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中国临床药理学与治疗学 ›› 2005, Vol. 10 ›› Issue (7): 824-827.

• 研究原著 • 上一篇    下一篇

腹腔镜术后加用米非司酮治疗子宫内膜异位症的疗效评估

徐岚, 张永凤, 张晓红1   

  1. 汕头大学医学院第一附属医院妇产科, 1B 超室, 汕头515041, 广东
  • 收稿日期:2005-05-20 修回日期:2005-06-13 出版日期:2005-07-26 发布日期:2020-11-10
  • 通讯作者: 徐岚, 女, 博士, 副主任医师, 主要从事临床生殖医学研究。Tel:0754-8877917 E-mail: xulandoctor@163.com
  • 基金资助:
    广东省医学科学技术研究基金(NOA2005435)

Clinical evaluation of mifepristone added after laparoscopy in treatment of patients with endometriosis

XU Lan, ZHANG Yong-fen, ZHANG Xiao-hong1   

  1. Department of Obstetrics and Gynecology, 1Department of Ultrasound, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
  • Received:2005-05-20 Revised:2005-06-13 Online:2005-07-26 Published:2020-11-10

摘要: 目的: 评估腹腔镜保守性手术后加用小剂量米非司酮治疗子宫内膜异位症的临床疗效、副作用及停药后对妊娠率、复发率的影响。方法: 158 例经腹腔镜手术确诊为子宫内膜异位症的患者, 随机分为2 组。米非司酮组82 例, 给予米非司酮10 mg 口服, 每日1 次;内美通组76 例, 口服内美通2.5 mg,每周2 次, 均连续用药3 个月。观察并比较2 组临床症状、体征、用药后的副作用及停药后1 年内症状复发率和妊娠率等变化。结果: 两组症状、体征缓解率相似, 均较治疗前明显改善(P <0.01); 米非司酮组体重增加、痤疮、肝功能损害、潮热、阴道干燥和异常出血等副作用发生率明显低于内美通组(P <0.01) 。停药后米非司酮组排卵和月经平均恢复时间较内美通组短(P <0.05); 1 年内米非司酮组不育症患者的累积妊娠率为36.59 %, 内美通组为38.16 %, 两组比较无显著性差异(P >0.05); 1 年内米非司酮组和内美通组症状和体征复发情况相似,两组比较差异无显著性(P >0.05) 。结论: 腹腔镜手术后加用小剂量米非司酮可有效控制子宫内膜异位症患者症状, 提高不孕患者的妊娠机会, 且副作用小、服用方便、价格低廉, 值得临床推广应用。

关键词: 子宫内膜异位症, 米非司酮, 内美通, 腹腔镜术

Abstract: AIM: To evaluate the clinical effects and side effects of lower dosage of mifepristone added after the conservative laparoscopy in the treatment of patients with endometriosis and the influences on the pregnancy and relapse rates within one year after the mifepristone was withdrawed. METHODS: 158 cases of endometriosis patients with laparoscopic confirmation were orally administration either mifepristone 10 mg·d-1 (group M, n =82) or gestrinone 2.5 mg, twice every week(group G, n =78) for 3 months. The clinical symptoms, signs and side effects before and duration of the treatment in both two groups as well as their relapse rate and pregnancy rate one year later after the drug withdrawed were observed and compared. RESULTS: The clinical symptoms and signs in both two groups were significantly improved during the treatment(P <0.01). Side effects including weight gain, acne, liver function damage, hot flushes, vaginal dryness and irregular bleeding in group M were less than those in group G (P <0.01). The average time for the restoration of ovulation and menstruation after drug withdrawing in groupM was earlier than that in group G (P <0.05). The pregnancy rates of the infertile women in group M and G within one year after the drug withdrawing were 36.59 % and 38.16 %, respectively, and there was no statistic significance between two groups (P <0.05). The symptom relapse rates in group M and G within one year after drug withdrawing were similar, and there was no difference between them (P <0.05). CONCLUSION: Lower dosage of mifepristone added after the conservative laparoscopy can not only effectively control the symptoms of patients with endometriosis and improve the pregnancy rate for those complicated with infertility but also have the advantages of fewer side effects, convenient usage and economic price.

Key words: endometriosis, mifepristone, gestrinone, laparoscopy

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