LNG-IUS联合戈舍瑞林治疗子宫腺肌病的效果及对雌孕激素水平、卵巢功能的影响OA
The Effect of LNG-IUS Combined with Goserelin in the Treatment of Adenomyosis and Its Influence on the Levels of Estrogen and Progesterone and Ovarian Function
目的:探究左炔诺孕酮宫内缓释系统(LNG-IUS)与戈舍瑞林联合用于子宫腺肌病的疗效,分析联合用药对患者雌孕激素、卵巢功能的影响.方法:选取 2022 年 2 月—2025 年 2 月淮安市第五人民医院接收的 88 例子宫腺肌病患者为研究对象.采用随机信封法分成单药组(n=44,实施戈舍瑞林治疗)与联合组(n=44,实施LNG-IUS联合戈舍瑞林治疗).比较两组治疗总有效率、月经失血图(PBAC)评估量表评分、雌孕激素[雌二醇(E2)、孕酮(P)]、卵巢功能[黄体生成素(LH)、卵泡刺激素(FSH)、抗缪勒氏管激素(AMH)]、不良反应发生率.结果:用药 6 个月后,联合组总有效率高于单药组,差异有统计学意义(P<0.05);与用药前比较,两组PBAC评分均降低,且联合组低于单药组,差异有统计学意义(P<0.05);与用药前比较,两组E2、P、LH、FSH、AMH水平均降低,联合组AMH高于单药组,差异有统计学意义(P<0.05),但两组间E2、P、LH、FSH水平对比无明显差异(P>0.05);两组不良事件发生率对比无明显差异(P>0.05).结论:LNG-IUS联合戈舍瑞林应用于子宫腺肌病患者的治疗中可提高疗效,减少月经量,稳定雌孕激素水平,保护卵巢功能,减少不良反应.
Objective:To investigate the efficacy of levonorgestrel intrauterine sustained-release system(LNG-IUS)combined with goserelin in the treatment of adenomyosis,and to analyze the effects of the combination therapy on patients'estrogen-progesterone levels and ovarian function.Method:A total of 88 patients with adenomyosis of uterus admitted to the Fifth People's Hospital of Huai'an City from February 2022 to February 2025 were selected as the research objects.The patients were randomly divided into a monotherapy group(n=44,treated with goserelin)and a combination group(n=44,treated with LNG-IUS combined with goserelin)by the random envelope method.The total effective rate of treatment,transblood loss chart(PBAC)score,estrogen and progesterone[estradiol(E2),progesterone(P)],ovarian function[luteinizing hormone(LH),follicle-stimulating hormone(FSH),anti-Mullerian hormone(AMH)],and the incidence of adverse reactions were compared between the two groups.Result:After 6 months of medication,the total effective rate in the combination group was higher than that in the monotherapy group,with a statistically significant difference(P<0.05).Compared with baseline levels,the PBAC scores in both groups decreased,with the combination group showing a lower reduction than the monotherapy group.The levels of E2,P,LH,FSH,and AMH in both groups decreased compared to baseline,with the combination group exhibiting a higher AMH level than the monotherapy group,and the differences were statistically significant(P<0.05).There were no significant differences were observed in the levels of E2,P,LH,and FSH between the two groups(P>0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion:The application of LNG-IUS combined with goserelin in the treatment of patients with adenomyosis can improve the therapeutic effect,reduce menstrual flow,stabilize the levels of estrogen and progesterone,protect ovarian function,and does not increase adverse reactions.
薛艳娟;刘亚菲;丁晓娟
淮安市第五人民医院 江苏 淮安 223300淮安市第五人民医院 江苏 淮安 223300淮安市第五人民医院 江苏 淮安 223300
左炔诺孕酮宫内缓释系统戈舍瑞林子宫腺肌病卵巢功能
Levonorgestrel intrauterine sustained-release systemGoserelinAdenomyosisOvarian function
《中外医学研究》 2026 (6)
28-31,4
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