摘要
目的 :评价长效醋酸甲孕酮 (depotmedroxypro gesteroneacetate ,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 4 8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 2 5例 ,月经来潮 5d内深部肌肉注射DMPA15 0mg ,2 8～ 30d注射 1次 ,共 6次 ;达那唑组 2 3例 ,于月经周期d 1开始口服达那唑 4 0 0mg·d-1,如无明显副反应增至 6 0 0mg·d-1,连续 2 4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4 1.5 % ,6个月后缩小了 5 6 .2 % (P <0 .0 5 )。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 5 2 .2 % (P <0 .0 5 )。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。
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 E 2 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 long-term 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.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2004年第8期889-892,共4页
Chinese Journal of Clinical Pharmacology and Therapeutics
基金
浙江省教委科研基金资助项目 (№SJY0 2 0 10 )
