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目的探究左炔诺孕酮宫内节育系统(曼月乐)联合注射用醋酸曲普瑞林(达菲林)、屈螺酮炔雌醇片(优思明)治疗子宫腺肌症中的临床疗效。方法 82例拒绝手术治疗的子宫腺肌症患者,按照完全随机的方法分成A组(28例)、B组(27例)和C组(27例)。A组患者给予曼月乐进行治疗,B组患者给予曼月乐和达菲林进行治疗,C组患者给予曼月乐和优思明进行治疗。对比三组患者的临床疗效及并发症情况。结果 A组患者的脱环率为14.3%,B组为0,C组为14.8%,B组患者的脱环率明显低于A组和C组(P<0.05);A组患者的脱环率与C组比较差异无统计学意义(P>0.05)。A组患者阴道不规则出血发生率明显高于B组和C组(P<0.05);B组患者阴道不规则出血发生率与C组比较,差异无统计学意义(P>0.05)。A、B、C三组患者的痛经缓解率分别为96.4%、100.0%、100.0%;A、B、C三组患者月经改善率分别为96.4%、100%、100%;比较差异均无统计学意义(P>0.05)。结论采用曼月乐联合达菲林、优思明能够降低并发症的发生率,联合达菲林的效果更优,可在临床上推广使用。
Objective To investigate the clinical efficacy of levonorgestrel-derived intrauterine contraceptive system (Mirena) in combination with triptorelin acetate (dafenlin) and drospirenone ethinyl estradiol (Yasmin) in the treatment of adenomyosis . Methods 82 patients with adenomyosis who refused surgery were divided into group A (n = 28), group B (n = 27) and group C (n = 27) according to a completely random method. Patients in group A were treated with Mirena, patients in group B were treated with Mirena and Tamiflu, patients in group C were treated with Mirena and Yousmin. The clinical efficacy and complications of three groups were compared. Results The rate of the group A was 14.3%, the group B was 0, the group C was 14.8%, the rate of the group B was significantly lower than that of the group A and C (P <0.05) There was no significant difference between the two groups in C group (P> 0.05). The incidence of vaginal irregular bleeding in group A was significantly higher than that in groups B and C (P <0.05). The incidence of vaginal irregular bleeding in group B was not significantly different from that in group C (P> 0.05). The alleviating rate of dysmenorrhea in group A, B and C were 96.4%, 100.0% and 100.0% respectively; the improvement rates of menstruation in group A, B and C were 96.4%, 100% and 100% respectively Significance (P> 0.05). Conclusion Mirena combined with Tamiflu, You Siming can reduce the incidence of complications, combined with Tamiflu better, and can be widely used in clinical practice.