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| Effects of Mirena combined with gonadotropin-releasing hormone agonist for treating patients with adenomyosis after operation on their uterine volume, serum human epididymis protein 4 level, and menstrual blood loss |
| 1. Zhumadian Hospital of Traditional Chinese Medicine, Henan Province, 463000; 2. Zhumadian Central Hospital, Henan Province; 3. The First Affiliated Hospital of Zhengzhou University |
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Abstract To investigate the effects of Mirena combined with gonadotropin-releasing hormone agonist (GnRH-a) for treating patients with adenomyosis (AM) after operation on their uterine volume, serum human epididymis protein 4 (HE4) level, and pictorial blood loss assessment chart (PBAC) score. Methods: 96 patients with AM after operation were selected and were divided into three groups (32 cases in each group) according to the random number table method from January 2019 to August 2020. The patients in group A were given Mirena inserted after operation, the patients in group B were given GnRH-a treatment after operation, and the patients in group C were given Mirena inserted combined with GnRH-a treatment after operation. The degree of dysmenorrhea evaluated by visual analogue scale (VAS), the uterine volume, the serum HE4 level, the PBAC score, and the recurrence of AM of the patients were compared among the three groups. Results: At 6 and 12 months after treatment, the VAS scores (1.86±0.58 points and 1.45±0.47 points) of the patients in group C were significantly lower than those (3.42±1.07 points and 2.89±0.88 points) of the patients in group B, and those (7.14±1.27 points and 2.03±0.59 points) of the patients in group A. The values of the uterine volume (88.32±29.23cm3 and 89.35±27.49cm3) of the patients in group C were significantly lower than those (105.32±32.34cm3 and 104.78±32.57cm3) of the patients in group B, and those (108.27± 33.25cm3 and 104.78±32.57cm3) of the patients in group A. The serum HE4 levels (43.86±3.85 U/ml and 42.22±3.36 U/ml) of the patients in group C were significantly lower than those (50.28±4.27 U/ml and 48.43±4.14 U/ml) of the patients in group B, and those (49.44±4.46 U/ml and 47.86±4.32 U/ml) of the patients in group A. The PBAC score (78.62±19.63 points and 63.74±18.18 points) of the patients in group C were significantly lower than those (95.75±24.34 points and 90.89±29.94 points) of the patients in group B, and those (90.87±22.76 points and 88.65±28.92 points) of the patients in group A. The recurrence rates (0 and 0) of the patients in group C in 6 and 12 months after treatment were significantly lower than those (6.3% and 211.9%) of the patients in group B, and those (3.1% and 18.8%) of the patients in group A (all P＜0.05). Conclusion: Mirena combined with GnRH-a for treating the patients with AM after treatment can significantly reduce the degree of dysmenorrhea, decrease the size of the uterus, the serum HE4 level, the PBAC score, and the recurrence of AM.
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