CAJ | 학술논문

目的：观察戊酸雌二醇联合地屈孕酮治疗非器质性月经过多的临床疗效及安全性。方法选取86例非器质性月经过多患者,采用信封法随机分为2组,每组43例。对照组患者采用戊酸雌二醇联合安宫黄体酮治疗,观察组采用戊酸雌二醇联合地屈孕酮治疗,两组患者均给予补充铁剂、加强营养、注意休息等对症支持治疗,均连续治疗3个周期。按照月经失血图评分法( PBAC )评估两组患者经血量,评分>100分(经血量>80 mL)为月经过多。记录两组患者用药后出血控制时间、出血停止时间,并根据两组患者阴道出血情况进行疗效评定。治疗期间严密观察两组患者不良反应发生情况。结果观察组、对照组的总有效率分别为95．35%、81．40%,两组比较差异有统计学意义( P <0．05)。观察组、对照组的出血控制时间分别为(16．5±2．0) d、(25．6±3．0) d,出血停止时间分别为(23．5±3．8) d、(40．5±5．0) d,两组比较差异均有统计学意义(P<0．05)。观察组治疗1个周期、2个周期、3个周期后,PABC评分明显低于对照组(P<0．05)。观察组、对照组分别有4例(9．30%)、5例(11．63%)发生不良反应,两组比较差异无统计学意义(P>0．05)。结论采用戊酸雌二醇联合地屈孕酮治疗非器质性月经过多,可迅速控制出血,减少月经出血量,不良反应少而轻微。
목적：관찰무산자이순연합지굴잉동치료비기질성월경과다적림상료효급안전성。방법선취86례비기질성월경과다환자,채용신봉법수궤분위2조,매조43례。대조조환자채용무산자이순연합안궁황체동치료,관찰조채용무산자이순연합지굴잉동치료,량조환자균급여보충철제、가강영양、주의휴식등대증지지치료,균련속치료3개주기。안조월경실혈도평분법( PBAC )평고량조환자경혈량,평분>100분(경혈량>80 mL)위월경과다。기록량조환자용약후출혈공제시간、출혈정지시간,병근거량조환자음도출혈정황진행료효평정。치료기간엄밀관찰량조환자불량반응발생정황。결과관찰조、대조조적총유효솔분별위95．35%、81．40%,량조비교차이유통계학의의( P <0．05)。관찰조、대조조적출혈공제시간분별위(16．5±2．0) d、(25．6±3．0) d,출혈정지시간분별위(23．5±3．8) d、(40．5±5．0) d,량조비교차이균유통계학의의(P<0．05)。관찰조치료1개주기、2개주기、3개주기후,PABC평분명현저우대조조(P<0．05)。관찰조、대조조분별유4례(9．30%)、5례(11．63%)발생불량반응,량조비교차이무통계학의의(P>0．05)。결론채용무산자이순연합지굴잉동치료비기질성월경과다,가신속공제출혈,감소월경출혈량,불량반응소이경미。
Objective To observe the efficacy and safety of estradiol valerate combined dydrogesterone in the treatment of non-organic menorrhagia. Methods 86 patients with non-organic menorrhagia were randomly divided into two groups,patients in control group (n=43) were treated with estradiol valerate combined with MPA,patients in ob-servation group (n=43) were given estradiol valerate combined with dydrogesterone,both groups were given iron sup-plements,nutrition,rest and other treatment,the patients were treated for 3 cycles continuously. The volume of menstru-al blood was assessed according to the menstrual blood loss figure score ( PBAC) ,and the score>100 points ( volume of menstrual blood>80 mL) was considered as menorrhagia. The time of bleeding control and stop was recorded,and the efficacy was evaluated,and the adverse effect of the two groups was observed. Results The total effective rate was 95. 35% in observation group and 81. 40% in control group,there was significant difference between the two groups (P<0. 05). The time of bleeding control in observation group and control group were (16. 5 ± 2. 0) d and (25. 6 ± 3. 0) d,and the bleeding stop time were (23. 5 ± 3. 8) d and (40. 5 ± 5. 0) d,there were significant differences be-tween the two groups (P<0. 05). The PABC scores at one cycle,two cycles and three cycles after treatment of obser-vation group were significantly lower than those of control group (P<0. 05). There were 4 cases (9. 30%) and 5 ca-ses (11. 63%) of adverse reactions in observation group and control group,no significant difference was found between the two groups ( P>0. 05 ) . Conclusion Estradiol valerate combined with dydrogesterone treatment for non-organic menorrhagia can quickly control bleeding,reduce the blood volume with rare and mild adverse reactions.