Clinical Observation Of Add-back Therapy In The Treatment Of Endometriosis

Purpose: Through the136patients with severe ovarianendometriosis after conservative surgery combined use of GnRHatreatment adverse effect and add-back therapy effect, To explore GnRHarelapse prevention and add-back therapy reverse endometriosis clinicalsignificance.Selection methods: Treatment of136patients with severe ovarianEMs of the first hospital in the jilin university between October2010and March2012, Severe group after surgery were randomly divided intotwo groups: single postoperative medication group separately givenGnRHa (Triptorelin) treatment of68cases, combined treatment groupgiven GnRHa in combination with small dose of estrogen afterpreparation (Livial) therapy of68cases, Observation and analysisadverse effect and recurrence.Results using SPSS17.0statisticalsoftware,and related data using and chi-square test(P<0.05),said thedifference was statistically significant.Results:1、The single drug group and combination group serumE2, FSH, LH: one month later, two groups of serum E2, FSH and LH level comparison there was no statistically significant difference(P>0.05); Medicine treatment two months later, the combination group,serum E2(82.7±20.6)pmol/l is higher than the single drug serum E2group (55.6±16.5)pmol/l(P<0.05).Medication treatment three monthslater, the combination group, serum E2(80.6±21.7)pmol/l is higher thanthe single drug serum E2group(40.7±18.6)pmol/l,(P<0.05).2、The single drug group and combined treatment group adverseevent severity: after one month, Kupperman score comparison there wasno statistically significant difference in both groups (P>0.05);Medication treatment three months later,two groups of patientsKupperman rating scores respectively (14.1±3.6)and(6.4±4.5), twogroups have significant difference (P<0.05).3、The single drug group and combination group after three monthsthe adverse event incidence comparison:two groups of sweating andsexual dysfunction are obviously clinical symptom, single drug group ofpatients, symptoms of hot flashes sweating88.2%, sexualdisorder47.0%,bone pain in27.9%, personality change35.2%, insomnia30.9%,anemic38.2%;Combination group of patients, symptoms of hotflashes sweating32.3%, sexual disorder30.9%, bone pain in14.7%,personality change10.3, insomnia13.2%,anemic14.7%;The incidenceof the side effects of single drug group were higher than in thecombination group(P<0.05),(except to the symptoms of sexual dysfunction).4、The single drug group and combination group recurrence rate:single drug group total recurrence rate was10.3%, among them6months postoperative recurrence rate was1.47%, postoperativerecurrence rate8.8%in one year. Combination group total recurrencerate was8.8%, among them6months postoperative recurrence rate was1.47%, postoperative recurrence rate7.4%in one year(P>0.05).Conclusion: endometriosis in childbearing age women, clinical useof conservative surgery. After conservative surgery combined withGnRHa treatment can effectively reduce the recurrence, caused by lowestrogen side effects can be corrected by reversing add therapy, serumE2levels remain within safe stage, neither increased risk of recurrenceand reduces low estrogen-induced side reactions, the treatment of thedisease occupy an important role.