己酮可可碱治疗子宫内膜异位症的随机对照研究(1)
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摘要：目的 探讨己酮可可碱治疗子宫内膜异位症相关不孕和痛经等症状的有效性。方法 前瞻性纳入2009年1月至2009年12月于我院行腹腔镜联合GnRH-α治疗EMS的不孕症患者150例，并随机分为实验组(n=75)和对照组(n=75)。实验组术后服用己酮可可碱，对照组术后服用安慰剂。评估术后随访期间的妊娠率、妊娠时间、EMS相关症状缓解程度以及复发率，并比较两组间的差异。结果 本研究实际纳入病例137例，其中实验组69例，对照组68例，两组患者基线情况一致。所有纳入患者均无明显不良反应事件。己酮可可碱可以明显提高EMS患者术后的妊娠率(53.6% vs. 30.9%, P=0.007)，患者的平均妊娠时间也得以明显提前(P=0.002)。并且己酮可可碱可以有效缓解EMS患者术后痛经和性交痛症状(P<0.05)。虽然己酮可可碱不能明显降低EMS术后复发率，但是可以延缓复发时间(p＝0.041)结论 己酮可可碱联合手术和GnRH-α治疗可以有效改善EMS的不孕症状，缓解EMS相关的疼痛症状。
关键词：己酮可可碱 子宫内膜异位症 随机对照试验 A Randomized Controlled Trial of Pentoxifylline Therapy for Endometriosis
Wei Jiang-Xia,Yang Jin-rong,Zhang Ling,Tang Qian-kun
Department of Gynecology, First People’s Hospital of Guangyuan (Guangyuan 628017)
Corresponding author: Yang Jin-rong, Email: shanzhaguo88@yahoo.cn
[Abstract]Objective: To determine the effectiveness of pentoxifylline in the treatment of endometriosis-related infertility and pelvic pain. Methods: Prospectively enrolled 150 patients underwent laparoscopic surgery combined with GnRH-α treatment from January 2009 to December 2009, were randomly assigned into two groups. The patients in experimental group (n=75) were given pentoxifylline postoperatively, while placebo were given to control group (n=75). The pregnancy rate were evaluated during the postoperative follow-up, as well as intervals from surgery to pregnancy, endometriosis-related symptoms and the recurrence rate, which were compared between two groups. Results: Finally 137 patients were enrolled in experimental group (n=69) and control group (n=68). The baselines characteristics of two groups were statistically similar. All included patients had no significant adverse events. Pentoxifylline could significantly improve the pregnancy rate of patients with endometriosis after surgery (53.6% vs. 30.9%, P=0.007), and shorten the intervals from surgery to pregnancy (P=0.002). Moreover, pentoxifylline could relieve the endometriosis-related symptoms, such as dysmenorrheal and dyspareunia (P<0.05). In addition, pentoxifylline could postpone the recurrence after surgery (P=0.041), although it cannot reduce the recurrence rate. Conclusion: Pentoxifylline combined surgery with GnRH-α treatment could significantly improve the endometriosis-related infertility and lead to the relief of endometriosis-related pelvic pain ......
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