بررسی مقایسه‌ای اثر کابرگولین و لتروزول و دکاپپتیل در درمان میوم‌های رحم: یک مطالعه کارآزمایی بالینی تصادفی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 رزیدنت گروه زنان و مامایی، واحد توسعه تحقیقات بالینی شهید اکبرآبادی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران.

2 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران.

3 استاد گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران.

10.22038/ijogi.2024.76333.5920

چکیده

مقدمه: درمان رایج میوم­ های رحمی که توسط اکثر پزشک ­ها به‌کار گرفته می­شود، هیسترکتومی و میومکتومی می ­باشد. با توجه به اینکه استفاده از دکاپپتیل، لتروزول و کابرگولین دکاپپتیل، لتروزول و کابرگولین به‌صورت تنها برای درمان میوم ­های رحمی مورد ارزیابی قرار نگرفته است، مطالعه حاضر با هدف ارزیابی استفاده از این داروها در درمان بیماری لیومیوم رحم انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی در سال­های 1400 و 1401 بر روی 75 بیمار مبتلا به میوم رحمی مراجعه کننده به درمانگاه ژنیکولوژی بیمارستان اکبرآبادی تهران انجام شد. بیماران به سه گروه 25 نفره تقسیم شدند. به گروه اول لتروزول به میزان 5/2 میلی‌گرم روزانه، به گروه دوم کابرگولین به میزان 5/0 میلی‌گرم هفتگی و به بیماران گروه سوم آگونیست ­های GnRH داده شد. میزان هموگلوبین و الگوی خون‌ریزی قاعدگی به‌ترتیب از طریق آزمایش شمارش کامل سلول­های خونی و مصاحبه با بیماران به‌دست آمد و در نهایت سایز میوم و تغییرات آن از طریق سونوگرافی مورد بررسی قرار گرفت. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و آزمون‌های کای دو، من‌ویتنی، کروسکال والیس و آزمون­ های تعقیبی بونفرونی انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ ها: میانگین هموگلوبین در گروه دریافت کننده کابرگولین در مقایسه با دو گروه دیگر بیشتر بود که از نظر آماری معنادار بود (001/0=p). از نظر بروز عوارض ناشی از مصرف داروها، گرگرفتگی در گروه دریافت کننده دکاپپتیل، درد عضلانی در گروه دریافت کننده لتروزول، سردرد، تهوع و بی‌اشتهایی در گروه دریافت کننده کابرگولین در مقایسه با سایر گروه‌ها بیشتر بود که این اختلاف ­ها از نظر آماری معنادار نبود (8/0=p). همچنین تفاوت معناداری از نظر الگوی خون‌ریزی قاعدگی و کاهش سایز میوم بین سه گروه وجود داشت (01/0=p).
نتیجه ­گیری: استفاده از کابرگولین در مقایسه با سایر داروها، نتایج بهتری در درمان بیماران از نظر کاهش سایز میوم و افزایش هموگلوبین داشته است.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Comparison of the effect of cabergoline, letrozole and decapeptyl in treatment of uterine myomas: A randomized clinical trial study

نویسندگان [English]

  • Noushin Modabber 1
  • Maryam Rahimi 2
  • Shahnaz Ahmadi 3
1 Resident, Department of Obstetrics and Gynecology, Shahid Akbar-Abadi Clinical Research Development Unit, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
2 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
3 Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: The common treatment for uterine myomas used by most physicians is hysterectomy and myomectomy. Given that the use of decapeptyl, letrozole, and cabergoline has not been evaluated as a single agent for the treatment of uterine myomas, the present study was conducted with aim to evaluate the use of these drugs in the treatment of uterine leiomyoma.
Methods: This randomized clinical trial study was conducted in 2021-2022 on 75 patients with uterine myoma referred to the Gynecology Clinic of Akbarabadi Hospital, Tehran. The patients were divided into three groups (n=25 per group). The first group was given letrozole at a dose of 2.5 mg daily, the second group was given cabergoline at a dose of 0.5 mg weekly, and the third group was given GnRH agonists. The hemoglobin levels and menstrual bleeding patterns were obtained through complete blood cell count and interviews with the patients, respectively, and finally the size of the myoma and its changes were examined through ultrasound. Data were analyzed using SPSS software (version 22) and Chi-square, Mann-Whitney, Kruskal-Wallis, and Bonferroni post hoc tests. P<0.05 was considered significant.
Results: The mean hemoglobin in the group receiving cabergoline was higher compared to the other two groups, which was statistically significant (p=0.001). In terms of drug-related complications, hot flashes were more common in the group receiving decapeptyl, muscle pain was higher in the group receiving letrozole, and headache, nausea, and anorexia were higher in the group receiving cabergoline compared to the other groups, which were no statistically significant (p=0.8). There was also a significant difference among the three groups in menstrual bleeding pattern and reduction in myoma size (p=0.01).
Conclusion: Using cabergoline compared to other drugs has better results in the treatment of patients in terms of reducing the size of myoma and increasing hemoglobin.

کلیدواژه‌ها [English]

  • Cabergoline
  • Decapeptil
  • Letrozole
  • Uterine myomas

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مجله زنان، مامایی و نازایی ایران
دوره 27، شماره 9
آذر 1403
صفحه 10-19

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