左炔诺孕酮缓释系统联合小剂量米非司酮治疗子宫腺肌病的临床研究

目的：研究小剂量米非司酮联合左炔诺孕酮缓释系统（LNG-IUS）治疗子宫腺肌病临床疗效,探讨小剂量米非司酮对于放置LNG-IUS后早期不规则阴道出血的疗效。方法：将84例子宫腺肌病患者随机分为2组,每组42例,治疗组应用小剂量米非司酮联合LNG-IUS治疗,对照组应用LNG-IUS治疗,观察2组患者治疗后3、6、9、12个月临床疗效和不良反应。结果：2组患者6个月时总有效率差异无统计学意义。治疗3个月后,治疗组患者月经间期出血天数、月经期天数多于对照组（P〈0.05）,治疗3、6个月时对照组阴道不规则流血人数多于治疗组（P〈0.05）,其余各时间点2组患者月经情况组间比较差异无统计学意义（P〈0.05）。2组患者治疗后痛经VAS评分较治疗前逐渐下降,差异有统计学意义（P〈0.05）,但各时间点组间比较差异无统计学意义（P〉0.05）;两组不良反应发生率比较差异无统计学意义（P〉0.05）。结论：小剂量米非司酮联合LNG-IUS治疗子宫腺肌病疗效确切,并且能够有效减轻治疗早期不规则阴道出血,可作为子宫腺肌病治疗的优选方案。

Study on low-dose mifepristone combined with levonorgestre-releasing intrauterine system in treatment of adenomyosis

Objective： To study clinical effect of low dose mifepristone and levonorgestre-releasing intrauterine system（LNG-IUS） on adenomyosis, and to discuss it on early irregular vaginal bleeding for placement of LNG- IUS. Methods： Eighty-four patients with adenomyosis were randomly divided into two groups, 42 cases were in each group, the treatment group were treated with low-dose mifepristone combined with LNG-IUS, the control group were treated with LNG-IUS, the clinical curative effect and adverse reaction were observed at 3rd month, 6th month, 9th month and 12th month after treatment. Results： Patients of the two groups at 6th month, there was no significant difference in the total efficiency. After 3 months of treatment, the days of intermenstrual bleeding and menses of patients in the treatment group were more than that of the control group（ P 〈 0.05 ）, after the treatment of 3 months and 6 months, the patients with irregular vaginal bleeding in the control group was more than that of the treatment group （ P 〈 0.05 ）, at the other time of menses in the treatment, there was no statistical significance between two groups （ P 〈 0. 05 ）. The VAS scores of dysmenorrheal of the patients after treatment gradually decreased than before treatment, the difference was statistically significant （ P 〈 0.05 ）, the difference was not statistically significant at different time between groups （ P 〉 0.05 ） ; Compared the incidence of adverse reactions between the two groups, there was no significant difference （ P 〉 0.05 ）. Conclusion： Low- dose of mifepristone combined with LNG-IUS in the treatment of adenomyosis has definite effect, and it can reduce the irregular vaginal bleeding effectively, it can be used as the optimum scheme of adenomyosis.