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原发性痛经的实验室及临床特征研究:镁与口服避孕药治疗效果比较

Investigation of Laboratory and Clinical Features of Primary Dysmenorrhea: Comparison of Magnesium and Oral Contraceptives in Treatment.

作者信息

Gök Soner, Gök Berfin

机构信息

Obstetrics and Gynecology, Pamukkale University, Denizli, TUR.

Obstetrics and Gynecology, Denizli State Hospital, Denizli, TUR.

出版信息

Cureus. 2022 Nov 29;14(11):e32028. doi: 10.7759/cureus.32028. eCollection 2022 Nov.

Abstract

Background The goal of this study was to identify the demographic, clinical, and laboratory characteristics of primary dysmenorrhea (PD) patients, as well as to compare the treatment options of 200 mg magnesium citrate (MgS) and combination oral contraceptive (COC) therapy. Methods This is a case-controlled prospective study consisting of 172 women with PD and a control group consisting of age-matched 172 without PD. The cases in the primary dysmenorrhea group were randomly divided into two groups, with 86 patients in the first group receiving 200 mg MgS, and 86 patients in the second group receiving COC treatment. The Visual Analogue Scale (VAS) was used to measure the severity of dysmenorrhea. VAS scoring was performed on the control group subjects included in the study at their first evaluation and the PD group subjects before treatment and at the third month of treatment (after three menstrual cycles). Results When compared to healthy controls, the PD patients had significantly more menstrual bleeding (p = 0.005), more history of maternal dysmenorrhea (p < 0.001), lower serum calcium (p < 0.001), lower serum 25-hydroxyvitamin D3 (p < 0.001) and more 25-hydroxyvitamin D deficiency (p < 0.001). When compared to the MgS group, the patients in the COC group had significantly lower VAS scores and less need for painkillers following treatment (p < 0.001). The MgS treatment group had significantly lower post-treatment VAS values than pre-treatment VAS values. Conclusion Lower serum calcium and 25-hydroxyvitamin D levels were found in the presence of PD. In addition, it was observed that the administration of 200 mg MgS to PD patients significantly reduced pelvic pain in dysmenorrhea, although not as much as COC administration, and caused significant reductions in the need for painkillers.

摘要

背景 本研究的目的是确定原发性痛经(PD)患者的人口统计学、临床和实验室特征,并比较200毫克柠檬酸镁(MgS)和复方口服避孕药(COC)疗法的治疗选择。方法 这是一项病例对照前瞻性研究,由172名患有PD的女性组成,对照组由172名年龄匹配的无PD女性组成。原发性痛经组的病例被随机分为两组,第一组86例患者接受200毫克MgS治疗,第二组86例患者接受COC治疗。采用视觉模拟评分法(VAS)测量痛经的严重程度。在研究纳入的对照组受试者首次评估时以及PD组受试者治疗前和治疗第三个月(三个月经周期后)进行VAS评分。结果 与健康对照组相比,PD患者的月经量明显更多(p = 0.005),母亲痛经史更多(p < 0.001),血清钙更低(p < 0.001),血清25-羟维生素D3更低(p < 0.001),25-羟维生素D缺乏更多(p < 0.001)。与MgS组相比,COC组患者治疗后的VAS评分明显更低,治疗后对止痛药的需求更少(p < 0.001)。MgS治疗组治疗后的VAS值明显低于治疗前的VAS值。结论 发现PD患者存在血清钙和25-羟维生素D水平降低的情况。此外,观察到给PD患者服用200毫克MgS可显著减轻痛经的盆腔疼痛,尽管不如服用COC效果显著,且可显著减少对止痛药的需求。

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