目的:通过比较撤退性出血情况,探讨不同剂量孕酮治疗无排卵型月经失调的临床效果,为临床用药提供参考.方法:为单中心、随机、开放、前瞻性临床试验.把符合入组标准的80例无排卵型月经失调患者随机区组法分配入100 mg/d、200 mg/d、300 mg/d、400 mg/d 4种剂量的口服黄体酮治疗组,通过月经卡评分及B超观察撤退性出血情况和用药前后的子宫内膜厚度.结果:入组80例患者,完成治疗74例.经过为期10天的治疗,撤退性出血率100 ng组89.5％,200 mg组94.7％,300 mg组及400 ng组均100％,4组间比较差异无统计学意义(P=0.309).月经卡评分4组间差异亦无统计学意义(P =0.676).结论:综合评价4个剂量的口服孕酮皆可以达到撤退出血的临床疗效.%Objective:To explore the efficacy of different closes of oral progesterone in the treatment of anovulatory dysfunction bleeding by comparing the withdrawal bleeding condition, and then to provide the reference for clinical use. Methods: This was a block randomized, open, prospective clinical trial. Eighty women coincidence the enrollment criteria were recruited and given oral progesterone for consecutive 10 days. They were randomly assigned into four groups (four different doses of progesterone): 100mg/d: 200 mg/d; 300 mg/d; 400 mg/d. Withdrawal bleeding was observed via PBAC score and endometrial thickness via ultrasound. Results:80 patients were enrolled in this study, 74 patients had finished. After 10 days therapy, the withdrawl bleeding rate in 100mg group was 89. 5%, in 200mg group was 94. 7%, in 300mg group and 400mg group was both 100%. Fisher's exact test showed no significant difference of bleeding rate a-mong the four groups ( P = 0. 309). Neither was there any significant difference for PBAC score ( P = 0. 676). Conclusions:Comprehensive evaluation of 4 different doses of oral progesterone shows that all of them can cause withdrawl bleeding.
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