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腹腔镜术后戈舍瑞林联合戊酸雌二醇治疗育龄期子宫内膜异位症的临床观察
Clinical observation of goserelin combined with estradiol valerate in the treatment of endometriosis in patients of childbearing age after laparoscopic surgery
- 中国药房 2024年35卷第14期 页码：1748-1752
- 作者机构：
1.新乡医学院第一附属医院妇科，河南 新乡 453100
2.新乡医学院第一附属医院血管外科，河南 新乡 453100
3.新乡医学院第一附属医院生殖医学科，河南 新乡 453100
- 作者简介：
副主任医师，硕士。研究方向：妇科肿瘤与内分泌。E-mail：wanghuiling0518@126.com
副主任医师，博士。研究方向：生殖内分泌。E-mail：wzf120@126.com
- 基金信息：河南省医学科技攻关计划项目(LHGJ20220616)
DOI：10.6039/j.issn.1001-0408.2024.14.13
中图分类号： R969.4纸质出版日期：2024-07-30，
收稿日期：2023-12-18，
修回日期：2024-06-20，
- 稿件说明：
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王慧玲,马宁,乔磊等.腹腔镜术后戈舍瑞林联合戊酸雌二醇治疗育龄期子宫内膜异位症的临床观察 Δ[J].中国药房,2024,35(14):1748-1752.
WANG Huiling,MA Ning,QIAO Lei,et al.Clinical observation of goserelin combined with estradiol valerate in the treatment of endometriosis in patients of childbearing age after laparoscopic surgery[J].ZHONGGUO YAOFANG,2024,35(14):1748-1752.
王慧玲,马宁,乔磊等.腹腔镜术后戈舍瑞林联合戊酸雌二醇治疗育龄期子宫内膜异位症的临床观察 Δ[J].中国药房,2024,35(14):1748-1752. DOI： 10.6039/j.issn.1001-0408.2024.14.13.
WANG Huiling,MA Ning,QIAO Lei,et al.Clinical observation of goserelin combined with estradiol valerate in the treatment of endometriosis in patients of childbearing age after laparoscopic surgery[J].ZHONGGUO YAOFANG,2024,35(14):1748-1752. DOI： 10.6039/j.issn.1001-0408.2024.14.13.
摘要
目的
2
观察腹腔镜术后戈舍瑞林联合戊酸雌二醇治疗育龄期子宫内膜异位症（EMs）的疗效和安全性。
方法
2
回顾性收集2020年1月－2022年12月在我院接受腹腔镜手术治疗的144例育龄期EMs患者资料，根据术后用药方案分为对照组（70例）和联合组（74例）。对照组患者于腹腔镜手术后首次月经来潮的第1～5天给予醋酸戈舍瑞林缓释植入剂，联合组患者在对照组用药的基础上给予戊酸雌二醇片。观察两组患者的近期疗效和远期疗效，记录术前和术后的疼痛评分、卵巢储备功能及不良反应发生情况。
结果
2
两组患者的近期总有效率、术后1年复发率及性欲下降、阴道干涩、胃肠道反应、皮疹、心律失常的发生率比较，差异均无统计学意义（
P
＞0.05）；联合组患者术后1年自然妊娠率显著高于对照组，早期流产率及潮热出汗、情绪波动、失眠乏力、关节肌肉疼痛、头晕头痛的发生率均显著低于对照组（
P
＜0.05）。术后6个月，两组患者的疼痛程度评分和抗米勒管激素、卵泡刺激素、黄体生成素、雌二醇水平均显著低于同组术前，窦卵泡计数显著高于同组术前，且联合组的抗米勒管激素、黄体生成素、雌二醇水平和窦卵泡计数均显著高于对照组，疼痛程度评分及卵泡刺激素水平均显著低于对照组（
P
＜0.05）。
结论
2
腹腔镜术后戈舍瑞林联合戊酸雌二醇治疗育龄期EMs疗效显著，且安全性较好。
Abstract
OBJECTIVE
2
To observe the efficacy and safety of goserelin combined with estradiol valerate in the treatment of endometriosis （EMs） in patients of childbearing age after laparoscopic surgery.
METHODS
2
The clinical data of 144 patients with EMs of childbearing age who underwent laparoscopic surgery in our hospital from January 2020 to December 2022 were collected retrospectively， and those patients were divided into control group （70 cases） and combination group （74 cases） based on different postoperative medication regimens. Control group was given Acetate goserelin sustained-release implant on the 1st to 5th day of their first menstrual cycle after laparoscopic surgery， while combination group was additionally given Estradiol valerate tablets on the basis of control group. The short-term and long-term efficacy of 2 groups were observed； preoperative and postoperative pain scores， ovarian reserve function， and the incidence of adverse reactions were all recorded in 2 groups.
RESULTS
2
There was no statistically significant difference in short-term total effective rate， 1-year postoperative recurrence rate and the incidence of decreased libido， vaginal dryness， gastrointestinal reactions， rash， or arrhythmia between two groups
（
P
＞0.05）. The natural pregnancy rate of combination group was significantly higher than control group at 1 year after surgery， while the incidence of early miscarriage， hot flashes and sweating， emotional fluctuations， insomnia and fatigue， joint muscle pain， dizziness and headache were significantly lower than control group （
P
＜0.05）. However， at 6 months after surgery， pain scores and the levels of anti-Müllerian hormone， follicle stimulating hormone， luteinizing hormone， estradiol of both groups were significantly lower than before surgery in the same group， while the number of antral follicle count was significantly higher than before surgery in the same group； the levels of anti-Müllerian hormone， luteinizing hormone， estradiol， and the number of antral follicles in the combination group were significantly higher than control group， while pain score and follicle stimulating hormone level were significantly lower than control group （
P
＜0.05）.
CONCLUSIONS
2
The combination of goserelin and estradiol valerate after laparoscopic surgery has a significant therapeutic effect and good safety in the treatment of EMs of childbearing age.
关键词
子宫内膜异位症腹腔镜手术戈舍瑞林戊酸雌二醇妊娠率卵巢储备功能安全性
Keywords
laparoscopic surgerygoserelinestradiol valeratepregnancy rateovarian reserve functionsafety
references
朱思萍，李红，齐英. 子宫内膜异位症患者疾病知晓情况及健康教育需求调查[J]. 重庆医学，2023，52（S01）：304-307.
ZHU S P，LI H，QI Y. Survey on disease awareness and health education needs of patients with endometriosis[J]. Chongqing Med，2023，52（S01）：304-307.
HORNE A W，MISSMER S A. Pathophysiology，diagnosis，and management of endometriosis[J]. BMJ，2022，379：e070750.
杨洁，林叶飞，郑小妹，等. 腹腔镜手术治疗子宫内膜异位症的疗效分析[J]. 中国现代医学杂志，2022，32（16）：57-61.
YANG J，LIN Y F，ZHENG X M，et al. Clinical efficacy of laparoscopic surgery for endometriosis[J]. China J Mod Med，2022，32（16）：57-61.
徐晓飞，石明晴，章芳芳. 补肾活血方联合戈舍瑞林治疗子宫内膜异位症的临床观察[J]. 中华中医药学刊，2019，37（2）：492-495.
XU X F，SHI M Q，ZHANG F F. Clinical observation of strengthening kidney and activating blood decoction combined with goserelin in treatment of patients with endometriosis[J]. Chin Arch Tradit Chin Med，2019，37（2）：492-495.
杨华琴，胡霞，王慧，等. 戈舍瑞林联合替勃龙治疗子宫内膜异位症的临床效果[J]. 解放军医药杂志，2020，32（6）：64-68.
YANG H Q，HU X，WANG H，et al. Clinical effect of goserelin combined with tibolone in the treatment of endometriosis[J]. Med Pharm J Chin People’s Liberation Army，2020，32（6）：64-68.
DELLA CORTE L，BARRA F，MERCORIO A，et al. Tolerability considerations for gonadotropin-releasing hormone analogues for endometriosis[J]. Expert Opin Drug Metab Toxicol，2020，16（9）：759-768.
梁新新，林睿. 二甲双胍联合戊酸雌二醇、克罗米芬治疗多囊卵巢综合征所致不孕症对患者胰岛素、胰岛素抵抗指数水平及卵巢排卵功能的影响[J]. 陕西医学杂志，2023，52（4）：460-463.
LIANG X X，LIN R. Effects of metformin combined with estradiol valerate and clomiphene in treatment of patients with infertility caused by polycystic ovary syndrome on levels of FINS，HOMA-IR and ovarian ovulation function[J]. Shaanxi Med J，2023，52（4）：460-463.
张燕，覃丽英，莫秋，等. 培坤丸联合戊酸雌二醇治疗月经不调的临床研究[J]. 现代药物与临床，2023，38（6）：1418-1422.
ZHANG Y，QIN L Y，MO Q，et al. Clinical study of Peikun pills combined with estradiol valerate in treatment of menstrual disorder[J]. Drugs Clin，2023，38（6）：1418-1422.
谢幸，苟文丽. 妇产科学[M]. 8版. 北京：人民卫生出版社，2013：224-226.
XIE X，GOU W L. Obstetrics and gynecology[M]. 8th ed. Beijing：People’s Health Publishing House，2013：224-226.
LI P S，PENG X M，NIU X X，et al. Efficacy of acupunc-ture for endometriosis-associated pain：a multicenter randomized single-blind placebo-controlled trial[J]. Fertil Steril，2023，119（5）：815-823.
CHAPRON C，MARCELLIN L，BORGHESE B，et al. Rethinking mechanisms，diagnosis and management of endometriosis[J]. Nat Rev Endocrinol，2019，15（11）：666-682.
孙鸿博，刘丽娜，朱曼丽，等. 腹腔镜手术联合GnRH-a治疗子宫内膜异位症近期疗效及预后复发分析[J]. 中国妇产科临床杂志，2023，24（1）：79-80.
SUN H B，LIU L N，ZHU M L，et al. Analysis of short-term efficacy and prognosis recurrence of laparoscopic surgery combined with GnRH-a in the treatment of endometriosis[J]. Chin J Clin Obstet Gynecol，2023，24（1）：79-80.
RESTA C，MOUSTOGIANNIS A，CHATZINIKITA E，et al. Gonadotropin-releasing hormone（GnRH）/GnRH receptors and their role in the treatment of endometriosis[J]. Cureus，2023，15（4）：e38136.
DONNEZ J，DOLMANS M M. GnRH antagonists with or without add-back therapy：a new alternative in the management of endometriosis?[J]. Int J Mol Sci，2021，22（21）：11342.
汪涛，张岩. 子宫内膜异位症保守手术后GnRHa联合戊酸雌二醇反向添加疗法的疗效及对血清VEGF、CA125、IL-6、TNF-α水平的影响[J]. 中国妇幼保健，2019，34（2）：283-285.
WANG T，ZHANG Y. Effect of GnRHa combined with estradiol valerate reverse addition therapy after conservative surgery for endometriosis and its influence on serum VEGF，CA125，IL-6 and TNF-α levels[J]. Matern Child Health Care China，2019，34（2）：283-285.
罗宁. 子宫内膜异位症保留生育功能术后应用性腺激素释放激素激动剂联合不同反加疗法的效果及对相关血清学指标的影响[J]. 中国综合临床，2020，36（5）：393-398.
LUO N. Effect of gonadotropin releasing hormone agonist combined with different add-back therapy and its in-fluence on the related serological indexes after the operation of maintaining fertility function of endometriosis[J]. Clin Med China，2020，36（5）：393-398.
邢雅玲，李芳，杨玉芳，等. 小剂量戊酸雌二醇反向添加疗法对子宫内膜异位症腹腔镜术后卵巢储备功能的影响[J]. 中国妇幼保健，2022，37（2）：284-286.
XING Y L，LI F，YANG Y F，et al. Effect of low-dose estradiol valerate reverse addition therapy on ovarian reserve function after laparoscopic surgery for endometriosis[J]. Matern Child Health Care China，2022，37（2）：284-286.
郁平，姬小凡，王敏，等. 腹腔镜手术联合亮丙瑞林、戊酸雌二醇治疗子宫内膜异位症效果及对腹腔液血管内皮生长因子、糖类抗原125水平影响[J]. 临床误诊误治，2020，33（2）：46-51.
YU P，JI X F，WANG M，et al. Effects of laparoscopic surgery combined with leuprolide and estradiol valerate on endometriosis and its influence on vascular endothelial growth factor and carbohydrate antigen 125 in peritoneal fluid[J]. Clin Misdiagnosis Mistherapy，2020，33（2）：46-51.
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