注射用醋酸亮丙瑞林微球联合优思明治疗子宫内膜异位症顽固性疼痛临床分析.docVIP

注射用醋酸亮丙瑞林微球联合优思明治疗子宫内膜异位症顽固性疼痛临床分析 　　【摘要】 目的 探?注射用醋酸亮丙瑞林微球联合屈螺酮炔雌醇片（优思明）治疗子宫内膜异位症顽固性疼痛的临床疗效。方法 60例子宫内膜异位症顽固性疼痛患者， 采用随机双盲分为治疗组和对照组， 各30例。对照组采用注射用醋酸亮丙瑞林微球[促性腺激素释放激素激动剂（GnRH-a）]治疗， 治疗组在对照组基础上序贯加用优思明治疗。比较两组治疗效果、复发情况、疼痛情况及不良反应发生情况。结果 对照组缓解率为73.3%（22/30）， 治疗组缓解率为96.7%（29/30）， 治疗组缓解率明显高于对照组， 差异具有统计学意义（P0.05）；治疗组不规则阴道出血发生率3.3%低于对照组20.0%， 差异有统计学意义（P0.05）。 　　结论 GnRH-a联合优思明用于治疗子宫内膜异位症顽固性疼痛具有明显疗效， 可有效降低复发率、延长复发时限， 比较安全、可靠， 值得临床应用。 　　【关键词】 子宫内膜异位症；顽固性疼痛；注射用醋酸亮丙瑞林微球；屈螺酮炔雌醇片 　　DOI：10.14163/j.cnki.11-5547/r.2018.01.003 　　【Abstract】 Objective To discuss the clinical efficacy of leuprorelin acetate microspheres for injection combined with drospirenone and ethinylestradiol tablets （yasmin） in the treatment of endometriosis with intractable pain. Methods A total of 60 endometriosis patients with intractable pain were divided by random double-blind method into treatment group and control group， with 30 cases in each group. The control group was treated with leuprorelin acetate microspheres for injection [gonadotropin releasing hormone agonist （GnRH-a）]， and the treatment group was treated with sequential treatment of yasmin on the basis of the control group. Comparison were made on treatment effect， recurrent status， pain status and occurrence of adverse reactions between two groups. Results The control group had remission rate as 73.3% （22/30）， while the treatment group had remission rate as 96.7% （29/30）. The treatment group had obviously higher remission rate than the control group， and the difference was statistically significant （P0.05）. The treatment group had lower incidence of irregular vaginal bleeding as 3.3% than 20.0% in the control group， and the difference was statistically significant （P 　　【Key words】 Endometriosis； Intractable pain； Leuprorelin acetate microspheres for injection； Drospirenone and ethinylestradiol tablets 　　子宫内膜异位症多见于年轻患者， 尤其是育龄期妇女发生率较高， 可达10%～15%， 近年来发病呈逐年上升趋势[1]。子?m内膜异位症疼痛是一种包括痛经、腰背痛、性交痛、排便痛、慢性腹盆肌性痛等的非特异性疼痛综合征， 疼痛表现为症状多样化。GnRH-a、优思明均对子宫内膜异位症具有一定