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目的:探讨促性腺激素释放激素激动剂(GnRH-a)治疗子宫内膜异位症的临床疗效。方法:将2007年8月～2012年1月本医务室收治的102例教师子宫内膜异位症患者随机分为三组,其中50例行GnRH-a加反向添加法治疗(Ⅰ组),28例行GnRH-a退缩疗法(Ⅱ组),24例作为对照组(Ⅲ组),对比三组治疗的临床疗效、垂体-卵巢轴内分泌变化及副反应。结果:Ⅰ组和Ⅱ组的治疗总有效率分别为96.0%和85.7%,均明显高于Ⅲ组(75.0%,P<0.05)。Ⅰ组和Ⅱ组治疗后患者的血清E2、FSH、LH、P的水平较治疗前均明显下降(P均<0.05),Ⅰ组和Ⅱ组之间治疗有效率及治疗后血清E2、FSH、LH、P的水平均无明显差异(P均>0.05),且三组治疗前后骨密度均无显著变化,治疗后三组之间骨密度亦无明显差异(P均>0.05)。结论:运用GnRH-a加反向添加法或退缩疗法治疗子宫内膜异位症,可显著改善患者的内分泌功能,临床效果明显优于常规处理,且副作用较小,值得临床推广应用。
Objective: To investigate the clinical efficacy of gonadotropin-releasing hormone agonist (GnRH-a) in the treatment of endometriosis. Methods: A total of 102 teachers with endometriosis treated in our clinic from August 2007 to January 2012 were randomly divided into three groups, of which 50 were treated with GnRH-a plus reverse addition (group Ⅰ) (N = 28) received GnRH-a withdrawal therapy (group Ⅱ) and 24 patients served as control group (n = 3). The clinical efficacy, pituitary-ovarian axis endocrine changes and side effects were compared between the three groups. Results: The total effective rates in group Ⅰ and group Ⅱ were 96.0% and 85.7%, respectively, which were significantly higher than those in group Ⅲ (75.0%, P <0.05). Serum levels of E2, FSH, LH and P in patients of group Ⅰ and group Ⅱ after treatment were significantly lower than those before treatment (all P <0.05). The therapeutic efficacies of group Ⅰ and group Ⅱ, serum E2, FSH, (P> 0.05). There was no significant difference in BMD between the three groups before and after treatment. There was no significant difference in BMD between the three groups after treatment (all P> 0.05). Conclusion: The treatment of endometriosis with GnRH-a plus reverse addition or withdrawal therapy can significantly improve the endocrine function of patients with clinical effects significantly better than conventional treatment, and the side effects of small, worthy of clinical application.