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目的探讨他莫西芬联合米非司酮治疗围绝经期子宫肌瘤的效果,为临床治疗子宫肌瘤提供理论基础。方法将98例围绝经期子宫肌瘤患者随机分为两组各49例,以单纯口服米非司酮12.5 mg/d治疗的患者为对照组,口服米非司酮12.5 mg/d联合10 mg/d的他莫西芬治疗的患者为观察组。观察两组患者治疗后6个月的临床效果,包括子宫和子宫肌瘤体积、雌二醇和孕酮水平、月经情况以及不良反应发生率。结果观察组患者治疗总有效率为95.92%,对照组患者治疗总有效率为93.88%,两组差异无统计学意义(P>0.05)。治疗6个月后,观察组患者子宫肌瘤以及子宫体积显著小于对照组患者,差异有统计学意义(P<0.05);雌二醇和孕酮水平显著低于对照组患者,差异均有统计学意义(P<0.05);月经复潮发生率低于对照组患者,而诱导绝经成功率高于对照组患者。结论他莫西芬联合米非司酮可以显著减小子宫和子宫肌瘤体积,降低雌二醇和孕酮水平,改善月经情况,治疗效果确切,具有一定的临床应用价值。
Objective To investigate the effect of tamoxifen combined with mifepristone in treating peri-menopausal uterine fibroids and to provide a theoretical basis for clinical treatment of uterine fibroids. Methods 98 cases of menopausal uterine fibroids were randomly divided into two groups of 49 cases, with a simple oral mifepristone 12.5 mg / d treatment of patients as the control group, oral mifepristone 12.5 mg / d combined with 10 mg The patients treated with tamoxifen / d were observation group. The clinical outcomes of the two groups were observed at 6 months after treatment, including the volume of uterine and uterine fibroids, estradiol and progesterone levels, menstrual conditions and the incidence of adverse reactions. Results The total effective rate of observation group was 95.92%, while that of control group was 93.88%. There was no significant difference between the two groups (P> 0.05). After 6 months of treatment, the uterine fibroids and uterine volume in the observation group were significantly less than those in the control group (P <0.05), and the levels of estradiol and progesterone in the observation group were significantly lower than those in the control group (P <0.05). The incidence of menstruation re-tide was lower than that of the control group, while the success rate of induced menopause was higher than that of the control group. Conclusion Tamoxifen combined with mifepristone can significantly reduce the volume of uterine and uterine fibroids, reduce estradiol and progesterone levels, improve menstrual conditions, the treatment effect is exact, has a certain clinical value.