Effect of Mirena combined with yasmin in the treatment of perimenopausal dysfunctional uterine bleeding
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摘要: 目的：探讨曼月乐环联合屈螺酮炔雌醇片治疗围绝经期功能失调性子宫出血的疗效。方法：选取围绝经期功能失调性子宫出血病人178例，依据随机数表法分为联合组和对照组，每组89例。对照组病人在诊刮术后5 d给予12.5 mg米非司酮口服治疗，在此基础上，联合组病人在诊刮术后5 d给予30 μg口服屈螺酮炔雌醇片联合曼月乐环治疗，采用酶联免疫吸附法检测血浆卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）水平，随访6个月，记录出血停止时间、疗效和治疗前后血浆FSH、LH、E2水平，比较治疗前和治疗后2、4、6个月的子宫内膜厚度及不良反应发生情况。结果：联合组病人治疗后出血停止时间（13.07±2.71）d，明显低于对照组的（15.78±3.24）d（P<0.01），联合组治疗有效率高于对照组（P<0.05）；联合组病人治疗后血浆FSH、LH、E2水平均明显低于对照组（P<0.01）；联合组病人治疗后2、4、6个月的子宫内膜厚度均明显低于对照组（P<0.01）；联合组和对照组病人不良反应发生率差异无统计学意义（P>0.05）。结论：曼月乐环联合屈螺酮炔雌醇片治疗可有效提高围绝经期功能失调性子宫出血病人的治疗疗效，改善病人子宫内分泌环境和降低子宫内膜厚度，且无增加病人不良反应发生的风险，值得临床进一步推广。Abstract: Objective:To investigate the effects of the Mirena combined with yasmin in the treatment of perimenopausal dysfunctional uterine bleeding.Methods:One hundred and seventy-eight patients with perimenopausal dysfunctional uterine bleeding were divided into the joint group and control group according to the random number table(78 cases each group).After 5 d of diagnostic curettage,the control group was treated with 12.5 mg of mifepristone,and the joint group was additionally treated with 30 μg of yasmin combined with mirena by oral based on control group.The serum levels of follicle hormone assay,luteinizing hormone(LH) and estradiol(E2) in two groups were detected using enzyme-linked immunosorbent assay.Two groups were followed up for 6 months.The amount of bleeding and menstruation,and serum levels of FSH,LH and E2 in two groups before and after treatment were recorded.The endometrial thickness and incidence rate of adverse reactions in two groups before and after 2,4 and 6 months of treatment were observed.Results:After treatment,the haemorrhage stopping time in joint group[(13.07±2.71)d] was significantly lower than that in control group[(15.78±3.24)d](P<0.01),and the treatment efficiency in joint group was higher than that in control group(P<0.05).After treatment,and the serum levels of FSH,LH and E2 in joint group were higher than those in control group(P<0.01).After 2,4 and 6 months of treatment,the endometrial thickness in joint group were significantly lower than that in control group(P<0.01).The difference of the incidence rate of adverse reactions between two groups was not statistically significant(P>0.05).Conclusions:The treatment of Mirena combined with yasmin can effectively improve the perimenopausal dysfunctional uterine bleeding and uterine endocrine environment,reduce the endometrial thickness,and do not increase the incidence of adverse reaction,which is worthy of further promotion.
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Keywords:
- dysfunctional uterine bleeding /
- perimenopause /
- Mirena /
- yasmin
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