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中国临床药理学与治疗学 ›› 2004, Vol. 9 ›› Issue (8): 889-892.

• 研究原著 • 上一篇    下一篇

长效酸甲孕酮治疗子宫内膜异位症术后疼痛复发的疗效和安全性评价

周洁, 雷贞武1, 徐肖文, 吕杰强, 孙静, 王繁   

  1. 温州医学院第二附属医院妇产科, 温州325027, 浙江;
    1四川生殖卫生学院附属医院, 成都610000, 四川
  • 收稿日期:2004-06-10 修回日期:2004-07-02 出版日期:2004-08-26 发布日期:2020-11-20
  • 通讯作者: 周洁,女,本科,副主任医师,研究方向:妇科内分泌及肿瘤。Tel:0577-88816207 E-mail:zhoujie9278@sina.com
  • 作者简介:雷贞武,男,教授。Tel:028-85229800 E-mail:leizhenw@mail.sc.chinfo.net
  • 基金资助:
    浙江省教委科研基金资助项目(№SJY02010)

Evaluation of efficacy and safety of depot medroxyprogesterone acetate in treatment of patients with recurrent pain of postoperative endometriosis

ZHOU Jie, LEI Zhen-Wu1, XU Xiao-Wen, LV Jie-Qiang, SUN Jing,WANG Fang   

  1. Department of Obstetrics Gynecology, Second Affiliated Hospital, Wenzhou Medical College, Wenzhou, 325027, Zhejiang, China ;
    1The Affiliated Hospital, Sichuang Reprocluction Hygiene Institute, Chengdu 61000, Sichuang, China
  • Received:2004-06-10 Revised:2004-07-02 Online:2004-08-26 Published:2020-11-20

摘要: 目的: 评价长效醋酸甲孕酮(depot medroxyprogesterone acetate,DMPA)治疗子宫内膜异位症术后疼痛复发的有效性和安全性。方法: 选择因子宫内膜异位症行保守手术后疼痛复发的患者48 例,随机分为长效醋酸甲孕酮组及达那唑组。长效醋酸甲孕酮组25 例,月经来潮5 d 内深部肌肉注射DMPA 150 mg,28 ~ 30 d 注射1 次,共6 次;达那唑组23 例,于月经周期d 1 开始口服达那唑400 mg·d-1,如无明显副反应增至600 mg·d-1,连续24 周。观察治疗前后症状、体征、肝、肾功能、血性激素变化及月经变化、体重改变等副反应。结果: DMPA 组总主观症状评分于治疗3 个月后下降了82.5 %,6 个月后下降了92.5 %,卵巢异位囊肿于3个月后缩小了41.5 %,6 个月后缩小了56.2 % (P<0.05)。达那唑组总主观症状评分于3、6个月后分别下降了84.1 %和95.1 %,卵巢异位囊肿分别缩小了34.4 %与52.2 % (P<0.05)。两组雌激素(E2)维持在卵泡早期水平。DMPA 主要副作用为阴道点滴状出血或突破性出血、排卵恢复延迟及体重增加,随用药时间延长闭经增加。达那唑主要副作用为肝功能损害、痤疮等雄性素作用及体重增加。结论: 长效醋酸甲孕酮可有效治疗子宫内膜异位症术后疼痛复发,因用药方便、价廉、副作用少等优点,可长期反复治疗。

关键词: 长效醋酸甲孕酮, 达那唑, 子宫内膜异位症, 疼痛复发, 副作用

Abstract: AIM: To evaluate the efficacy and safety of depot medroxyprogesterone acetate in the treatment of patients with recurrent pain of postoperative endometriosis.METHODS: 48 women suffering from recurrent pain of postoperative endometriosis were randomized into either of the following two groups:25 cases in the group of DMPA received intramuscular depot medroxyprogesterone acetate 150 mg every 28-30 days for 24 weeks; 23 cases in the other group of danazol took danazol 400-600 mg everyday for 24 weeks.Symptoms and signs were recorded before and after the treatment, and the menstrual and weight changes were also recorded.The levels of the liver and renal function, and sex hormone were examined at the same time.RESULTS: Total subjective symptoms scores of DMPA showed the decrement of 82.5 % after 12-week and 92.5 % after 24-week treatment.The size decreased 41.5 % in ovarian endometriooma after 12-week treatment and 56.2 % after 24-week treatment, respectively (P<0.05), The total snbjective symptoms scores were decreased 84.1 % and 95.1 % respectively after 12-week and 24-week treatment in the group of receiving danazol. Reductions of 34.4 % and 52.2 % in ovarian endometriooma were observed after 12 weeks and 24 weeks treatment, respectively (P<0.05).Serum E2 remained on the levels of early follicular phase in two groups.The main side effects of DMPA were irregular bleeding or spotting, delaying of ovulation and weight gaining.A longterm use of DMPA typically results in amenorrhea.Liver functional lesion and anabolic androgenic side effects of weight gainning and acne were more common in the group of receiving danazol. CONCLUSION: Depot medroxyprogesterone acetate is an effective agent in treatment of patients with recurrent pain of postoperative endometriosis because of its convenience, low-cost and good compliance with little side effects.It can be used repeatedly over a long period of time.

Key words: DMPA, danazol, endometriosis, recurrent pain, side effects

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