Effect Of Mirena And Megestrol Acetate In The Treatment Of Perimenopausal Non-structural Menorrhagia

Objective:To explore the clinical application value of Mirena and megestrol acetate in the treatment of non-structural abnormal uterine bleeding in perimenopausal period,in order to seek a continuous,efficient and economical method for the treatment of menorrhagia.Methods:From August 2015 to February 2017,116 patients who received conservative treatment in our hospital due to perimenopausal non-structural menorrhagia were selected as subjects for clinical trials.According to the inclusion criteria,they were divided into three groups according to the principle of complete randomization.They were group A?megestrol acetate group?in 37 cases,group B?Mirena group?in 39 cases,group C?megestrol acetate+Mirena group?in 40 cases,were prospectively followed up.Hemoglobin?HB?,Endometrium thickness?ET?and Follicle-stimulating hormone were measured before and after treatment.,FSH),luteinizing hormone?LH?,estradiol?Estradiol,E₂?and other observational indicators and changes in the ring position during treatment,using SPSS software for statistical analysis of data.Results:1.The general clinical data of the three groups including age,course of illness,and BMI were not statistically significant?P>0.05?and comparable.2.Comparison of hemoglobin:After 1 year of treatment,stratification according to time,the HB value of each group had no significant difference before treatment and 3 months after treatment?P>0.05?;between groups after treatment 6 There was a statistically significant difference between the two groups in months and 12 months?P<0.05?.The intragroup comparison showed that the HB values in the three groups were significantly higher than the baseline values before treatment.All had statistical significance?P<0.05?.C group was significantly better than A and B groups in the ability to increase HB.3.Comparison of endometrial thickness:There was no significant difference in the thickness of the intima of the three groups before treatment?P>0.05?;there was a significant difference between the 3 months,6 months,and 12 months of intrinsic treatment in each group?P<0.05?.The endometrial thickness values of the three groups of patients decreased significantly after treatment compared with the baseline values before treatment?P<0.05?.C group was significantly better than A and B groups in the ability to reduce endometrial thickness.4.The comparison of sex hormones:There was no significant difference in FSH,LH,E₂between the three groups before treatment?P>0.05?;between the groups,FSH,LH,and E₂ were shown to be in group A and B after treatment,and in groups B and C.The difference between the two groups was statistically significant?P<0.05?.The intragroup comparison showed that there was no significant difference in FSH,LH,and E2 before and after treatment in group B.After treatment,group A and group C decreased significantly compared with baseline values before and after treatment.The difference was statistically significant?P<0.05?.5.Comparison of ring changes:The overall rate of ring change in Group B and Group C was 7.59%?6/79?.Although the change rate of the ring position in group B was greater than that in group C,there was no significant difference between the two groups?P>0.05?.Conclusions:1.Megestrol acetate combined with Mirena was more effective than megestrol acetate or Mirena alone in the treatment of perimenopausal non-structural menorrhagia patients with significantly elevated haemoglobin levels and marked thinning of the endometrium.2.Mirena has no significant effect on the hypothalamus-pituitary-ovarian axis.Megestrol acetate can inhibit the secretion of FSH,LH,and E_2.3.Pretreatment with megestrol acetate before insertion into Mirena can reduce the impact of menstrual blood volume,reduce the change rate of the ring,and extend the continuation rate.