子宫内膜异位症疼痛的治疗推荐.ppt

环氧合酶抑制剂-临床应用 STUDY DESIGN after conservative surgery for symptomatic endometriosis (Stage I and II) (n = 28) . Rofecoxib 25mg per day (n = 16) or placebo (n = 12) was given for 6 months. RESULTS A significant improvement of both pelvic pain and dyspareunia was observed after a 6 months persisting since the end of the treatment (P 0.0001). The efficacy of rofecoxib was higher than placebo and no recurrence occurred, while in the placebo-treatment a 16% (2/12) occurred. No significant side effects have been found with the use of rofecoxib. CONCLUSIONS Rofecoxib was effective, safe and low cost therapy and might be also proposed in early stage of endometriosis. Cobellis L,European Journal of Obstetrics, Gynecology, Reproductive Biology. 116(1):100-2, 2004 Italy * 环氧合酶抑制剂COX-2 specific inhibitor Animal researchs Regression of endometrial explants in rats treated with the cyclooxygenase-2 inhibitor rofecoxib. Dogan E, Fertility Sterility. 82 Suppl 3, 2004 Turkey Cyclooxygenase-2 selective inhibitor prevents implantation of eutopic endometrium to ectopic sites in rats. Matsuzaki S. Fertility Sterility. 2004 France * NSAIDS differentially suppress endometriosis in a murine model Female C57BL/6 mice , implantation of autologous endometrium Several NSAIDs or the vehicle-matched control for 4 weeks, the lesion burden controls 5.7 mm celecoxib 1.3 mm indomethacin 1.4 mm naproxen 2.7 mm sulindac 3.1 mm rofecoxib 3.4 mm ibuprofen 4.1 mm aspirin 5.9 mm Fertil-Steril. 2005,83(1): 171-81 * 一线用药--避孕药 短效避孕药 1～2片/d，以闭经为准，连服6～9个月 疗效和假孕疗法相似 副作用轻 * 一线用药--避孕药 避孕药连续口服治疗： 50例术后周期服用避孕药仍有疼痛者 避孕药连续口服治疗2年 妈富隆（ethinyl estradiol (0.02 mg) and desogestrel (0.15 mg) 效果： 很满意： 13 (26%) 满 意： 27 (54%) 不好说： 1 (2%) 不满意： 8 16%) 很不满意： 1 (2%) Vercellini P ，et al. Fertil Steril. 2003 * 一线用药--避孕药Long-cycle treatment with oc long-cycle regimens with continuous administration of OCs for 3 or 6 months followed by a hormone-free interval of 7 days may