Application of medroxyprogesterone acetate combined with levonorgestrel intrauterine contraceptive system in the treatment of abnormal uterine bleeding during perimenopause

ZHOU Ailong; WAN Yuzhen

doi:10.14188/j.1671-8852.2023.0703

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Application of medroxyprogesterone acetate combined with levonorgestrel intrauterine contraceptive system in the treatment of abnormal uterine bleeding during perimenopause

更新时间：2026-11-05

- Application of medroxyprogesterone acetate combined with levonorgestrel intrauterine contraceptive system in the treatment of abnormal uterine bleeding during perimenopause
- Medical Journal of Wuhan University Vol. 46, Issue 3, Pages: 386-391(2025)
- 作者机构：
  
  江西省妇幼保健院妇科江西南昌 330006
- 作者简介：
- 基金信息：
- DOI：10.14188/j.1671-8852.2023.0703
  CLC： R711.52
- Received：28 December 2023，
  
  Published：25 March 2025
- 稿件说明：
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周爱龙,万玉珍.醋酸甲羟孕酮联合左炔诺孕酮宫内节育系统在围绝经期异常子宫出血治疗中的应用[J].武汉大学学报（医学版）,2025,46(03):386-391.

ZHOU Ailong,WAN Yuzhen.Application of medroxyprogesterone acetate combined with levonorgestrel intrauterine contraceptive system in the treatment of abnormal uterine bleeding during perimenopause[J].Medical Journal of Wuhan University,2025,46(03):386-391.
周爱龙,万玉珍.醋酸甲羟孕酮联合左炔诺孕酮宫内节育系统在围绝经期异常子宫出血治疗中的应用[J].武汉大学学报（医学版）,2025,46(03):386-391. DOI： 10.14188/j.1671-8852.2023.0703.

ZHOU Ailong,WAN Yuzhen.Application of medroxyprogesterone acetate combined with levonorgestrel intrauterine contraceptive system in the treatment of abnormal uterine bleeding during perimenopause[J].Medical Journal of Wuhan University,2025,46(03):386-391. DOI： 10.14188/j.1671-8852.2023.0703.

摘要

目的

探讨醋酸甲羟孕酮联合左炔诺孕酮宫内节育系统（LNG‑IUS）治疗围绝经期异常子宫出血的疗效。

方法

选取江西省妇幼保健院收治的120例围绝经期异常子宫出血患者，使用随机数字表法分为3组（各40例），A组口服醋酸甲羟孕酮片，B组采用LNG‑IUS治疗，C组联合应用醋酸甲羟孕酮和LNG‑IUS治疗。观察3组治疗前后的月经情况、子宫内膜厚度、性激素水平及贫血指标变化，对比治疗效果、不良反应发生率等。

结果

相比治疗前，3组治疗后的子宫内膜厚度变薄，月经量减少，经期时间缩短，血清FSH、LH及E

水平下降（

0.05）。组间对比显示，C组的子宫内膜厚度明显比另外两组更薄，月经量比另外两组更少，经期时间比另外两组更短，血清FSH、LH、E

水平比另外两组更低，差异有统计学意义（

0.05）。A组与B组的子宫内膜厚度、月经量、经期时间、血清FSH、LH及E

水平接近（

0.05）。3组治疗后的血红蛋白、红细胞比容水平均较治疗前明显升高（

0.05），并且C组的血红蛋白、红细胞比容水平显著高于另外两组（

0.05）。C组的总有效率为95.00%，显著高于A组的75.00%和B组的72.50%（

0.05），A组与B组的总有效率比较差异无统计学意义（

0.05）。3组的不良反应发生率接近（

0.05）。

结论

醋酸甲羟孕酮联合LNG‑IUS治疗围绝经期异常子宫出血，可有效调节患者的性激素水平，降低子宫内膜厚度，减少出血，其治疗效果显著，且无明显不良反应。

Abstract

Objective

To explore the efficacy of medroxyprogesterone acetate combined with levonorgestrel intrauterine contraceptive system (LNG‑IUS) in the treatment of abnormal uterine bleeding during perimenopause.

Methods

A total of 120 patients with abnormal uterine bleeding during perimenopause admitted to Jiangxi Maternal and Child Health Hospital were randomly divided into three groups (

=40) by a random number table method. Group A received oral medroxyprogesterone acetate tablets

Group B received LNG‑IUS treatment

and Group C received a combination of medroxyprogesterone acetate and LNG‑IUS treatment. The changes in menstrual status

endometrial thickness

sex hormone levels

and anemia indicators before and after treatment in three groups were observed

and the treatment effect and incidence of adverse reactions were compared among the three groups.

Results

After treatment

the endometrial thickness of t

he three groups decreased

menstrual volume decreased

menstrual period time shortened

and serum FSH

and E

levels decreased after treatment (

0.05). The inter⁃group comparison showed that the endometrial thickness of Group C was significantly thinner than the other two groups

with fewer menstrual cycles and shorter menstrual periods compared to the other two groups. The serum levels of FSH

and E

were lower than the other two groups

and the difference was statistically significant (

0.05). The endometrial thickness

menstrual volume

menstrual duration

serum FSH

and E

levels in Group A and Group B were similar (

0.05). After treatment

the levels of hemoglobin and hematocrit in all three groups were significantly higher than before treatment (

0.05)

and the levels of hemoglobin and hematocrit in Group C were significantly higher than those in the other two groups (

0.05). The total effective rate of Group C was 95.00%

which was significantly higher than 75.00% in Group A and 72.50% in Group B (

0.05). There was no statistically significant difference in the total effective rate between Group A and Group B (

0.05). The incidence of adverse reactions in the three groups was similar (

0.05).

Conclusion

The combination of medroxyprogesterone acetate and LNG‑IUS in the treatment of abnormal uterine bleeding during perimenopause can effectively regulate the patient's sex hormone levels

reduce endometrial thickness

and reduce bleeding. The treatment effect is significant

and there are no significant adverse reactions.

关键词

Keywords

references

陈思妤 , 钱玉 , 郭英 . 围绝经期异常子宫出血患者子宫内膜病变的相关因素研究进展 [J ] . 临床医学进展 , 2023 , 13 ( 3 ): 4141 ‑ 4146 .

CHEN S Y , QIAN Y , GUO Y . Research progress on the related factors of endometrial lesions in perimenopausal patients with abnormal uterine bleeding [J ] . Advances in Clinical Medicine , 2023 , 13 ( 3 ): 4141 ‑ 4146 .

范蒙洁 , 王晓晔 . 孕激素治疗异常子宫出血的研究进展 [J ] . 中国计划生育和妇产科 , 2022 , 14 ( 7 ): 31 ‑ 32 .

FAN M J , WANG X Y . Research progress of progesterone in the treatment of abnormal uterine bleeding [J ] . Chin J Fam Plan Gynecotokology , 2022 , 14 ( 7 ): 31 ‑ 32 .

沈育红 , 刘延 , 龙雯晴 . 左炔诺孕酮宫内节育系统联合宫腔镜子宫内膜电切术治疗围绝经期异常子宫出血的临床疗效及安全性评价 [J ] . 临床和实验医学杂志 , 2021 , 20 ( 2 ): 197 ‑ 200 .

SHEN Y H , LIU Y , LONG W Q . Clinical efficacy and safety of levonorgestrel intrauterine birth control system combined with hysteroscopic abnormal endometrial electrotomy in the treatment of abnormal uterine bleeding in perimenopausal period [J ] . J Clin Exp Med , 2021 , 20 ( 2 ): 197 ‑ 200 .

中华医学会妇产科学分会绝经学组 . 围绝经期异常子宫出血诊断和治疗专家共识 [J ] . 中华妇产科杂志 , 2018 , 53 ( 6 ): 396 ‑ 401 .

Menopause Subgroup, Chinese Society of Obstetrics and Gynocology, Chinese Medical Association . Expert consensus on diagnosis and treatment of abnormal uterine bleeding in perimenopausal period [J ] . Chin J Obstet Gynecol , 2018 , 53 ( 6 ): 396 ‑ 401 .

AKBAR F , JOHN A , AHMAD NAEEM M , et al . Prevalence of multiple aetiologies of abnormal uterine bleeding in perimenopausal women using ultrasound [J ] . EAS J Radiol Imag Technol , 2021 , 3 ( 2 ): 102 ‑ 106 .

ALJUBRAN F , GRAHAM A , CUI W , et al . Increased CXCL12 expression in endometrium of women with abnormal uterine bleeding is post‑transcriptionally mediated via miR‑23b‑3p and is associated with decreased expression of the miR‑23b‑3p/24‑3p/27b‑3p cluster: A pilot study [J ] . F&S Sci , 2020 , 1 ( 1 ): 90 ‑ 97 .

李燕 , 张爱英 , 臧学利 , 等 . 雌激素联合醋酸甲羟孕酮治疗功能失调性子宫出血患者的临床研究 [J ] . 中国临床药理学杂志 , 2020 , 36 ( 20 ): 3208 ‑ 3211 .

LI Y , ZHANG A Y , ZANG X L , et al . Estrogen in combination with medroxyprogesterone acetate in the treatment of dysfunctional uterine bleeding [J ] . Chin J Clin Pharmacol , 2020 , 36 ( 20 ): 3208 ‑ 3211 .

陈亚敏 , 冯成参 . 复方炔诺酮片联合醋酸甲羟孕酮片治疗围绝经期功能失调性子宫出血患者的效果 [J ] . 中国民康医学 , 2023 , 35 ( 24 ): 58 ‑ 60 .

CHEN Y M , FENG C S . Effects of compound norethisterone tablets combined with Medroxyprogesterone acetate tablets in treatment of patients with perimenopausal dysfunctional uterine bleeding [J ] . Med J Chin People's Health , 2023 , 35 ( 24 ): 58 ‑ 60 .

张巧颖 . 宫腔镜分别联合左炔诺孕酮宫内节育系统与醋酸甲羟孕酮片治疗异常子宫出血的效果比较 [J ] . 临床合理用药杂志 , 2022 , 15 ( 17 ): 120 ‑ 123 .

ZHANG Q Y . Comparison of hysteroscopy combined with levonorgestrel intrauterine birth control system and progesterone tablets acetate in the treatment of abnormal uterine bleeding [J ] . Chin J Clin Ration Drug Use , 2022 , 15 ( 17 ): 120 ‑ 123 .

夏萍 , 郑志群 . 长效醋酸甲羟孕酮对子宫内膜异位症大鼠疗效及副作用探讨 [J ] . 创伤与急诊电子杂志 , 2019 , 7 ( 1 ): 38 ‑ 46 .

XIA P , ZHENG Z Q . The effect of DMPA in the rat model of endometriosis [J ] . J Trauma Emerg Electron Version , 2019 , 7 ( 1 ): 38 ‑ 46 .

郎景和 , 冷金花 , 邓姗 , 等 . 左炔诺孕酮宫内缓释系统临床应用的中国专家共识 [J ] . 中华妇产科杂志 , 2019 , 54 ( 12 ): 815 ‑ 825 .

LANG J H , LENG J H , DENG S , et al . China expert consensus on clinical application of levonorgestrel intrauterine sustained‑release system [J ] . Chin J Obstet Gynecol , 2019 , 54 ( 12 ): 815 ‑ 825 .

谢庆莉 , 邱慧敏 , 黄翠薇 , 等 . 左炔诺孕酮宫内节育系统应用于异常子宫出血的临床观察 [J ] . 海南医学 , 2021 , 32 ( 12 ): 1565 ‑ 1567 .

XIE Q L , QIU H M , HUANG C W , et al . Clinical observation of levonorgestrel intrauterine birth control system applied to abnormal uterine bleeding [J ] . Hainan Med J , 2021 , 32 ( 12 ): 1565 ‑ 1567 .

武富云 . 左炔诺孕酮宫内节育系统联合屈螺酮炔雌醇片(Ⅱ)对围绝经期异常子宫出血患者疗效研究 [J ] . 中国药物与临床 , 2020 , 20 ( 24 ): 4124 ‑ 4126 .

WU F Y . Clinical study on levonorgestrel intrauterine birth control system combined with drospirenone ethinyl estradiol tablets (Ⅱ) in the treatment of abnormal uterine bleeding in perimenopausal period [J ] . Chin Remedies Clin , 2020 , 20 ( 24 ): 4124 ‑ 4126 .

代晟 , 杨冰 . 宫腔镜子宫内膜息肉电切术联合左炔诺孕酮宫内缓释系统治疗子宫内膜息肉的临床价值 [J ] . 河北医药 , 2022 , 44 ( 24 ): 3779 ‑ 3781 .

DAI S , YANG B . Clinical value of hysteroscopic resection of endometrial polyps combined with levonorgestrel‑releasing intrauterine system in the treatment of endometrial polyps [J ] . Hebei Med J , 2022 , 44 ( 24 ): 3779 ‑ 3781 .

徐艺 , 陈霞 , 顾金云 , 等 . 醋酸甲羟孕酮片联合复方炔诺酮片治疗围绝经期功能性子宫出血患者的临床研究 [J ] . 中国临床药理学杂志 , 2023 , 39 ( 6 ): 768 ‑ 771 .

XU Y , CHEN X , GU J Y , et al . Clinical trial of medroxyprogesterone acetate tablets combined with compound norethisterone tablets in the treatment of patients with perimenopausal functional uterine bleeding [J ] . Chin J Clin Pharmacol , 2023 , 39 ( 6 ): 768 ‑ 771 .

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