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目的观察左炔诺孕酮宫内缓释系统(曼月乐)治疗子宫腺肌病的临床疗效。方法选取2012年11月—2013年10月苏州市中西医结合医院收治的子宫腺肌病患者150例,随机分为观察组(76例)与对照组(74例)。观察组采用曼月乐治疗,对照组采用曲普瑞林治疗。观察两组患者治疗前和治疗后3个月痛经程度、月经量、月经来潮时间、血清激素水平及不良反应情况。结果两组患者治疗前痛经程度、月经量及月经来潮时间比较,差异无统计学意义(P>0.05),治疗后3个月观察组患者痛经程度低于对照组,月经量少于对照组,月经来潮时间短于对照组(P<0.05);治疗后3个月两组患者痛经程度低于治疗前,月经量少于治疗前,月经来潮时间短于治疗前(P<0.05);两组患者治疗前血清黄体生成素(LH)、卵泡刺激素(FSH)及雌二醇(E2)水平比较,差异无统计学意义(P>0.05),治疗后3个月观察组患者血清LH、FSH及E2水平高于对照组(P<0.05);治疗后3个月对照组患者血清LH、FSH及E2水平低于治疗前(P<0.05)。结论曼月乐治疗子宫腺肌病的临床疗效显著,可改善痛经程度,减少月经量,缩短月经来潮时间,且对患者卵巢功能无明显影响,安全性较高。
Objective To observe the clinical efficacy of levonorgestrel-releasing intrauterine system (Mirena) in the treatment of adenomyosis. Methods A total of 150 patients with adenomyosis admitted to Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from November 2012 to October 2013 were randomly divided into observation group (76 cases) and control group (74 cases). The observation group was treated with Mirena, while the control group was treated with triptorelin. The levels of dysmenorrhea, menstrual flow, menstrual cramps, serum hormone levels and adverse reactions were observed before treatment and 3 months after treatment in both groups. Results There was no significant difference in dysmenorrhea, menstrual flow and menstrual cramps before treatment between two groups (P> 0.05). The degree of dysmenorrhea in the observation group was lower than that in the control group at 3 months after treatment, and the amount of menstruation was less than that in the control group. Menstrual cramps shorter than the control group (P <0.05); 3 months after treatment, the degree of dysmenorrhea in both groups was lower than before treatment, menstruation less than before treatment, menstrual cramps shorter than before treatment (P <0.05); two groups The levels of serum LH, FSH and E2 in the patients before treatment were not significantly different (P> 0.05). After 3 months of treatment, the levels of serum LH, FSH (P <0.05). The levels of serum LH, FSH and E2 in the control group were lower than those before treatment (P <0.05) 3 months after treatment. Conclusion Mirena treatment of adenomyosis clinical significant effect, can improve the degree of dysmenorrhea, reduce menstrual flow, shorten the menstrual cramps time, and no significant effect on ovarian function in patients with high safety.