發(fā)布時間：2018-08-10 07:09

【摘要】：目的月經(jīng)過多是育齡期和圍絕經(jīng)期婦女的常見癥狀，在世界范圍內(nèi)約30％的育齡期婦女罹患有月經(jīng)過多。而特發(fā)性月經(jīng)過多無內(nèi)分泌功能異常及器質(zhì)性病變，血生殖激素水平也有正常周期波動，育齡期婦女多見。本研究將病例根據(jù)不同治療方法進行分組，對比分析左炔諾孕酮宮內(nèi)緩釋系統(tǒng)、復方口服避孕藥、非甾體消炎藥治療特發(fā)性月經(jīng)過多的臨床療效及安全性有無差異，以指導臨床合理用藥。方法收集2012年1月到2013年9月就診于寧夏自治區(qū)人民醫(yī)院的特發(fā)性月經(jīng)過多的育齡期婦女，嚴格納入標準，收集符合病例101例，將收集病例按治療方法不同進行分組，比較分析治療前、治療后1個月、3個月、6個月月經(jīng)量、經(jīng)期、月經(jīng)周期有無差異性，以評估其有效性，同時記錄不良反應發(fā)生情況，以評估其安全性；對三種治療方法治療后的月經(jīng)量降幅、治療有效率以及藥物不良反應發(fā)生率兩兩之間進行統(tǒng)計分析，比較其差異有無統(tǒng)計學意義，同時調(diào)查記錄患者的依從性，以指導臨床合理用藥。結果三組治療前與治療后1個月、3個月、6個月月經(jīng)量明顯減少、經(jīng)期明顯縮短，P均＜0.05,差異有統(tǒng)計學意義。三組治療前與治療后不同時期月經(jīng)周期均輕微波動，P均＞0.05，差異無統(tǒng)計學意義。曼月樂組較COC組及NSAIDs組月經(jīng)量降幅明顯，有效率明顯高于COC組及NSAIDs組，P均0.05，差異有統(tǒng)計學意義。COC組與NSAIDs組月經(jīng)量降幅、有效率差距不顯著，P均＞0.05，差異無統(tǒng)計學意義。COC組治療后不良反應主要為類早孕反應（9.1％）、NSAIDs組不良反應主要是胃腸道反應（6.2％），曼月樂治療組主要不良反應是陰道不規(guī)則流血（19.4％），三組之間不良反應總發(fā)生率兩兩之間進行比較，P均＞0.05，差異無統(tǒng)計學意義。三組患者表示愿意繼續(xù)目前治療的比例依次是COC（38％）、NSAIDs（41％）、曼月樂（95.7％）。結論1、復方口服避孕藥、非甾體消炎藥、左炔諾孕酮宮內(nèi)釋放系統(tǒng)均能明顯減少月經(jīng)量、經(jīng)期，且對月經(jīng)周期無明顯影響，不良反應發(fā)生較少，均是治療特發(fā)性月經(jīng)過多安全有效的方法2、曼月樂在月經(jīng)量降幅及治療有效率上均明顯優(yōu)于另外兩種治療方法，而不良反應無明顯差異，同時患者的繼續(xù)治療的愿望亦明顯優(yōu)于避孕藥組及非甾體消炎藥組，因此曼月樂是一種效果顯著、更容易被患者接受的一種新型治療特發(fā)性月經(jīng)過多的方法，，有較高的臨床應用價值。
[Abstract]:Objective menorrhagia is a common symptom in women of childbearing age and perimenopause. About 30% of women of childbearing age worldwide suffer from excessive menstruation. There is no endocrine dysfunction and organic pathological changes of idiopathic menorrhagia. The level of blood reproductive hormones also fluctuates normally. The treatment methods were divided into groups, compared and analyzed the levonorgestrel intrauterine sustained release system, the compound oral contraceptive pill, the non steroidal anti-inflammatory drugs in the treatment of the clinical efficacy and safety of idiopathic menorrhagia, in order to guide the clinical rational use of drugs. Methods collected from January 2012 to September 2013 in the Ningxia Autonomous Region People's Hospital of special menstruation Too many women of childbearing age, strictly included in the standard, collect 101 cases of cases, collect cases according to different treatment methods to group, compare and analyze before treatment, 1 months, 3 months, 6 months of menstrual, menstrual period, menstrual cycle have no difference, to assess its effectiveness, and record the occurrence of adverse reactions, in order to assess their safety. A statistical analysis was made between the decrease of menstrual volume, the effective rate of treatment and the incidence of adverse drug reactions (22) after the treatment of the three treatments. There was no statistical significance between the three groups before treatment and 1 months, 3 months and 6 months after treatment. Obviously decreased, the menstrual period was significantly shortened, P < 0.05, the difference was statistically significant. The menstrual cycle of the three groups before and after the treatment were slightly fluctuating, P > 0.05, the difference was not statistically significant. The Meno group was significantly lower than the COC group and the NSAIDs group, and the effective rate was significantly higher than that of the COC group and the NSAIDs group, P was 0.05, the difference was statistically significant. There was no significant difference in the rate of menstruation between group.COC and group NSAIDs. The difference in efficiency was not significant, P was > 0.05. There was no statistically significant difference between group.COC and group.COC. The main adverse reaction was gastrointestinal reaction (6.2%) in group NSAIDs, and the main ungood reaction was irregular vaginal bleeding in the treatment group of menlla (19.4%), and the three groups were not between them. The total incidence of good reaction was compared with 22, P was > 0.05, and the difference was not statistically significant. The proportion of the three groups said to continue the current treatment was COC (38%), NSAIDs (41%), and menlle (95.7%). Conclusion the compound oral contraceptives, non steroidal anti-inflammatory drugs, and levonorgestrel intrauterine release system can significantly reduce the amount of menstruation, During menstruation, there is no obvious influence on menstrual cycle and less adverse reactions, which are 2 safe and effective methods to treat idiopathic menorrhagia. Menses are obviously superior to the other two methods in menstrual decline and treatment efficiency, but there is no significant difference in adverse reactions, and the desire for continued treatment is obviously superior to contraception. The drug group and the non steroidal anti-inflammatory drug group, so menlon is a new method of treating idiopathic menorrhagia which is more effective and easier to be accepted by the patients. It has high clinical value.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R711.52

【參考文獻】

相關期刊論文 前10條

1 李改玲;史惠蓉;;左炔諾孕酮宮內(nèi)緩釋系統(tǒng)非避孕臨床應用[J];國際生殖健康/計劃生育雜志;2010年01期

2 鄧姍,郎景和;左炔諾孕酮宮內(nèi)緩釋系統(tǒng)的臨床功用及相關基礎研究[J];國外醫(yī)學.婦產(chǎn)科學分冊;2004年05期

3 鐘亞莉;;去氧孕烯炔雌醇片聯(lián)合氨甲環(huán)酸片治療月經(jīng)過多療效觀察[J];海峽藥學;2012年07期

4 劉素萍,黃紫蓉;復方口服避孕藥的發(fā)展狀況[J];實用婦產(chǎn)科雜志;2004年06期

5 韓字研;;現(xiàn)代口服避孕藥除避孕外的婦科臨床應用[J];實用婦產(chǎn)科雜志;2009年02期

6 劉穎;徐苓;;雌激素或避孕藥治療青春期功能性子宮出血的效果分析[J];生殖醫(yī)學雜志;2006年03期

7 劉蕓;成九梅;夏雪;段華;郭銀樹;王金娟;李長東;;左炔諾孕酮宮內(nèi)緩釋系統(tǒng)治療子宮腺肌病的療效[J];中國婦幼保健;2010年07期

8 張莉嘉,翁梨駒;左炔諾孕酮宮內(nèi)系統(tǒng)臨床使用五年的安全性研究[J];中華婦產(chǎn)科雜志;2001年11期

9 沈嵐;劉玲;蔣希菁;;薈萃分析氨甲環(huán)酸治療特發(fā)性月經(jīng)過多的療效[J];中國現(xiàn)代應用藥學;2012年12期

10 劉小艷;楊合榮;王江;王惠;羅靜雯;常青;;左炔諾孕酮宮內(nèi)緩釋系統(tǒng)不同適應證臨床應用分析[J];現(xiàn)代婦產(chǎn)科進展;2012年10期

本文編號：2175330