Clinical study of efficacy of GnRH-a combined with add back therapy in the treatment of advanced endometrosis after conservative laparoscopic operation

Objective:To observe the therapeutic effects and safety of endocrine response of gonadotropin(hormone)-releasing hormone-analogue(GnRH-a)combined with conjugated equine estrogen(CEE)and medroxy progesterone acetate(MPA)in the treatment of advanced endometrosis after conservatived laparoscopic operation.Methods:39 cases of endometriosis patients were randomly divided into 3 groups:add back group(n=13)were treated with GnRH-a 3.6 mg by hypodermic injection of 6 doses,each given 4 weeks apart;CEE(0.625 mg/d)and MPA(5 mg/d)were used as add back therapy from 4 to 6 courses of treatment;GnRH-a alone group(n=14)were only treated with GnRH-a after conservative laparoscopic operation,the control group(n=14)were without drug treatment.Results:Compared to the control group,the symptomatic relief rate of the two drug-treatment groups were obviously increased while cumulative relapse frequencies were obviously decreased(P0.01,respectively).The levels of LH,FSH,E2 of GnRH-a alone group were obviously decreased after than those before GnRH-a treatment.Conclusion:GnRH-a combined with CEE and MPA add-back therapy is an effective therapy in the treatment of advanced endometrosis after conservative laparoscopic operation.It could improve the symptom of hypoestrogenemia,decrease bone turn-over.It is an effective and safe agent in relieving side effects induced by GnRH-a.