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目的 探讨孕三烯酮 (内美通 )联合小剂量司米安 (米非司酮 )治疗子宫内膜异位症 (内异症 )的临床疗效及副反应。方法 选择 3 1例经腹腔镜和 /或手术证实的Ⅰ～Ⅳ期内异症患者作为观察对象。用药方法为月经来潮第二天始服孕三烯酮 2 .5mg ,每周 2次 ,司米安 10mg或米非司酮 12 .5mg ,每日 1次 ,连服 12周为一疗程。同时加服保肝药物。用药前后作CA12 5、EMAb和性激素测定。结果 经 1～ 2个疗程治疗后 ,临床症状完全消失 ,月经都被控制 ,且阴道无不规则性流血。临床症状缓解和体征完全消失的有 18例 ,占 5 8.66% ;临床症状缓解体征明显改善的有 10例 ,占 3 2 .2 6% ,总有效率为 90 .3 2 %。 3例继发不孕症中有 1例已妊娠 3 + 月。无肝功能损害和性激素变化 ,仅有少数患者体重增高。结论 孕三烯酮联合小剂量司米安治疗内异症的疗效确切 ,尤其对术后复发或手术不彻底的日后治疗较为理想。由于观察病例数较少 ,随访时间不长 ,远期疗效如何有待进一步积累临床资料和长期随访。
Objective To investigate the clinical efficacy and side effects of gestrinone combined with low dose of semifestine in the treatment of endometriosis. Methods A total of 31 patients with stage Ⅰ-Ⅳ endometriosis confirmed by laparoscopy and / or surgery were selected as the observation objects. Medication method for the first day of menstrual cramps gestrinone 2 .5mg, twice a week, or 10 mg mifepristone mifepristone, once daily, even for 12 weeks for a course of treatment. At the same time add clothes liver medicine. Before and after treatment for CA12 5, EMAb and sex hormone determination. Results 1 to 2 courses of treatment, the clinical symptoms disappeared completely, menstruation was controlled, and the vagina without irregular bleeding. Clinical symptoms and signs of complete disappearance of 18 cases, accounting for 5 8.66%; clinical symptoms were significantly improved in 10 cases, accounting for 32.26%, the total effective rate was 90.32%. 3 cases of secondary infertility in 1 case of pregnancy 3 + month. No liver damage and sex hormone changes, only a small number of patients with weight gain. Conclusions Gestrinone combined with low dose of semimethamine treatment of endometriosis has the exact effect, especially for postoperative recurrence or incomplete surgical treatment is ideal. Due to the small number of cases observed and the short follow-up time, how to further accumulate clinical data and long-term follow-up of long-term efficacy?