DOI: 10.66106/fyejay.20250103 ISSN: 3105-6954

两种不同剂量孕激素治疗围绝经期功血的疗效与安全性对比(Comparison of efficacy and safety of two different doses of progesterone in the treatment of perimenopausal dysfunctional uterine bleeding)

速建华 Jianhua Su
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Abstract：Objective To clarify the efficacy and safety differences of using different doses of progesterone (low-dose vs. conven-tional dose) in the clinicaltreatment of dysfunctional uterine bleeding (DUB) during the perimenopausal period, aiming to providea reference for selecting clinical medication regimens for perimenopausal DUB.Methods A total of 90 patients diagnosed withperimenopausal DUB in the gynecology department of our hospital from June 2023 to December 2024 were selected as the studysubjects. They were randomly divided into a low-dose group (45 cases) and a conventional-dose group (45 cases) using a randomnumber table. The low-dose group received dydrogesterone at 10 mg per dose, twice daily, while the conventional-dose group re-ceived dydrogesterone at 10 mg per dose, three times daily. Both groups took the medication from day 11 to 25 of the menstrualcycle (or withdrawal bleeding), with continuous treatment for three menstrual cycles. The clinical efficacy, endometrial thickness, hemoglobin levels, hemostasis time, bleeding control time, and incidence of adverse drug reactions were compared and analyzed between the two groups.Results Intergroup data comparison revealed statistically significant differences ( P <0.05). The total effective rate in the conventional-dose group (97.78%) was higher than that in the low-dose group (84.44%).In terms of endometrial thickness improvement, post-treatment comparison showed P<0.05, with the conventional-dose group exhibiting significantly thinner endome- trium [(5.12±0.81) mm] compared to the low-dose group [(6.53±0.94) mm]. Regarding hemoglobin recovery levels, post-treatment comparison showed P<0.05, with the conventional-dose group having higher hemoglobin levels [(118.36±5.42) g/L] than the low- dose group [(112.74±6.15) g/L]. In terms of complete hemostasis time and bleeding control time, the conventional-dose group was shorter than the low-dose group, with statistically significant differences ( P <0.05). The incidence of adverse reactions was higher in the conventional-dose group (26.67%) than in the low-dose group (11.11%), with statistically significant differences ( P <0.05). Conclusion For patients with perimenopausal DUB, the conventional-dose progesterone treatment regimen demonstrates more significant efficacy in controlling bleeding, improving anemia, and reversing endometrial hyperplasia, but it is also associated with a relatively higher risk of adverse drug reactions. The low-dose regimen offers better safety but relatively weaker efficacy. In clini- cal practice, the appropriate progesterone dose should be selected based on the patient's specific condition, tolerance, and treatment goals, balancing efficacy and safety individually.

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