Clinical Valuation Of Observe Add-back Therapy In Patients Treated With A GnRH Agonist For Symptomatic Endometriosis

Objective:To investigate clinical valuation of GnRH-a combined with add-back therapy by analyzing endocrine hormone levels, low estrogen symptoms and bone loss of GnRH-a treatment for symptomatic endometriosis after laparoscopic surgery.Methods: Collected64patients with endometriosis who had been diagnosed by surgery.64patients were divided into two groups evenly and randomly,group-Aand group-B.The patients of group-A accepted injections of Zoladex. In addition to injection of Zoladex,the patients of group-B took extra tibolone during the injection from the second injection of Zoladex. After treatment,clinical parameters and first menstruation were recorded and analyzed, including VAS,Kuapperman index,the serum level of FSH,E2and BGP.Results:After six months treatment,the level of serum FSH and E2in both group declined significantly compared with the level after a month of treatment(P<0.01);the level of serum E2in group B was significantly higher than that in group A(P<0.05). After one month of treatment and after treatment,level of BGP was insignificantly difference.VAS, Kupperman score and serum osteocalcin level were significantly decreased between after one month of treatment and after treatment in both groups(P<0.01). After the treatment,the value of the total score of the pain level and algopareunia was significantly decreased in both groups(P<0.05); After the menstruation came back the score of dysmenorrhea was significantly decreased in both groups(P<0.01).Conclusions:GnRH-a combined with tibolone could reduce hypo-estrogenic symptoms, reduce bone change to protect bone mass and relieve pain of endometriosis.Therefore,it is a safe and effective treatment which can also improve compliance of patients.