摘要目的 探讨在子宫内膜异位症中促性腺激素释放激素激动剂与口服避孕药联合的临床应用价值.方法 选取2012年1-12月在我院诊断为子宫内膜异位症患者186例,应用随机数字表分为对照组93例和观察组93例,对照组于腹腔镜手术保守治疗后给予妈富隆术后月经第1天口服,1片/d,连续6个月.观察组在手术保守治疗基础上给予以下药物治疗:诺雷德术后1周开始应用,3.6 mg皮下注射,每4周1次,连续3次;妈富隆于诺雷德用药结束后1片/d连续口服3个月,观察两组患者治疗前后总主观症状评分和治疗有效率、受孕率及不良反应发生情况.结果 观察组治疗后总主观症状评分为(0.91 ±0.32)分,明显低于对照组[(1.64±0.74)分],组间比较差异有统计学意义(t=8.73,P＜0.01);观察组治疗有效率为95.70％(89/93),明显高于对照组[82.80％(77/93)],组间比较差异有统计学意义(x2 =4.328,P＜0.05);观察组不良反应发生率为4.30％ (4/93),复发率为3.23％(3/93),均明显低于对照组[16.13％ (15/93)与10.75％ (10/93)],组间比较差异均具有统计学意义(x2值分别为4.854、5.168,P均＜0.05);观察组治疗后不孕患者受孕率为85.71％(12/14),明显高于对照组[61.54％(8/13)],组间比较差异有统计学意义(x2=3.987,P＜0.05).结论 促性腺激素释放激素激动剂联合避孕药能够明显缓解子宫内膜异位症患者临床症状,减少不良反应,降低复发率,提高临床治疗效果及不孕患者受孕率,值得推广应用.

abstractsObjective To investigate the treatment effect of gonadotropin releasing hormone agonist and oral contraceptive on endometriosis diseases.Methods One hundred and eighty-six cases with endometriosis who were hospitalized in Traditional Chinese Medicine Hospital of Fangshan District of Beijing from Jan.2012 to Dec.2012,were randomly divided into control group (93 cases) and observation group (93 cases).Patients in control group were given Marvelon by oral from the first day of menstruation after operation to 6 months,1 tablet/day,and patients in observation group were given Marvelon combined with Zoladex after laparoscopic conservative treatment (3.6 ml subcutaneous injected Zoladex from the first week after operation,4 weeks/time,3 times).The total subjective symptom scores,efficacy rate,Pregnancy rate and adverse reaction were calculated and recorded.Results Subjective symptom score of observation group was (0.91 ± 0.32),significantly lower than that of the control group (1.64 ± 0.74 ; t =8.73,P ＜ 0.01).The efficiency rate in observation group were 95.70％ (89/93) was significantly higher than that in control group(82.80％ (77/93) ;t =4.328,P ＜0.05).Adverse reactions rate and reoccurrence in observation group were 4.30％ (4/93) and 3.23％ (3/93),lower than that of the control group(16.13％ (15/93) and 10.75％ (10/93) ; x2 =4.854,5.168 ; P ＜ 0.05).After treatment,the pregnancy rate in infertile patients of observation group the was 85.71％ (12/14),significantly higher than that of the control group (61.54％ (8/13),x2 =3.987,P ＜ 0.05).Conclusion Gonadotropinreleasing hormone agonist combined contraceptive is worthy of recommendation due to alleviating clinical symptoms,reducing adverse reactions occur,the relapse rate and improving the chances of conceiving infertility patients.