醋酸甲羟孕酮治疗排卵障碍性异常子宫出血的临床研究OA
Clinical trial of medroxyprogesterone acetate in the treatment of ovulatory dysfunctional uterine bleeding
目的 探讨醋酸甲羟孕酮片治疗排卵障碍性异常子宫出血的临床疗效和安全性.方法 将排卵障碍性异常子宫出血患者按照治疗方法分为对照组和试验组.对照组给予地屈孕酮片每次10 mg,每日2次,服用10 d,从月经第14天开始服用;试验组给予醋酸甲羟孕酮片每次2 mg,每日3次,服用10 d,从月经第14天开始服用,均治疗3个月经周期.比较2组患者的临床疗效、恢复指标、血管生成和炎症反应指标,并进行安全性评价.结果 共入选135例患者,其中对照组64例、试验组71例.治疗后,试验组和对照组患者治疗总有效率分别为88.73％(63例/71例)和82.81％(53例/64例)(P＞0.05).治疗后,试验组和对照组子宫内膜厚度分别为(6.78±1.23)和(7.36±1.48)mm,月经量分别为(60.83±9.78)和(64.61±9.25)mL,止血时间分别为(3.55±1.85)和(3.95±1.82)d;促卵泡生成素(FSH)分别为(6.07±0.96)和(6.51±1.05)U·L-1,催乳素(PRL)分别为(8.92±1.37)和(9.65±1.49)μg·L-1,孕酮(P)分别为(0.87±0.13)和(0.94±0.16)pg·mL-1;基质金属蛋白酶 9(MMP9)分别为(22.16±3.58)和(23.93±3.71)pg·mL-1,转录激活蛋白-1(AP-1)分别为(36.82±4.76)和(39.57±5.37)pg·mL-1,前列环素 I2(PGI2)分别为(21.39±3.84)和(23.18±4.06)pg·mL-1,血管紧张素 Ⅱ(Ang-Ⅱ)分别为(164.47±22.58)和(175.81±35.94)pg·mL-1,碱性成纤维细胞生长因子(bFGF)分别为(21.15±3.42)和(19.63±3.08)pg·mL-1;除出血时间外,以上指标,组间比较在统计学上差异均有统计学意义(P＜0.05).试验组和对照组药物不良反应发生率分别为8.45％(6例/71例)和12.50％(8例/64例),在统计学上差异无统计学意义(P＞0.05).结论 与地屈孕酮片治疗比较,醋酸甲羟孕酮片治疗排卵障碍性异常子宫出血同样具有良好疗效与安全性,但醋酸甲羟孕酮片改善子宫内膜厚度和月经量、性激素、血管生成等相关指标效果较好.
Objective To investigate the clinical efficacy and safety of medroxyprogesterone acetate tablets in the treatment of ovulatory dysfunction-related abnormal uterine bleeding.Methods Patients with ovulatory dysfunction-related abnormal uterine bleeding were allocated into control group and treatment group based on their treatment regimen.The control group received dydrogesterone tablets(10 mg,twice daily)for 10 days starting from the 14th day of the menstrual cycle.The treatment group received medroxyprogesterone acetate tablets(2 mg,three times daily)for 10 days,also starting from the 14th day of the menstrual cycle.Both groups were treated for three menstrual cycles.The clinical efficacy,recovery indicators,angiogenesis and inflammatory response markers,and safety were compared between the two groups.Results A total of 135 cases were included in the analysis,with 64 in the control group and 71 in the treatment group.The overall response rate of treatment group and control group were 88.73％(63 cases/71 cases)and 82.81％(53 cases/64 cases),respectively(P＞0.05).After treatment,endometrial thickness of treatment group and control group were(6.78±1.23)and.(7.36±1.48)mm,respectively;menstrual blood loss were(60.83±9.78)and(64.61±9.25)mL,respectively;hemostasis time were(3.55±1.85)and(3.95±1.82)d,respectively;follicle stimulating hormone(FSH)levels were(6.07±0.96)and(6.51±1.05)U·L-1,respectively;prolactin(PRL)levels were(8.92±1.37)and(9.65±1.49)μg·L-1,respectively;progesterone(P)levels were(0.87±0.13)and(0.94±0.16)pg·mL-1,respectively;matrix metalloproteinase 9(MMP-9)levels were(22.16±3.58)and(23.93±3.71)pg·mL-1,respectively;activator protein-1(AP-1)levels were(36.82±4.76)and(39.57±5.37)pg·mL-1,respectively;prostaglandin I2(PGI2)levels were(21.39±3.84)and(23.18±4.06)pg·mL-1,respectively;angiotensin-Ⅱ(Ang-Ⅱ)levels were(164.47±22.58)and(175.81±35.94)pg·mL-1,respectively;basic fibroblast growth factor(bFGF)levels were(21.15±3.42)and(19.63±3.08)pg·mL-1,respectively.Except for hemostasis time,all the above indicators showed statistically significant differences between the two groups(all P＜0.05).The incidence of adverse reactions in the treatment group and control group was 8.45％(6 cases/71 cases)and 12.50％(8 cases/64 cases),respectively,with no statistical significance(P＞0.05).Conclusion Compared with dydrogesterone,medroxyprogesterone acetate tablets demonstrates comparable efficacy and safety in treating ovulatory dysfunction-related abnormal uterine bleeding.However,medroxyprogesterone acetate tablets shows superior effects in improving endometrial thickness,reducing menstrual blood loss,regulating sex hormone levels,modulating angiogenesis-related markers.
董福云;赵云;肖虹
济南市第四人民医院,妇科,山东济南 250000济南市第四人民医院,产科,山东济南 250000北京中医药大学房山医院,妇科 北京 102400
医药卫生
醋酸甲羟孕酮片地屈孕酮片排卵障碍异常子宫出血血管生成
medroxyprogesterone acetate tabletsdydrogesterone tabletsovulatory dysfunctionabnormal uterine bleedingangiogenesis
《中国临床药理学杂志》 2026 (8)
1077-1081,5
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