| ObjectiveAs a new pregnancy-hormone drug for the treatment of endometriosis diseases,dienogest is currently approved for market in China.Foreign studies have reported accurate efficacy,and domestic guidelines recommend it as the first-line drug for the treatment of endometriosis.It has certain effects for conservative treatment of ovarian endometriosis cyst or long-term postoperative management to prevent recurrence.The objective of this study was to quantify and compare the efficacy and safety of dienogest and combined oral contraceptive(Daine-35)in the conservative treatment of ovarian endometriosis,and to explore and compare the efficacy and safety of the two drugs in the treatment of ovarian endometriosis cysts.MethodsAccording to the inclusion criteria,patients selected from the gynecological outpatient department of Shaoxing People’s Hospital of Zhejiang Province from January 2020 to January2022 were retrospectively analyzed.A total of 121 patients diagnosed with ovarian endometriosis and clinically diagnosed as unilateral "ovarian endometriosis cyst" were statistically analyzed according to the Guidelines for Diagnosis and Treatment of Endometriosis formulated by the endometriosis Collaboration Group of the Gynecology and Obstetrics Branch of the Chinese Medical Association in 2015.According to the treatment conditions,the patients were divided into DNG group,COC group and the control group.Patients in the three groups were respectively treated with dienogest and Daine-35 for 6 months respectively,and patients in the control group were only followed up.Before were given the treatment,patients’ general information(including age,number of pregnancies,BMI,etc.),gynecological B-ultrasound examination,serum tumor index carbohydrate antigen 125(CA125),dysmenorrhea VAS pain score and sex hormones were tested.Follow-up was conducted again at 3 months and 6 months after treatment,and the above items were reviewed and recorded.Clinical adverse reactions of dienogest and Daine-35 during treatment were observed.Through data collection and analysis,the therapeutic effects and adverse reactions of the above two drugs for long-term management and treatment of ovarian endometriosis cyst were compared.ResultsBefore treatment and 6 months after treatment were compared among the three groups,the mean diameter of ovarian cyst lesions in DNG group and COC group was significantly reduced.VAS scores and CA125 values were significantly lower than those before the treatment,and the difference was statistically significant(P<0.05).After 6 months of the drug treatment,the longest lesion diameter and the mean dysmenorrhea VAS scores of ovarian endometriosis cyst in dienogest group and combined oral contraceptive group were significantly decreased,but the difference was not statistically significant(P > 0.05).However,the serum CA125 values of dienogest group was significantly lower than that of combined oral contraceptive group,and the difference was statistically significant(P< 0.05).Irregular vaginal bleeding was the most common adverse reaction in the dienogest group with a total of 28 cases(70.00%).The most common adverse reactions in the combined oral contraceptive group were nausea and emesis in 19 cases(50.00%),dizziness and fatigue in 16 cases(42.11%).ConclusionDienogest can effectively reduce serum CA125,and long-term administration can shrink ovarian endometriosis cyst lesions and alleviate clinical symptoms of dysmenorrhea in patients.The main adverse reaction was change in the pattern of menstrual bleeding,but the most of patients were tolerable and did not need special treatment.2.Combined oral contraceptive Daine-35 has a certain therapeutic effect on ovarian endometriosis cyst,and its adverse reactions include weight gain,nausea and emesis,dizziness and fatigue during treatment.In addition,the stimulation of combined oral contraceptive on breast may be greater than that of dienogest,so a long time using is less safe. |
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