中国药物警戒 ›› 2017, Vol. 14 ›› Issue (2): 82-86.

• 基础与临床研究 • 上一篇    下一篇

不同剂量孕三烯酮治疗子宫内膜异位症期间不规则子宫出血的影响因素和用药方案优化探讨

王俊岭   

  1. 河南省周口市中医院妇产科,河南 周口 466000
  • 收稿日期:2017-03-10 修回日期:2017-03-10 出版日期:2017-02-20 发布日期:2017-03-10
  • 作者简介:王俊玲,女,本科,副主任医师,妇产科常见疾病的临床诊治。

Influence Factors and Medical Scheme Optimization Investigation of Irregular Uterine Bleeding during Treatment of Different Dosage of Gestrinone on Endometriosis

WANG Jun-ling   

  1. Department of Obstetrics and Gynecology, Zhoukou Hospital of Traditional Chinese Medicine, Henan Zhoukou 466000, China
  • Received:2017-03-10 Revised:2017-03-10 Online:2017-02-20 Published:2017-03-10

PDF (PC)

95

摘要： 目的 探讨不同剂量孕三烯酮治疗子宫内膜异位症期间不规则子宫出血的影响因素和用药方案优。方法 选取我院2015年1月至2016年6月于确诊的160例子宫内膜异位症患者,并随机分为3组:每周2次组54例,首月3次组53例,每周3次组53例。各组均于月经第1~5天开始服药,2.5 mg/次。给药期间记录服药情况、症状改善情况、阴道出血情况及其他不适症状,检测并记录患者治疗前后肝肾功能指标和凝血功能指标,并通过多元logistic回归分析的方法计算不规则子宫出相关危险因素及回归系数。结果 ①首月3次组在服药期间和服药3月后不规则子宫出血发生率低于每周2次组和每周3次组,差异具有统计学意义（P<0.05）;②多元logistic回归分析显示,每周2次组发生不规则子宫出血的概率是首月3次组和每周3次组的4倍,而卵巢正常者发生不规则子宫出血的概率是卵巢异常者的3倍,差异具有统计学意义（P<0.05）;③3组患者服药后INR、FIB、PT、TT、APTT在正常范围内均有所升高,3组间各凝血指标比较差异无统计学意义（P>0.05）;④3组患者服药3月后有12例患者ALT轻微升高（49 U·L-1<ALT<100 U·L-1）其中8例来自于每周3次组,2例来自于每周2次组,2例来自于每周2次组,其余患者肝功能指标未见异常,患者服药及随访期间肾功能无异常。结论 ①孕三烯酮是治疗子宫内膜异位症的常用药物,其更适用于卵巢异常的子宫内膜异位症患者;②首月剂量加倍可显著降低患者服药后不规则子宫出血的发生率;③孕三烯酮治疗子宫内膜异位症疗效确切,不良反应轻微,又可减少患者的经济负担,值得临床推广运用。

关键词: 孕三烯酮, 子宫内膜异位症, 不规则子宫出血

Abstract: Objective To investigate the influence factors and medical scheme optimization of irregular uterine bleeding during the treatment of different dosage of gestrinone on endometriosis.Methods Clinical data of 160 patients with endometriosis in our hospital from January 2015 to September 2016 were selected. With the random group division method, the 160 patients were divided into twice a week group (54 cases), three times first month group (53 cases) and three times a week group (53 cases), taking medicine every day 1~day 5 of menstrual cramps, 2.5 mg dose at one time. The condition of dose taking, symptom improvement, vaginal bleeding, and other unpleasant symptoms were recorded during treatment. At the same time detected and recorded the liver function, renal function and blood coagulation function before and after treatment. The related risk factors and the regression coefficient were analyzed by the multiple logistic regression analysis.Results ①In contrast to twice a week group and three times a week group, the incidence of irregular uterine bleeding of double dose first month group was the lowest, there were significant differences between three groups (P<0.05). ②Multiple logistic regression analysis showed that the risk of irregular uterine bleeding of twice a week group was 4-fold higher than that in three times first month group and three times a week group. And in contrast to the abnormal ovarian volume, the risk of normal uterine bleeding of the abnormal ovarian volume was 4-fold higher (P<0.05). ③INR, FIB, PT, TT and APTT of three group were increased after treatment but all of them were in normal range, there were also no significant differences between the groups. ④After the treatment of three months, 12 cases of ALT levels were slightly elevated (49 U·L-1<ALT<100 U·L-1), 8 cases of them came from three times a week group, 2 cases of them came from twice a week group, the other 2 cases of them came from double dose first month group, the remaining patients had no liver and renal function damage.Conclusion ①Gestrinone is commonly used drugs for the treatment of endometriosis. It is more suitable for endometriosis patients with abnormal ovarian. ②First double dose can significantly decrease the incidence of irregular uterine bleeding after taking the medicine. ③Gestrinone is safe and effective, can reduce economic burden of patients, and it is worth popularizing.

Key words: gestrinone, endometriosis, irregular uterine bleeding

中图分类号: