more effective than goserelin+LNG-IUS in alleviating pain,improving menstrual blood loss,hemoglobin levels,and serum CA125 levels,reducing uterine volume and endometrial thickness,while maintaining a high safety profile.
作者
古素芬
梁余玉
欧阳甜
GU Sufen;LIANG Yuyu;OUYANG Tian(Department of Gynecology,Heyuan Maternal and Child Health Hospital,Heyuan Guangdong 517000,China;Department of Pharmacy,Heyuan Maternal and Child Health Hospital,Heyuan Guangdong 517000,China)
出处
《天津药学》
2025年第5期572-576,604,共6页
Tianjin Pharmacy
基金
河源市社会发展科技计划(指导性)项目[河科(2023)62号-102]。
