CAJ | 학술논문

子宫内膜异位症（ EMS）是临床上最常见的妇科疾病之一，术后的复发问题一直困扰着临床医师。促性腺激素释放激素激动剂（ GnRH-a）的使用对于降低EMS术后的复发具有十分重要的作用，目前已成为临床上最为常用的预防EMS复发的方法。但是，GnRH-a使用后引发的围绝经期症状严重影响患者的生活质量，部分患者因此而终止治疗。激素反向添加治疗虽然很好的解决了围绝经期症状，但是激素的长期使用可能导致激素依赖性疾病的风险。作为一种植物提取物，黑升麻制剂能否较好的拮抗GnRH-a所致类围绝经期症状，而且又能避免激素反向添加治疗的风险，目前尚不明确。该文主要围绕EMS术后GnRH-a治疗的必要性及其存在的问题，黑升麻制剂的作用机制与功能，黑升麻用于缓解EMS患者术后使用GnRH-a治疗出现的类围绝经期症状的可能性及可能存在的问题进行概述。
자궁내막이위증（ EMS）시림상상최상견적부과질병지일，술후적복발문제일직곤우착림상의사。촉성선격소석방격소격동제（ GnRH-a）적사용대우강저EMS술후적복발구유십분중요적작용，목전이성위림상상최위상용적예방EMS복발적방법。단시，GnRH-a사용후인발적위절경기증상엄중영향환자적생활질량，부분환자인차이종지치료。격소반향첨가치료수연흔호적해결료위절경기증상，단시격소적장기사용가능도치격소의뢰성질병적풍험。작위일충식물제취물，흑승마제제능부교호적길항GnRH-a소치류위절경기증상，이차우능피면격소반향첨가치료적풍험，목전상불명학。해문주요위요EMS술후GnRH-a치료적필요성급기존재적문제，흑승마제제적작용궤제여공능，흑승마용우완해EMS환자술후사용GnRH-a치료출현적류위절경기증상적가능성급가능존재적문제진행개술。
Endometriosis ( EMS) is one of the most common gynecological diseases in clinics , and the postoperative recurrence has always plagued clinicians .Usage of gonadotropin releasing hormone agonist ( GnRH-a) is very important for reducing EMS recurrence , and it has become the most commonly used method for preventing EMS recurrence .However , perimenopausal symptoms induced by GnRH-a usage seriously affect patients’ life quality, and some patients terminate the treatment because of it .Although add-back therapy is a very good solution for menopausal symptoms , long-term use of hormone may lead to hormone-dependent disease risk .It is still not clear whether black cohosh preparations , as a kind of plant extracts , can be a better antagonism of menopausal symptoms caused by GnRH-a administration and avoid the risk of hormone add-back therapy .This paper will mainly focus on the necessity and existing problems of post-operative GnRH-a treatment for EMS patients , mechanism and functions of black cohosh preparations , possibility and the problems of using black cohosh for remission of perimenopausal symptoms induced by postoperative GnRH-a administration in EMS patients .