地诺孕素联合亮丙瑞林治疗外生型子宫腺肌症的临床研究OA

Objective To evaluate the clinical efficacy and safety of dienogest combined with leuprorelin in the treatment of external adenomyosis(AM).Methods Patients with external AM were divided into a experimental group and a control group using the cohort method.The control group received leuprorelin 3.75 mg subcutaneously once every 4 weeks for a total of 3 doses(3-month course).The experimental group received leuprorelin at the same dose and schedule plus oral dienogest 2 mg once daily for 3 months.The visual analogue scale(VAS),uterine volume,lesion volume,serum carbohydrate antigen 125(CA125)level,and incidence of adverse drug reactions were compared between the two groups.Results After treatment,the dysmenorrhea VAS scores were 2.11±0.93 in the experimental group and 3.34±1.18 in the control group,uterine volumes were 115.83±30.27 cm3 and 142.16±33.54 cm3,lesion volumes were 16.47±6.74 cm3 and 23.15±7.82 cm3,serum CA125 levels were 22.83±9.45 U·mL-1 and 31.46±11.83 U·mL-1,all with significant differences(all P＜0.05).The overall incidence of adverse drug reactions was 59.15％in the experimental group and 67.61％in the control group,with no statistically significant difference(P＞0.05).The incidence of hot flushes was lower in the experimental group,while the incidence of irregular vaginal bleeding was higher compared with the control group(both P＜0.05).Conclusion Dienogest combined with leuprorelin shows better short-term efficacy than leuprorelin alone for external adenomyosis,effectively alleviating dysmenorrhea,reducing uterine and lesion volumes,and lowering serum CA125 levels.The combination regimen is associated with a lower incidence of hot flushes but a higher incidence of irregular vaginal bleeding,with generally manageable safety profile.