孕三烯酮与亮丙瑞林联合治疗子宫内膜异位症疗效及对性激素、炎症指标及外周血CA125、EMAb、AMH水平的影响

doi:10.3969/j.issn.1006-5725.2026.02.008

Abstract

Abstract:

Objective To explore the efficacy of gestrinone combined with leuprolide in the treatment of endometriosis （EMs） and its effects on sex hormones， inflammatory indicators and peripheral blood carbohydrate antigen 125 （CA125）， endometrial antibody （EMAb） and anti-Müllerian hormone （AMH）. Methods 120 patients with EMs admitted to our hospital from November 2019 to November 2022 were selected. All patients were divided into control group and study group according to the random number table method， with 60 cases in each group. Control group was treated with gestrinone， and study group was additionally given leuprolide on the basis of control group. The clinical efficacy after 6 months of treatment， sex hormones indicators ［estradiol （E₂）， luteinizing hormone （LH）， follicle stimulating hormone （FSH）］， inflammatory indicators ［interleukin-6 （IL-6）， IL-8， tumor necrosis factor α （TNF-α）， hypersensitivity C-reactive protein （hs-CRP）］ and serum-related indicators （CA125， EMAb， AMH） before treatment and after 6 months of treatment were compared between the two groups， and the occurrence of adverse drug reactions during medication. Results After 6 months of treatment， the total effective rate of treatment in study group was significantly higher than that in control group （91.67% vs. 76.67%）（P < 0.05）. After 6 months of treatment， the levels of E₂， LH， FSH， IL-6， IL-8， TNF-α， hs-CRP， CA125 and EMAb in the two groups were significantly decreased compared with those before treatment while the level of AMH was increased （P < 0.05）， and the above indexes in study group were significantly different from those in control group during the same period （P < 0.05）. During 6 months of medication， there were no differences in the incidence rates of adverse drug reactions between the two groups （P > 0.05）. Conclusion Gestrinone combined with leuprolide has a significant effect in the treatment of patients with endometriosis， and it can significantly improve the endocrine， relieve inflammatory response and improve serum-related indicators， and it has high safety and good application value.

Key words: endometriosis, gestrinone, leuprolide, efficacy

CLC Number:

R969.4

Junpeng LI,Wei FENG,Yan CHEN,Tingting WU. Efficacy of gestrinone combined with leuprolide in the treatment of EMs and its effects on sex hormones， inflammatory indicators and peripheral blood CA125， EMAb and AMH[J]. The Journal of Practical Medicine, 2026, 42(2): 230-235.

Figures/Tables 5

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References 27

[1]	BECKER C M， BOKOR A， HEIKINHEIMO O， et al. ESHRE guideline： Endometriosis［J］. Hum Reprod Open， 2022， 2022（2）： hoac009. doi：10.1093/hropen/hoac009 . doi: 10.1093/hropen/hoac009
[2]	HOLDSWORTH-CARSON S J， CHUNG J， MACHALEK D A， et al. Predicting disease recurrence in patients with endometriosis： An observational study［J］. BMC Med， 2024， 22（1）： 320. doi：10.1186/s12916-024-03508-7 . doi: 10.1186/s12916-024-03508-7
[3]	DE SOUZA PINTO L P， FERRARI G， DOS SANTOS I K， et al. Evaluation of safety and effectiveness of gestrinone in the treatment of endometriosis： A systematic review and meta-analysis［J］. Arch Gynecol Obstet， 2023， 307（1）： 21-37. doi：10.1007/s00404-022-06846-0 . doi: 10.1007/s00404-022-06846-0
[4]	ZHANG S， WANG L， ZHANG J， et al. The efficacy and safety of Kuntai capsule combined with leuprorelin acetate in the treatment of endometriosis： A protocol for systematic review and meta-analysis［J］. Medicine， 2021， 100（11）： e25080. doi：10.1097/MD.0000000000025080 . doi: 10.1097/MD.0000000000025080
[5]	ADILBAYEVA A， KUNZ J. Pathogenesis of endometriosis and endometriosis-associated cancers［J］. Int J Mol Sci， 2024， 25（14）： 7624. doi：10.3390/ijms25147624 . doi: 10.3390/ijms25147624
[6]	GRUBER T M， MECHSNER S. Pathogenesis of endometriosis： The origin of pain and subfertility［J］. Cells， 2021， 10（6）： 1381. doi：10.3390/cells10061381 . doi: 10.3390/cells10061381
[7]	BLANCO L P， SALMERI N， TEMKIN S M， et al. Endometriosis and autoimmunity［J］. Autoimmun Rev， 2025， 24（4）： 103752. doi：10.1016/j.autrev.2025.103752 . doi: 10.1016/j.autrev.2025.103752
[8]	江璐，德丽娜尔·乌尔肯别克，毛新敏，等. 孕三烯酮联合醋酸亮丙瑞林治疗对子宫内膜异位症患者生殖激素水平、子宫动脉血流参数以及妊娠率的影响［J］. 中华保健医学杂志， 2023， 25（4）： 411-414. doi：10.3969/j.issn.1674-3245. 2023. 04.012 . doi: 10.3969/j.issn.1674-3245. 2023. 04.012
[9]	林伟宏，李鲁宏，朱思远. 醋酸亮丙瑞林联合孕三烯酮对子宫内膜异位症术后患者的疗效及免疫炎症水平的影响［J］. 中国临床药学杂志， 2024， 33（4）： 284-288. doi：10.19577/j.1007-4406.2024.04.010 . doi: 10.19577/j.1007-4406.2024.04.010
[10]	中华医学会妇产科学分会子宫内膜异位症协作组. 子宫内膜异位症的诊治指南［J］. 中华妇产科杂志， 2015， 50（3）： 161-169. doi：10.3760/cma.j.issn.0529-567x.2015.03.001 . doi: 10.3760/cma.j.issn.0529-567x.2015.03.001
[11]	谢幸. 妇产科学［M］. 8版. 北京：人民卫生出版社， 2013： 345.
[12]	薛芳芳，王红艳，王稳莹，等. 基于年龄-时期-队列模型的1990-2019年中国子宫内膜异位症疾病负担研究［J］. 实用妇产科杂志， 2024， 40（12）： 1013-1018.
[13]	TAYLOR H S， KOTLYAR A M， FLORES V A. Endometriosis is a chronic systemic disease： Clinical challenges and novel innovations［J］. Lancet， 2021， 397（10276）： 839-852. doi：10.1016/S0140-6736（21）00389-5 . doi: 10.1016/S0140-6736（21）00389-5
[14]	GARVEY M. Endometriosis： Future biological perspectives for diagnosis and treatment［J］. Int J Mol Sci， 2024， 25（22）： 12242. doi：10.3390/ijms252212242 . doi: 10.3390/ijms252212242
[15]	刘文霞，罗如思，梁芳芳，等. 手术干预对卵巢型子宫内膜异位症患者IVF/ICSI助孕结局的影响［J］. 实用医学杂志， 2025， 41（14）： 2204-2209. doi：10.3969/j.issn.1006-5725.2025.14.012 . doi: 10.3969/j.issn.1006-5725.2025.14.012
[16]	RENKE G， ANTUNES M， SAKATA R， et al. Effects， doses， and applicability of gestrinone in estrogen-dependent conditions and post-menopausal women［J］. Pharmaceuticals， 2024， 17（9）： 1248. doi：10.3390/ph17091248 . doi: 10.3390/ph17091248
[17]	KOU L， HUANG C， XIAO D， et al. Pharmacologic interventions for endometriosis-related pain： A systematic review and meta-analysis［J］. Obstet Gynecol， 2025， 146（2）： e23-e35. doi：10.1097/AOG.0000000000005923 . doi: 10.1097/AOG.0000000000005923
[18]	ZHENG Y， MA R， XU H， et al. Efficacy and safety of different subsequent therapies after fertility preserving surgery for endometriosis： A systematic review and network meta-analysis［J］. Medicine， 2023， 102（31）： e34496. doi：10.1097/MD.0000000000034496 . doi: 10.1097/MD.0000000000034496
[19]	FILINDRIS T， PAPAKONSTANTINOU E， KERAMIDA M， et al. The effect of GnRH-a on the angiogenesis of endometriosis［J］. Hormones， 2024， 23（3）： 509-515. doi：10.1007/s42000-024-00559-6 . doi: 10.1007/s42000-024-00559-6
[20]	YU F， RONG S， JUAN S， et al. Effect of Mirena intrauterine device combined with GNRH-A on endometriosis， sex hormone level and carbohydrate antigen 125［J］. Cell Mol Biol， 2022， 68（7）： 22-26. doi：10.14715/cmb/2022.68.7.4 . doi: 10.14715/cmb/2022.68.7.4
[21]	QING X， HE L， MA Y， et al. Systematic review and meta-analysis on the effect of adjuvant gonadotropin-releasing hormone agonist （GnRH-a） on pregnancy outcomes in women with endometriosis following conservative surgery［J］. BMC Pregnancy Childbirth， 2024， 24（1）： 237. doi：10.1186/s12884-024-06430-1 . doi: 10.1186/s12884-024-06430-1
[22]	GHODSI M， HOJATI V， ATTARANZADEH A， et al. Evaluation of IL-3， IL-5， and IL-6 concentration in the follicular fluid of women with endometriosis： A cross-sectional study［J］. Int J Reprod Biomed， 2022， 20（3）： 213-220. doi：10.18502/ijrm.v20i3. 10713 . doi: 10.18502/ijrm.v20i3. 10713
[23]	陈璐，林莉，朱小兰. 巨噬细胞极化在子宫内膜异位症中的研究进展［J］. 实用医学杂志， 2022， 38（21）： 2751-2754. doi：10.3969/j.issn.1006-5725.2022.21.021 . doi: 10.3969/j.issn.1006-5725.2022.21.021
[24]	SUI Y， LIU Z， YAO Y， et al. Estrogen receptor β inhibits breast cancer migration and promotes its apoptosis through NF-κB/IL-8 signaling［J］. Transl Cancer Res， 2025， 14（3）：1824-1835. doi：10.21037/tcr-24-1267 . doi: 10.21037/tcr-24-1267
[25]	GAJBHIYE R K. Endometriosis and inflammatory immune responses： Indian experience［J］. Am J Reprod Immunol， 2023， 89（2）： e13590. doi：10.1111/aji.13590 . doi: 10.1111/aji.13590
[26]	DI CLEMENTE N， RACINE C， PIERRE A， et al. Anti-müllerian hormone in female reproduction［J］. Endocr Rev， 2021， 42（6）： 753-782. doi：10.1210/endrev/bnab012 . doi: 10.1210/endrev/bnab012
[27]	张慧，陈丹丹. 腹腔镜术后醋酸甲羟孕酮戊酸雌二醇联合亮丙瑞林治疗EMT的临床疗效［J］. 安徽医学， 2021， 42（9）： 1036-1039.

组别	例数	年龄/岁	体质量指数/（kg/m²）	R-AFS分期/［例（%）］
组别	例数	年龄/岁	体质量指数/（kg/m²）	Ⅰ期	Ⅱ期	Ⅲ期
研究组	60	32.32 ± 2.83	22.74 ± 2.21	22（36.67）	31（51.67）	7（11.67）
对照组	60	33.08 ± 2.98	22.28 ± 1.57	21（35.00）	29（48.33）	10（16.67）
χ²/t值		1.447	1.305	0.619
P值		0.151	0.194	0.734

分组	例数	治愈	显效	有效	无效	总有效率
研究组	60	16（26.67）	25（41.67）	14（23.33）	5（8.33）	55（91.67）
对照组	60	11（18.33）	16（26.67）	19（31.67）	14（23.33）	46（76.67）
χ² 值						5.065
P值						0.024

组别	例数	E₂/（ng/L）		LH/（IU/L）		FSH/（IU/L）
组别	例数	治疗前	治疗6个月后	治疗前	治疗6个月后	治疗前	治疗6个月后
研究组	60	117.50 ± 15.67	39.85 ± 7.28^*	10.53 ± 3.37	3.56 ± 0.84^*	7.93 ± 2.22	3.05 ± 0.99^*
对照组	60	115.82 ± 23.90	62.58 ± 8.96^*	11.23 ± 3.72	4.73 ± 1.38^*	7.94 ± 2.36	4.31 ± 1.26^*
t值		0.457	15.257	1.089	5.325	0.022	6.448
P值		0.648	< 0.001	0.278	< 0.001	0.983	< 0.001

组别	例数	IL-6/（pg/mL）		IL-8/（pg/mL）		TNF-α/（ng/L）		hs-CRP/（mg/L）
组别	例数	治疗前	治疗6个月后	治疗前	治疗6个月后	治疗前	治疗6个月后	治疗前	治疗6个月后
研究组	60	54.84 ± 12.14	26.01 ± 6.89^*	42.02 ± 7.09	18.60 ± 2.86^*	45.81 ± 5.37	13.60 ± 2.41^*	18.54 ± 4.83	6.79 ± 1.97^*
对照组	60	51.82 ± 10.45	32.37 ± 7.55^*	42.41 ± 6.62	28.64 ± 4.42^*	46.81 ± 5.36	18.26 ± 3.68^*	17.42 ± 3.44	10.07 ± 2.77^*
t值		1.461	4.824	0.304	14.771	1.018	8.201	1.460	7.480
P值		0.147	< 0.001	0.761	< 0.001	0.311	< 0.001	0.147	< 0.001

组别	例数	CA125/（U/mL）		EMAb/（ng/L）		AMH/（ng/mL）
组别	例数	治疗前	治疗6个月后	治疗前	治疗6个月后	治疗前	治疗6个月后
研究组	60	41.88 ± 4.65	9.89 ± 1.68^*	629.99 ± 67.10	210.42 ± 31.97^*	2.73 ± 0.71	3.82 ± 0.93^*
对照组	60	41.65 ± 6.10	13.69±2.09^*	652.92 ± 69.04	318.27 ± 55.65^*	2.58 ± 0.52	3.22 ± 0.64^*
t值		0.228	10.968	1.845	13.017	1.305	4.112
P值		0.820	< 0.001	0.068	< 0.001	0.194	< 0.001

Efficacy of gestrinone combined with leuprolide in the treatment of EMs and its effects on sex hormones， inflammatory indicators and peripheral blood CA125， EMAb and AMH

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