曼月乐与安宫黄体酮治疗围绝经期异常子宫出血的疗效及对性激素水平的影响研究

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目的对比研究曼月乐(左炔诺孕酮宫内缓释系统,LNG-IUS)与安宫黄体酮(MPA)治疗围绝经期异常子宫出血(AUB)的临床疗效及对性激素水平的影响。方法选取2014年6月-2016年6月该院收治的围绝经期AUB患者84例,按照随机数字表法分为两组,观察组(42例)采用曼月乐治疗,对照组(42例)采用安宫黄体酮治疗。比较两组临床疗效、治疗前后子宫内膜厚度、月经量、经期时间、血红蛋白(Hb)水平及性激素水平。结果观察组的治愈率及总有效率分别为83.33%、95.24%,显著高于对照组的59.52%、80.95%(P<0.05);治疗后两组的月经量、月经时间及子宫内膜厚度均显著降低,且观察组显著低于对照组(P<0.05);两组Hb均显著升高,且观察组显著高于对照组(P<0.05);治疗后两组的雌二醇(E2)、卵泡刺激素(FSH)及黄体生成素(LH)水平均较治疗前显著降低,且观察组显著低于对照组(P<0.05);两组不良反应均较少,组间比较差异无统计学意义(P>0.05)。结论 LNG-IUS与MPA治疗围绝经期AUB均具有显著疗效,但LNG-IUS能够更好地调节性激素水平、抑制子宫内膜增生并改善贫血症状,疗效更优且使用更为方便。 Objective To compare the clinical effects of Mirena (levonorgestrel-releasing intrauterine system, LNG-IUS) and angiotensin-a-medroxyprogesterone acetate (MPA) in the treatment of patients with abnormal uterine bleeding in perimenopausal period (AUB) and its effect on sex hormone levels. Methods Eighty-four peri-menopausal AUB patients admitted from June 2014 to June 2016 in our hospital were divided into two groups according to the random number table. The observation group (n = 42) was treated with Mirena, while the control group (n = 42) The use of An Gong progesterone treatment. The clinical efficacy, endometrial thickness, menstrual flow, menstrual period, hemoglobin (Hb) level and sex hormone level before and after treatment were compared between the two groups. Results The cure rate and total effective rate in the observation group were 83.33% and 95.24%, respectively, which were significantly higher than those in the control group (59.52% and 80.95%, P <0.05). The menstrual flow, menstrual time and endometrial thickness (P <0.05). The Hb in both groups were significantly higher than those in the control group (P <0.05), and the levels of estradiol (E2) in the two groups were significantly lower than those in the control group ), Follicle stimulating hormone (FSH) and luteinizing hormone (LH) were significantly lower than those before treatment, and the observation group was significantly lower than the control group (P <0.05). There were fewer adverse reactions in both groups, with no significant difference between the two groups Statistical significance (P> 0.05). Conclusions LNG-IUS and MPA have a significant effect in the treatment of perimenopausal AUB. However, LNG-IUS can better regulate sex hormone levels, inhibit endometrial hyperplasia and improve the symptoms of anemia, which is more effective and more convenient to use.
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