子宫内膜异位症合并不孕的原因及治疗方案探讨

目的：探讨子宫内膜异位症并不孕的原因及治疗方案的临床意义。方法：随机选取2007年6月至2012年8月就诊于我院的不孕症或疑似子宫内膜异位症（EMS）经检查确诊为EMS的患者216例,按照用药区别平均分为六组,分别为三苯氧胺组、米非司酮组、丹那唑组、诺雷德组、无效成分安慰剂组及两阶段复合治疗组,记录上述患者经治疗后随访1年内受孕率情况。结果：无效成分安慰剂组无疗效,各方面与其他组比较有明显差异（P〈0.05）,其余各组疗效相比无明显差异（P〉0.05）;三苯氧胺组与丹那唑组不良反应发生率高于其他组,比较有明显差异（P〈0.05）;两阶段复合治疗组的复发率最低,受孕率最高,除安慰剂组外其他组之间比较无明显差异（P〉0.05）。结论：此次研究的药物治疗效果近似,但是副作用、复发率及受孕率具有差异,临床应根据患者具体情况施治。

The Reason of Endometriosis and Infertility and the Treatment Programs

Objective： To study causes of endometriosis and infertility and clinical significance of the treatment programs.Methods： 216 cases diagnosed with endometriosis（EMS） who suspected endometriosis or infertility from June 2007 to August 2012 in our hospital were randomly divided into six groups,according to the medication difference.They were tamoxifen group,mifepristone group,danazol group,Zoladex group,invalid component placebo group and two-phase composite group,and recorded 1 year pregnancy rate of these patients after treatment.Results： There was invalid effect in invalid component placebo group,and there were significant differences compared with the other groups（P0.05）;there were no significant differences of effect in the other groups（P0.05）;the incidence of adverse reactions of tamoxifen and Danazol group were higher than the other groups（P0.05）;the two-phase composite treatment group had the lowest recurrence rate and the highest pregnancy rate;they showed no significant difference in the other groups except for the placebo group（P0.05）.Conclusion： The effects of drug treatment were approximation,but the side effects,the recurrence rate and pregnancy rate were different,and the clinical methods should be applied according to the condition of the patients.