Add-Back and Combined Regulation in GnRH-a Treatment of Endometriosis

IF 0.4 4区 医学 Q4 OBSTETRICS & GYNECOLOGY
Huimin Tang, Qiucheng Jia, Zhiyong Dong, Yao Chen, Wulin Shan, Yihan Wu, Miao Miao, Tingwei Xing, Weiwei Wei, Bin Tang, Hong Zheng, Ruxia Shi, Bairong Xia, Jiming Chen
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引用次数: 0

Abstract

Objective: The purpose of this review is to summarize drug selection for peri-menopausal symptoms caused by gonadotropin releasing-hormone agonist (GnRH-a) in the treatment of endometriosis. Mechanism: GnRH-a treatment often leads to low estrogen levels, resulting in peri-menopausal symptoms and osteoporosis. Add-back therapy relieves clinical symptoms by supplementing low-dose estrogen. The idea of “combined regulation” is to improve symptoms by adding plant preparations or proprietary Chinese medicines. Studies have shown that they may play a role by regulating serotonin activity. Findings in Brief: For patients treated with GnRH-a for less than 3 months, the combined-regulation regimen can be considered, whereas for patients who have had more than 3 courses of GnRH-a, add-back therapy with sex hormones must be used because the patients will have begun to have obvious bone-mass loss and even bone pain; this bone-mass loss is often irreversible. Conclusions: In the early treatment of endometriosis with GnRH-a, non-hormone combined-regulation therapy is a relatively safe and feasible choice, but hormone add-back therapy should be selected for patients who have had more than 3 courses of GnRH-a.
GnRH-a加回与联合调控治疗子宫内膜异位症
目的:综述促性腺激素释放激素激动剂(GnRH-a)治疗子宫内膜异位症引起的围绝经期症状的药物选择。机制:GnRH-a治疗常导致雌激素水平低,导致围绝经期症状和骨质疏松症。补充疗法通过补充低剂量雌激素缓解临床症状。“联合调理”的概念是通过添加植物制剂或中成药来改善症状。研究表明,它们可能通过调节血清素的活性发挥作用。结论:对于GnRH-a治疗不足3个月的患者,可考虑联合调节方案,而对于GnRH-a治疗超过3个疗程的患者,由于患者已开始出现明显的骨量丢失,甚至骨痛,必须使用性激素加回治疗;这种骨质流失通常是不可逆转的。结论:早期GnRH-a治疗子宫内膜异位症时,非激素联合调节治疗是一种相对安全可行的选择,但对于GnRH-a治疗3个疗程以上的患者应选择激素加回治疗。
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来源期刊
CiteScore
0.50
自引率
0.00%
发文量
241
审稿时长
1 months
期刊介绍: CEOG is an international, peer-reviewed, open access journal. CEOG covers all aspects of Obstetrics and Gynecology, including obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine. All submissions of cutting-edge advances of medical research in the area of women''s health worldwide are encouraged.
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