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目的比较3种不同剂量米非司酮治疗子宫肌瘤的临床效果。方法对2004年6月至2007年5月来我院妇科门诊就诊的90例子宫肌瘤患者随机分为3组。A组30例,每天口服米非司酮10mg;B组30例,每日口服米非司酮12.5mg;C组30例,每日口服米非司酮25mg。全部患者均从月经周期第2天开始服药,3个月为1个疗程,治疗前及3个月后用B超测量子宫及肌瘤体积;抽血检查血促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E2)和孕酮(P)。结果3组患者在治疗期间均出现闭经,用药3个月后,3组患者的子宫和肌瘤体积均明显缩小,生殖激素FSH、LH、E2和P用药前后对比,激素平均水平下降,尤其以E2和P下降明显,各组治疗前后对比,差异有统计学意义(P<0.05);组间对比,差异无统计学意义(P>0.05)。如以肌瘤体积缩小20%作为疗效判别指标,则A、B、C组有效率分别为76.66%(23/30)、70.00%(21/30)和73.33%(22/30),组间比较差异无统计学意义(P>0.05)。结论米非司酮治疗子宫肌瘤是较理想的非手术治疗手段,治疗效果与剂量关系不密切,每日口服米非司酮12.5mg可能是较为理想的治疗剂量。
Objective To compare the clinical efficacy of three different doses of mifepristone in the treatment of uterine fibroids. Methods From June 2004 to May 2007, 90 patients with uterine fibroids who came to our hospital gynecological clinic were randomly divided into 3 groups. A group of 30 patients, daily oral mifepristone 10mg; B group of 30 patients, daily oral mifepristone 12.5mg; C group of 30 patients, daily oral mifepristone 25mg. All patients took medication from the second day of the menstrual cycle, three months for a course of treatment, before treatment and 3 months after the measurement of uterine and fibroid volume by B ultrasound; blood test for blood follicle-stimulating hormone (FSH), corpus luteum (LH), estradiol (E2) and progesterone (P). Results The amenorrhea was observed in all three groups. After three months of treatment, the volume of uterus and fibroids in all three groups were significantly reduced. The levels of FSH, LH, E2 and P decreased before and after treatment, and the average level of hormones decreased E2 and P decreased significantly, the difference between before and after treatment was statistically significant (P <0.05). There was no significant difference between the two groups (P> 0.05). If the size of fibroids is reduced by 20%, the effective rates of A, B and C groups are 76.66% (23/30), 70.00% (21/30) and 73.33% (22/30), respectively The difference was not statistically significant (P> 0.05). Conclusion Mifepristone treatment of uterine fibroids is an ideal non-surgical treatment, the treatment effect is not closely related to dose, oral administration of mifepristone 12.5mg may be the ideal therapeutic dose.