頁籤選單縮合
題名 | The Efficacy and Safety of a 19 Nor-Steroid in the Treatment of Endometriosis=使用黛美痊治療子宮內膜異位症的療效及安全性評估 |
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作者 | 楊再興; 昝舜華; 陳春榮; 張昇平; 吳香達; Yang, Tzay-shing; Tsan, Shun-hwa; Chen, Chuen-rong; Chang, Sheng-ping; Ng, Heung-tat; |
期刊 | 中華醫學雜誌 |
出版日期 | 19960800 |
卷期 | 58:2 1996.08[民85.08] |
頁次 | 頁89-96 |
分類號 | 417.27 |
語文 | eng |
關鍵詞 | 子宮內膜異位症; 黛美痊; Endometriosis; Gestrinone; |
中文摘要 | 背景 黛美痊是一種合成劑型的類脂醇,具有對抗性腺激素及對抗女 性荷爾蒙的特性,因此可用於治療各種依賴女性荷爾蒙的疾病。本研究的目的 即在探討黛美痊用來治療子宮內膜異位症的療效及安全性。 方法 本篇共收集了20位停經期前的婦女,並經過腹腔鏡診斷患有子宮內膜 異位症。每位患者均給予黛美痊,每週服用二次,每次2.5毫克,共治療6個 月。患者在治療前先接受一次腹腔鏡檢查,並且在治療結束後接受第二次腹腔 鏡檢查來評估臨床效果。此外,每位患者在治療前均接受血漿CA-125濃度測定, 血脂測定及骨密度檢查作為基準;並與療程結束後的數據互相比較。 結果 每位患者的腹腔鏡檢查都是依照修正版的美國不孕症學會(r-AFS)的計分 標準來評分。在本篇研究中,20位患者的平均分數從治療前的20.16降低至治 療後的4.68 (p < 0.01)。而20位患者的血漿CA-125濃度的平均值經過治療後也 從44.04 U/ml下降至18.64 U/ml (p < 0.01)。至於黛美痊在影響血脂代謝方面的研 究結果顯示,高密度脂蛋白(HDL)膽固醇有顯著的降低(-21.9%, p < 0.05),而低密 度脂蛋白(LDL)膽固醇有中度的增加(+14.9%, p > 0.05)。至於總膽固醇及三酸甘 油酯雖有輕微的增加但是沒有統計學上的意義。骨密度的檢查則顯現不論是脊 椎骨或是股骨頭在經過黛美痊6個月的治療後,骨密度並無有意義的改變。在 臨床的副作用方面,使用黛美痊後發生熱潮紅的現象比起使用性腺激素釋放素 類似物(GnRH agonist)的患者少;而且產生體重增加及粉刺的現象也比使用療得 高(Danazol)的患者輕微(依照我們先前的研究結果相比較)。 結論 本篇研究顯示,使用黛美痊每週服用二次,每次2.5毫克,連續治療6 個月,對患有子宮內膜異位症的婦女是一種相當安全又有效的治療。 |
英文摘要 | Background. An oral synthetic 19 norsteroid (gestrinone) characterized by antigonadotropic activity and antioestrogenic properties provides its use in the treatment of oestrogen depending pathologic conditions. The purpose of this open study is to evaluate the efficacy and tolerance of gestrinone in the treatment of endometriosis. Methods. Twenty premenopausal women with laparoscopically confirmed endometriosis received 2.5 mg gestrinone two times per week for six months. Laparoscopy was performed before treatment, and clinical responses were determined by second laparoscopy after six months. Serum CA-125 level, plasma lipid and bone density measurements during and after therapy were compared with baseline. Results. The mean endometriosis score, defined by the revised American Fertility Society scoring system, decreased from 20.16 to 4.68 (p < 0.01). The mean serum level of CA-125 also declined from 44.04 U/ml to 18.64 U/ml (p < 0.01). Metabolic studies showed a significant decrease of cholesterol in high-density lipoprotein (p < 0.05), a moderate increase in low-density lipoprotein (p > 0.06), and a slight increase in both triglyceride and total cholesterol levels (p > 0.05). Bone density in this study also showed no significant difference in either spine or femur neck for a duration of six months treatment. Hot flush occurred in less frequency in gestrinonetreated group than in gonadotropin releasing hormone agonist (GnRHa-treated group), where the side effects of weight gain and acne were less often than in the danazol group well. Conclusions. Gestrinone 2.5 mg given twice a week for six months provides an effective and safe treatment for those women suffering from endometriosis. |
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