| 摘要: |
| 子宫腺肌病是育龄期女性常见的良性子宫疾病，以进行性加重的痛经、月经过多、慢性盆腔疼痛和不孕为主要临床表现，严重影响患者的生活质量和生育结局。该病病因复杂，机制未完全阐明，子宫切除术虽为根治手段，但药物治疗在保留生育功能、延缓复发及长期管理中具有不可替代的作用。近年来，子宫腺肌病的药物治疗取得显著进展：孕激素类、促性腺激素释放激素激动剂与拮抗剂、选择性孕激素受体调节剂等在有效性、安全性及长期管理方面积累了高级别证据；联合治疗方案进一步优化了疗效与耐受性的平衡；新靶点如泌乳素受体的发现及靶向单克隆抗体药物的研发为难治性病例带来新希望。本文就子宫腺肌病常用治疗药物的疗效与安全性、新型药物研究进展、新靶点开发及未来研发方向进行综述，旨在为临床合理用药和后续研究提供参考依据。 |
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zhu ying jun1,2,3
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1.Tianjin Central Hospital of Obsterics &2.amp;3.Gynecology
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| Abstract: |
| Adenomyosis is a common benign uterine disease in women of reproductive age, characterized by progressively aggravated dysmenorrhea, menorrhagia, chronic pelvic pain and infertility, which seriously affects the quality of life and reproductive outcomes of patients. The pathogenesis is complex and not fully elucidated. Although hysterectomy remains the definitive treatment, drug therapy plays an irreplaceable role in fertility preservation, recurrence prevention and long-term management. In recent years, significant progress has been made in the pharmacological treatment of adenomyosis. High-level evidence has accumulated for progestogens , gonadotropin-releasing hormone agonists and antagonists, and selective progesterone receptor modulators regarding their efficacy, safety and long-term management. Combined regimens have further optimized the balance between efficacy and tolerability. The discovery of novel targets such as the prolactin receptor and the development of targeted monoclonal antibody drugs have brought new hope for refractory cases. This review summarizes the efficacy and safety of commonly used therapeutic agents, the progress of novel drugs, the development of new targets, and future research directions for adenomyosis, aiming to provide a reference for rational clinical medication and future studies. |
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