目的 探究不同劑量米非司酮聯(lián)合炔雌醇環(huán)丙孕酮對于圍絕經(jīng)期異常子宮出血的臨床效果。方法 選取2013年6月-2016年6月至梧州市紅十字會醫(yī)院治療的異常子宮出血患者69例，按隨機數(shù)字表法分為A、B、C組，3組均使用炔雌醇環(huán)丙孕酮作為基礎治療，A組在基礎治療上予以米非司酮6.25 mg/d，B組予以米非司酮12.5 mg/d，C組予以米非司酮18.75mg/d。療程為6個月。測定3組患者治療前后的卵泡刺激素（FSH）、黃體生成素（LH）、雌二醇（E）、孕酮（P）以及子宮體積與內膜厚度的變化。觀察并比較3組患者的治療有效率和不良反應發(fā)生率。結果 與治療前相比，治療后A、B、C組的血清內FSH、LH、P和E水平均降低，差異有統(tǒng)計學意義（P<0.05）；B組和C組治療后體內E水平低于A組，差異均有統(tǒng)計學意義（P<0.05）；治療后3組FSH、LH、P水平差異無統(tǒng)計學意義。治療前后3組患者子宮體積差異均無統(tǒng)計學意義。治療前3組子宮內膜厚度差異無統(tǒng)計學意義，治療后3組子宮內膜厚度均較治療前降低，差異有統(tǒng)計學意義（P<0.05），而治療后3組之間子宮內膜厚度差異無統(tǒng)計學意義。B組和C組治療有效率均大于A組，差異有統(tǒng)計學意義（P<0.05），而B、C兩組之間治療有效率差異無統(tǒng)計學意義。B、C組控制出血時間少于A組，差異有統(tǒng)計學意義（P<0.05）；不良反應主要表現(xiàn)為惡心、頭暈和腹痛，A、B兩組不良反應發(fā)生率差異無統(tǒng)計學意義；C組高于A、B兩組，差異有統(tǒng)計學意義（P<0.05）。結論 米非司酮12.5 mg/d的劑量聯(lián)合炔雌醇環(huán)丙孕酮治療圍絕經(jīng)期異常子宮出血的治療有效率較高，且不良反應發(fā)生率較低，可作為最佳治療劑量推薦臨床使用。

Objective To explore the clinical efficacy of different doses mifepristone combined with ethinylestradiol for the treatment of perimenopausal dysfunctional uterine bleeding.Methods 69 cases with functional uterine bleeding in June 2013-June 2016 were divided into three groups A,B,C by random number table method.The cases in group A were treated with mifepristone of 6.25 mg/d,in group B were 12.5 mg/d,and in group C were 18.75 mg/d.At same time,all cases were treated with ethinylestradiol.FSH,LH,E,and P levels as well as the volume of uterus and the change of the endometrium thickness were reduced.The treatment effectiveness and the incidence of three groups were compared.Results After treated the FSH,LH,P and E were lower than before treated,the difference was statistically significant (P< 0.05).After treatment the level of E in group B and group C were lower than group (P< 0.05).The uterine size had no significant difference between before and after treated.After treated three groups of endometrial thickness had a significance different between before treated (P< 0.05).The total effective of group B and group C were higher than group A,the difference was statistically significant (P< 0.05).The control bleeding time of group C was less than A and B (P< 0.05).The incidence of adverse reactions of group C was higher than group A and B (P< 0.05).Conclusion For patients with perimenopausal dysfunctional uterine bleeding,the 12.5 mg/d does of mifepristone combined with ethinylestradiol is superior,and the adverse reactions after treatment is less;the method is safe and reliable,which is worthy to be popularized in clinic.