目的:分析GnRH-α反向添加疗法对性子宫内膜异位症手术患者的性激素水平及性欲的影响,为子宫内膜异位症手术患者术后临床症状改善及性激素分泌平衡维持治疗选择方案提供治疗参考.方法:选择2013年2月至2016年2月我院收治的56例行子宫内膜异位症手术患者作为研究对象,将其采用数字随机表法分为对照组和试验组,每组28例.对照组术后予以常规治疗,试验组患者在常规治疗的基础上再予以GnRH-α反向添加疗法.两组患者均连续治疗6个月.分别比较两组患者术前、术后1周、术后4周、2个月、6个月的雌二醇、黄体酮及睾酮水平;比较两组患者术后4周和8周更年期症状评分(改良Kupperman评分)、潮热、情绪波动、腹痛发生率;比较两组患者术后6个月性欲减退发生率.结果:试验组与对照组治疗前、术后l周雌二醇、睾酮明显高于正常值,卵泡期黄体酮明显高于正常值,组间比较差异均无统计学意义(P＞0.05);术后经药物治疗4周、6个月后,两组患者的雌二醇、卵泡期黄体酮及睾酮水平均有明显降低(P＜0.05),但试验组上述指标明显低于对照组,组间差异有统计学意义(P＜0.05).试验组治疗4周、8周后潮热、情绪波动、腹痛发生率明显低于对照组患者(P＜0.05),Kupperman评分均明显低于对照组(P＜0.05).两组治疗6个月后,试验组性欲减退发生率14.29％ (4/28),明显低于对照组32.14％(9/28),(r=11.214,P=0.000).结论:GnRH-α反向添加疗法对改善子宫内膜异位症手术患者术后性激素水平疗效确切,对患者术后6个月性欲影响较小,具有较高的临床价值.%Objectives:To analyze the effect of reverse adding GnRH-alpha therapy on sex hormone levels in patients with endometriosis so as to provide treatment reference for improving clinical symptoms of endometriosis patients after surgery and hormone secretion balance.Methods:56 patients with endometriosis treated in our hospital from February 2013 to February were selected and divided into control group and experimental group,with 28 cases in each group.Control group was treated with routine treatment,and experimental group was treated with reverse adding GnRH-alpha therapy on the basis of conventional treatment.Patients in the two groups were treated for 6 months.The estradiol,progesterone and testosterone levels of two groups before and a week,4 weeks,2 months and 6 months after the surgery were compared.Menopause symptom score (modified Kupperman score),the incidence of hot flashes,mood swings and abdominal pain 4 weeks and 8 weeks after the surgery of two groups were compared.The incidences of hyposexuality at 6 months after surgery of two groups were compared.Results:The levels estradiol and testosterone of experimental group and control group before treatment and a week after the surgery were significantly higher than the normal value and the follicular phase progesterone level was significantly higher than the normal value.The differences between the two groups were not statistically significant (P ＞ 0.05).At 4 weeks and 6 months after surgery,the levels of estradiol,progesterone and testosterone in follicular phase of two groups were significantly decreased (P ＜ 0.05),but the experimental group were lower than the control group,with significant difference (P ＜ 0.05).At 4 weeks and 8 weeks after surgery,the incidence rates of hot flashes,mood swings and abdominal pain of experimental group were significantly lower than these of control group (P ＜ 0.05).Kupperman score of experimental group was significantly lower than that of control group (P ＜ 0.05).At 6 months after surgery,the incidence of hyposexuality in experimental group was 14.29％ (4/28),which was significantly lower than that of control group (9/28,32.14％),(x2 =11.214,P =0.000).Conclusion:Reverse adding GnRH-alpha therapy can improve the level of sexual hormone in patients with endometriosis after surgery,with less impact on sexual desire at 6 months after surgery.
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