Clinical Research Of Efficacy Of The Combined Laparoscopy And Mifepristone From The Treatment Of 138 Pelvic Endometriosis

Objective:To investigate the effect of the combined laparoscopy and mifepristone for treating endometriosis,and the observations of how does different dose of mifepristone effect endocrine.Methods:One hundred and thirty eight patients with endometriosis were selected and divided into three groups randomly in Jining hospital of Chinese Medicine and Jining First People's hospital from Jan 2004 to Jan 2007 as group A treated by single laparoscopic group,group B treated by ultra low-dose mifepristone combined therapy group and group C treated by low-dose mifepristone combined therapy group,containing 45,47and 46 patients,respectively.The combined infertility case was 17,19,18,respectivly.In the combined therapy group,mifepristone was prescribed for each patient since the first day after menstruation.Mifepristone was prescribed in a dose of 6.25mg/d continuously for 6 months in the group B,compared with 12.5mg in the group C.All the patients had been followed up for 12 months. Through analyzing the data of the three groups of patients' symptomatic relief,the recurrence rate,the pregnancy rate through clinical observation.The changes of the endocrine were observed by detected estradiol,follicle stimulating hormone,luteinizing hormone,progestogen before and after taking mifepristone.Results:The follow-up rate was 90.58%(125/138).Symptoms of dysmenorrhea of three group patients received varying degrees of ease.The effective rate was 40.00%,72.09%,72.50%,respectivly.The difference was significant between group A and group B or between group A and group C(P＜0.05).There was no significant difference between group B and group C(P＞0.05).The recurrence rate was 32.50%,11.63%,10.00%,respectivly.The difference was significant between group A and group B or between group A and group C(P＜0.05).There was no significant between group B and group C(P＞0.05).Comparision of the three groups pregnancy rate,there was no significant difference among of them(P＞0.05),may be because of medication affect the pregnancy.The level of estradiol,progesterone,luteinizing hormone didn't change obviously after taking mifepristone six months ago in group B.Estradiol,progesterone,luteinizing hormone fell after taking mifepristone six months ago in group C,and the difference was remarkable(P＜0.01).There was significant difference between group B and group C which compared gastrointestinal(P＜0.01).Conclusion:The effect of the combined therapy group is superior to the single operation group,which can effectively control endometriosis patients with the symptoms,decrease the recurrence rate.Though ultra low-dose mifepristone has a slight impact on endocrine,decreasing the dose could lessen the effect and reduce the occurency rate of side effect.Administering of ultra low-dose mifepristone after laparoscopic operation could be a promising method of endometriosis treatment.