Clinical Observation of Efficacy of GnRHa Combined with Add Back Therapy in the Treatment of Advanced Endometriosis After Laparoscopic Operation

Objective: To observe the therapeutic effects and safety of endocrine response of gonadotropin(hormone)releasing hormone-analogue(GnRHa) combined with conjugated estrogen(CEE) and medroxyprogesterone acetate(MPA) in the treatment of advanced endometriosis after laparoscopic operation.Methods: Ninety-six cases of endometriosis after laparoscopic.Patients were randomly divided into three groups,single-agent group(33 cases): in postoperative subcutaneous injection of triptorelin 3.75 mg,once every 4 weeks for 6 times;anti-plus group(32 cases): after subcutaneous injection of triptorelinin 3.75 mg,once every 4 weeks for 6 times,since the fourth injection,we add conjugated estrogens 0.625 mg/d with medroxyprogesterone acetate 5 mg/d for 3 months;the control group(31 cases) without drug treatment.Results: Complete remission rate of clinical symptoms in single-agent group and add-back group was 90.9% and 93.8% respectively,significantly higher than 48.4% in control group(P 0.01);cumulative relapse rates in single-agent group and add-back group were 3.0% and 6.2%,significantly lower than 33.3% in the control group(P 0.01);the serum E2,FSH,LH concentration in single-agent group after treatment was significantly lower than that before treatment(P 0.01).Conclusions: GnRHa combined with conjugated estrogen and medroxyprogesterone acetate is safe and effective in the control of low estrogen symptoms,reduce bone turnover,etc.Add-back therapy can reduce the side effects of GnRHa with unaffectting its efficacy.