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目的探讨米非司酮配伍与不配伍小剂量雌孕激素治疗子宫肌瘤的临床效果。方法将有症状(经量增多、贫血等)的子宫肌瘤患者100例随机分成两组(每组50例),A组为米非司酮组,每天口服米非司酮10mg,连服3个月;B组为米非司酮配伍小剂量雌孕激素组,从月经第8天始每天口服米非司酮10mg,连续8天,后继续服用甲羟孕酮片1mg加乙炔雌二醇0.025mg,连服8天为1个治疗周期,3～4个周期为1个疗程。治疗前后B超测量子宫体积、肌瘤体积;行子宫内膜病检观察子宫内膜变化;检测雌、孕激素水平,血红蛋白,肝肾功能,观察服药后的副作用。结果两组治疗后子宫体积、最大肌瘤的体积均缩小,血红蛋白上升。A组患者在治疗期间出现闭经,子宫内膜及雌孕激素水平维持于增殖早期。B组却使雌激素保持在较低水平,停药后发生周期性内膜剥落,出现“月经来潮”。治疗后两组之间差异无显著性(P>0.05)。结论米非司酮配伍与不配伍小剂量雌孕激素治疗子宫肌瘤均有较好的临床效果,但米非司酮配伍小剂量雌孕激素满足了患者希望“月经来潮”的愿望,增加了治疗的依从性。
Objective To investigate the clinical effect of mifepristone with or without small doses of estrogen and progesterone in the treatment of uterine fibroids. Methods 100 cases of uterine leiomyoma with symptomatic (increased volume, anemia, etc.) were randomly divided into two groups (50 cases in each group), Group A was mifepristone group, oral administration of mifepristone 10mg, and even served 3 Month; Group B, mifepristone with small doses of estrogen and progesterone group, oral Mifepristone 10mg daily from the 8th day of menstruation for 8 days, then continue to take medroxyprogesterone tablets 1mg plus ethinyl estradiol 0.025mg, and even served 8 days for a treatment cycle, 3 to 4 cycles for a course of treatment. B-ultrasound before and after treatment of uterine volume, fibroids volume; line of endometrial disease was observed endometrial changes; detection of estrogen and progesterone levels, hemoglobin, liver and kidney function, observe the side effects after taking medicine. Results After treatment, the volume of the uterus and the size of the largest myoma decreased and the hemoglobin increased. A group of patients during treatment, amenorrhea, endometrial and estrogen and progesterone levels remain in early proliferation. B group estrogen to keep at a low level, after discontinuation of periodic endometrial stripping, there “menstrual cramps.” There was no significant difference between the two groups after treatment (P> 0.05). Conclusion The combination of mifepristone and non-compatibility of small doses of estrogen and progesterone treatment of uterine fibroids have a good clinical effect, but the combination of small doses of mifepristone and estrogen and progesterone patients to meet the hope of “menstrual cramps,” an increase of Treatment compliance.