The efficacy of Yunkang oral liquid combined with dexamethasone and low-molecular-weight heparin in the treatment of recurrent miscarriage complicated with prethrombotic state in pregnant women / 中国医师杂志

Objective:To investigate the clinical efficacy of Yunkang oral liquid combined with dexamethasone and low-molecular-weight heparin in the treatment of recurrent spontaneous abortion (RSA) complicated with pre thrombotic state (PTS), and its effects on thromboelastogram and serum progesterone, β-human chorionic gonadotropin (β- hCG), and helper T cell (Th) 1/Th2 cytokine levels in patients with recurrent spontaneous abortion (RSA).Methods:A prospective selection of 94 RSA patients with PTS admitted to the Baoding Second Central Hospital from January 2015 to December 2020 was conducted. They were randomly divided into two groups using a random number table method, with 47 patients in each group. The control group was treated with dexamethasone combined with low molecular weight heparin, while the observation group was treated with Yunkang oral liquid in addition to the control group. Continuously treat until 12 weeks of pregnancy to evaluate the efficacy of both groups and observe the adverse reactions in both groups. Two sets of thromboelastogram parameters were compared before and after treatment, including clot formation time (K value), clot reaction time (R value), and clot formation rate (α angle), maximum clot strength (MA value), and coagulation comprehensive index (CI), as well as serum progesterone β- hCG, Th1/Th2 cytokine levels. The pregnancy outcomes of the two groups were followed up.Results:The total effective rate of the observation group [95.7%(45/47)] was significantly higher than that of the control group [83.0%(39/47), P<0.05]. After treatment, the K and R values of both groups were significantly prolonged compared to before treatment (all P<0.05), the angle α, MA value, and CI value were significantly reduced compared to those before treatment (all P<0.05); After treatment, the K and R values in the observation group were significantly longer than those in the control group (al P<0.05), The angleα, MA value, and CI value were significantly lower than those of the control group (all P<0.05). After treatment, the levels of β- hCG serum progesterone of the two groups were significantly higher than those before treatment (all P<0.05), and The β-hCG levels of the serum progesterone were all higher than those in the control group (all P<0.05). After treatment, The levels serum Th1 cytokines [interferon-γ (INF- γ), tumor necrosis factor- α (TNF- α)] of both groups were significantly decreased compared to those before treatment (all P<0.05), and the levels of serum Th2 cytokines [interleukin-4, IL-10] were significantly increased compared to those before treatment (all P<0.05); After treatment, the observation group's serum IFN- γ, TNF- α were significantly lower than those of the control group (all P<0.05), and The levels of serum IL-4 and IL-10 were significantly higher than those of the control group all P<0.05). The live birth rate of the observation group was 87.2%(41/47), which was higher than that of the control group [70.2%(33/47)] ( P<0.05). There was no statistically significant difference in the adverse reaction rate between the observation group [6.4%(3/47)] and the control group [4.3%(2/47)] ( P>0.05). Conclusions:The treatment of RSA combined with PTS with Yunkang oral liquid, dexmedroxyprogesterone, and low molecular weight heparin can significantly alleviate blood hypercoagulability, increase reproductive endocrine hormone levels, regulate Th1/Th2 cytokine balance, improve live birth rate and clinical efficacy, and is safe and reliable.

The Addition of Dydrogesterone after Frozen Embryo Transfer in Hormonal Substituted Cycles with Low Progesterone Levels / Uso adicional de didrogesterona após transferência de blastocisto em ciclos substituídos com valores baixos de progesterona

Abstract Objective To determine whether a rescue strategy using dydrogesterone (DYD) could improve the outcomes of frozen embryo transfer cycles (FET) with low progesterone (P4) levels on the day of a blastocyst transfer. Methods Retrospective cohort study including FET cycles performed between July 2019 and October 2020 following an artificial endometrial preparation cycle using estradiol valerate and micronized vaginal P4 (400 mg twice daily). Whenever the serum P4 value was below 10 ng/mL on the morning of the planned transfer, DYD 10 mg three times a day was added as supplementation. The primary endpoint was ongoing pregnancy beyond 10 weeks. The sample was subdivided into two groups according to serum P4 on the day of FET: low (< 10 ng/mL, with DYD supplementation) or normal (above 10 ng/mL). We performed linear or logistic generalized estimating equations (GEE), as appropriate. Results We analyzed 304 FET cycles from 241 couples, 11.8% (n = 36) of which had serum P4 below 10 ng/mL on the FET day. Baseline clinical data of patients was comparable between the study groups. Overall, 191 cycles (62.8%) had a biochemical pregnancy, of which 131 (44,1%) were ongoing pregnancies, with a 29,8% miscarriage rate. We found no statistically significant differences in the hCG positive (63 vs 64%) or ongoing pregnancy rates (50 vs 43,3%) between those FETs with low or normal serum P4 values, even after multivariable logistic regression modelling. Conclusion Our results indicate that DYD 10 mg three times a day administered in women who perform FET with P4 serum levels < 10 ng/mL, allows this group to have pregnancy rates beyond 12 weeks at least as good as those with serum levels above 10 ng/mL.

Resumo Objetivo Determinar se uma estratégia de resgate usando didrogesterona (DYD) pode melhorar os resultados dos ciclos de transferência de embriões congelados (TEC) com baixos níveis de progesterona (P4) no dia de uma transferência de blastocisto. Métodos Estudo de coorte retrospectivo que incluiu ciclos TEC realizados entre julho de 2019 e outubro de 2020 após um ciclo de preparação endometrial artificial usando valerato de estradiol e P4 vaginal micronizado (400 mg duas vezes ao dia). Sempre que o valor de P4 sérico estava abaixo de 10 ng/mL na manhã da transferência planejada, adicionou-se 10 mg de DYD tri-diário como suplementação. O desfecho primário foi gravidez evolutiva após 10 semanas. A amostra foi subdividida em dois grupos de acordo com o P4 sérico no dia da TEC: baixo (< 10 ng/mL, com suplementação de DYD) ou normal (acima de 10 ng/mL). Realizamos equações de estimativa generalizada linear ou logística (GEE), conforme apropriado. Resultados Analisaram-se 304 ciclos de FET de 241 casais, dos quais 11,8% (n = 36) tinham valores de P4 sérico abaixo de 10 ng/mL no dia da TEC. Os dados clínicos e demográficos dos pacientes eram comparáveis entre os grupos. Globalmente, 191 ciclos (62,8%) tiveram uma gravidez bioquímica, dos quais 131 (44,1%) foram gestações em curso, com uma taxa de aborto espontâneo de 29,8%. Não encontramos diferenças estatisticamente significativas na taxa de gravidez bioquímica (63 vs. 64%) ou nas taxas de gravidez evolutiva (50 vs. 43,3%) entre TEC com valores séricos de P4 baixos ou normais, mesmo após modelação com regressão logística multivariável. Conclusão Nossos resultados indicam que a suplementação com DYD 10 mg três vezes ao dia em mulheres com níveis séricos de P4 abaixo de 10 ng/mL em ciclos de TEC substituídos parecem conseguir resultados pelo menos tão bons como nos ciclos com valores superiores para taxas de gravidez em curso além de 12 semanas.

Oral dydrogesterone in frozen-thawed embryo transfer cycles

SUMMARY OBJECTIVE: The aim of this study was to compare the use of micronized vaginal progesterone and oral dydrogesterone in the endometrial preparation for frozen-thawed embryo transfer. METHODS: This was a randomized, controlled, open, two-armed clinical trial, with women undergoing frozen-thawed embryo transfer along with hormone replacement therapy for endometrial preparation, between September 2019 and February 2021. A total of 73 patients were randomly selected and orally administered 40 mg/day dydrogesterone (dydrogesterone group, n=36) or 800 mg/day micronized vaginal progesterone (micronized vaginal progesterone group, n=37), after endometrial preparation with transdermal estradiol. The main outcome was a viable ongoing pregnancy with 12 weeks of gestation as evaluated by ultrasound. RESULTS: The reproductive outcomes in frozen-thawed embryo transfer cycles were similar, with pregnancy rates in the dydrogesterone and micronized vaginal progesterone treatment groups being, respectively, 33.3 and 32.4% at 12 weeks pregnancy (confidence interval= -22.4-20.6, p=0.196). CONCLUSIONS: The use of oral dydrogesterone may be a more patient-friendly approach to endometrial preparation in frozen-thawed embryo transfer cycles, avoiding undesirable side effects and discomfort resulting from vaginal administration, while also providing similar reproductive results.

Effectiveness and safety of dydrogesterone in the treatment of dysmenorrhea ：a prospective ，random-controlled， open-label and multicenter clinical study / 中国药房

OBJECTIVE To evaluate the efficacy and safety of dydrogesterone in the treatment of dysmenorrhea. METHODS The prospective ，random-controlled，open-labeland multicenter clinical study was adopted. A total of 108 women with dysmenorrhea were randomly assigned into dydrogesterone group and control group according to the ratio of 1∶1，with 54 patients in each group. Dydrogesterone group was treated with dydrogesterone 10 mg orally ，twice a day ，on the 5th-25th day of menstrual cycle ，for 3 menstrual cycles. Control group received Guizhi fuling capsule 0.93 g orally ，three times a day，since the end of menstrual bleeding to the third day of the next menstruation ，for 3 menstrual cycles. Main results were the changes of visual analogue scale （VAS）scores in 2 groups after 3 menstrual cycles ；secondary results were the changes of COX menstrual symptom scale （CMSS），quality life of 36-item short form （SF-36），levels of carbohydrate antigen 125（CA125）and interleukin 6（IL-6）after 3 menstrual cycles ；other findings included additional benefits and drug safety. RESULTS The results of intention to analysis data set and the follow-up study protocol analysis data set showed that VAS scores of 2 groups after treatment of dysmenorrhea for 1，2 and 3 menstrual cycles were lower than those before treatment ，the longer the treatment time ，the more obvious the decrease of VAS score （P＜0.05），and VAS score decline of dydrogesterone group was better than that of control group（P＜0.05）. After 3 menstrual cycles ，both the two group showed significant reduction in the severity and duration scores of CMSS（P＜0.05）；and the decrease of the above scores in the dydrogesterone group was superior than in the control group （P＜ 0.05）. After 3 menstrual cycles ，among 8 dimensions of SF- 36 scale，the scores of 7 dimensions in dydrogesterone group were significantly higher than those before treatment ，such as the scores of physiological function ，physical role ，physical pain ， emotional function ，social function ，general health status and energy （P＜0.05）；the increase of the scores of four dimensions were higher than those in the control group ，such as physical pain ，social function ，general health status ，energy（P＜0.05）. There was no significant difference in the levels of CA 125 and IL- 6 between 2 groups before and after treatment （P＞0.05）. After 3 menstrual cycles，the menstrual cycle and menstrual period in the dydrogesterone group were shorter than those before treatment ，and the menstrual volume decreased （P＜0.05）；but there was no significant change in the above indexes of control group （P＞0.05）. After 3 menstrual cycles ，the incidence of adverse drug events and adverse reactions in dydrogesterone group was 32.69％（17/52）and 28.85％（15/52）；no serious adverse drug events or adverse reactions such as thrombosis occurred in both groups. CONCLUSIONS Dydrogesterone can effectively reduce the VAS score ，also relieve dysmenorrhea-related symptoms ，and improve the quality of life. The efficacy of dydrogesterone is superior than that of Guizhi fuling capsule in treatment for dysmenorrheal ，without serious adverse reactions. It is well tolerated.

El defecto inherente del endometrio causa fallo de implantación en Técnica de Reproducción Asistida / Inherent defect of the endometrium causes implantation failure in Assisted Reproductive Technique

Introduction. Implantation failure appears to be a significant factor in Assisted reproductive technique (ART) procedures. Even a mature endometrium may be non-receptive, preventing implantation or rejection of implanted embryo in early months of pregnancy, resulting in miscarriage or unexplained infertility with or without other associated factors. Objective. To investigate causes of failed implantation inspite of uneventful Grade I embryo transfer in ART procedure Material and Method. 90 women aged range between 25-40 yr old who visited Department of Reproductive Medicine at Calcutta Fertility Mission, over a period of 24 months(January 2017 to December 2019) , satisfying the inclusion criteria, were enrolled in this observational study. Endometrial aspirate histopathology was done along with ∞5ß3 integrin expression. They were treated with natural micronized progesterone (NMP) or oral dydrogesterone and results of endometrial changes were statistically analyzed. Results. 28.89% and 31.11% of women were seen to have mid-secretory changes of the endometrium after being treated with NMP and dydrogesterone respectively. Integrins were expressed in only 59.26% of women with mid-secretory endometrium and 5.41% of early secretory endometrium, which was statistically significant (p value <0.001). Conclusion. About 70% patients even after treatment with estrogen and progestin did not have adequate response in endometrial maturation. Not all patients with mid-secretory endometrium had integrin positive, when tested. NMP and oral Dydrogesterone have similar effect in endometrial maturation as well as in yielding successful pregnancy in some patients with previously failed In-vitro fertilization embryo transfer (IVF-ET).

Comparative study between vaginal natural progesterone and oral dydrogesterone in prevention of red degeneration of uterine fibroid in pregnancy

Background: Uterine leiomyomas are highly prevalent benign monoclonal tumors, arising from the smooth muscle of the myometrium; they occur in up to 50-60% of reproductive age women, causing significant morbidity in up to 30% of women. The most serious complication of uterine fibroids; is red degeneration that causes severe pain, and may lead to preterm labour, miscarriage, fetal and maternal morbidity and mortality. Objective of this study was designed to compare between the effect of vaginal natural MP and oral dydrogesterone in prevention of red degeneration of uterine fibroid during pregnancy.Methods: Patients were recruited from El-Shatby Maternity University Hospital. They were 50 pregnant females, diagnosed having a uterine fibroid more than 3 cm in size then there were divided into two groups, Group A: twenty-five treated by vaginal natural progesterone, Group B: twenty-five treated by oral dydrogesterone. All patients at 14-15 weeks of gestational age underwent complete history taking, clinical examination and ultrasound examination for mean gestational age and assessment of the type and uterine fibroid.Results: Results showed that there were no statistically significant differences as regards age, obstetric history (gravidity and parity), number, Site, grade and size of the fibroid. There was a significant difference between the two studied groups, regarding the acute abdominal pain, it occurred to only 3 cases (12%) in Group A, versus to 16 cases (64%) in Group B. Regarding occurrence of red degeneration, it occurred only to 3 cases (12%) in Group A, while in Group B it occurred to 15 cases (60%).Conclusions: Vaginal natural micronized progesterone is more effective than oral dydrogesterone in prevention of red degeneration of uterine fibroid in pregnancy with fewer complications. Vaginal natural progesterone daily dose of 200 mg is recommended to all pregnant females with uterine fibroids.

Therapeutic Efficacy of Active Immunization Combined with Dydrogesterone in the Treatment of Recurrent Abortion and Its Effects on Serum Levels of LP and ADPN / 中国药房

OBJECTIVE:To observe the therapeutic efficacy of active immunization combined with dydrogesterone in the treatment of recurrent abortion,and its effects on serum levels of leptin(LP)and adiponectin(ADPN). METHODS:Totally 103 patients with recurrent abortion from department of gyhecology,Jinan Third People's Hospital during Nov. 2015 to Nov. 2016 were selected as trial group,and then divided into trial group one(n＝51)and trial group two(n＝52)according to admission order. Other 100 normal pregnant women were taken as control group. Trial group one was given active immunization combined with dydrogesterone,including that lymphocytes from the patients'spouse were injected subcutaneously into the patient,every half a month,3 times of active immunization as a course of treatment,and was given Dydrogesterone tablet 10 mg after pregnancy,bid, until 3 months after the pregnancy. Trial group two was given Dydrogesterone tablet 10 mg,bid,until 3 months after the pregnancy. The serum levels of β-HCG,LP and ADPN were compared between trial group and control group at admission,the serum levels of β-HCG,LP,ADPN and pregnancy outcome(recurrent abortion,full-term pregnancy and successful delivery rate) was compared between 2 trial groups after treatment. RESULTS:At admission,the serum levels of β-HCG,LP and ADPN in trial group were significantly lower than control group. After treatment,the levels of β-HCG,LP and ADPN,successful delivery rate and full-term pregnancy rate in trial group one were significantly higher than trial group two, recurrent abortion rate was significantly lower than trial group two,with statistical significance(P＜0.05). No adverse reactions were observed in the study. CONCLUSIONS:The use of active immunization combined with dydrogesterone can significantly improve the serum levels of LP and ADPN as well as pregnancy outcome,with good safety.

Clinical Observation of Low-molecular-weight-heparin-sodium Combined with Dydrogesterone in the Treat-ment of Threatened Abortion / 中国药房

OBJECTIVE:To observe therapeutic efficacy and safety of low-molecular-weight-heparin-sodium combined with dy-drogesterone in the treatment of threatened abortion. METHODS:Medical information of 72 patients with threatened abortion were analyzed retrospectively and divided into control group(36 cases)and observation group(36 cases). Control group was given Dy-drogesterone tablet with initial dose of 40 mg,one day later every 12 h 10 mg/time. Observation group was additionally given ab-dominal subcutaneous injection of Low-molecular-weight-heparin-sodium injection 5000 U,once a day,on the basis of control group. Both groups were treated for a week. Clinical efficacies of 2 groups were observed,and lumbar acid,vaginal bleeding,ab-dominal pain time,total treatment time,neonatal birth weight were also observed. The levels of hs-CRP,fibrinogen,D-dimer and platelet,the occurrence of ADR were observed before and after treatment. RESULTS:The total response rate of observation group was significantly higher than that of control group(91.7%vs. 80.6%),the backache,vaginal bleeding,abdominal pain time and to-tal treatment time of observation group were significantly shorter than those of control group,the neonatal birth weight and gesta-tional age of observation group were significantly more than those of control group,with statistical significance(P0.05);after treatment,the levels of hs-CRP,fibrinogen,D-dimer and platelet in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,with statistical significance (P0.05). CONCLUSIONS:Based on routine treatment,low-molecu-lar-weight-heparin-sodium combined with dydrogesterone shows good therapeutic efficacy and safety for threatened abortion.

Clinical effect of single use or combination of dydrogesterone and progestin in treatment of threatened abortion caused by uteal phase defect / 药物评价研究

Objective To explore the clinical effect of single use or combination of dydrogesterone and progestin in treatment of threatened abortion caused by uteal phase defect.Methods Totally 186 patients with threatened abortion caused by uteal phase defect accepted in The First Affiliated Hospital of Henan from April 2015 to April 2016 were selected and randomly divided into groups A,B,and C with 62 cases in each group.Patients in group A were given dydrogesterone,those in group B were given progestin,and those in group C were given dydrogesterone combined with progestin.Then the clinical effect,expression of hormones,treatment outcome,and adverse reaction were observed and compared.Results The total effective rates of groups A and B were 72.58％ and 66.13％,respectively,which were obviously lower than 90.32％ of group C with statistically significance (P ＜0.05).The expression levels of P,E2,and hCG of three groups after treatment were higher than those before,those in group C were the highest among them (P ＜ 0.05).The successful treatment rates of groups A,B,and C were 83.87％,82.26％,and 95.16％,respectively,which had no great difference.Conclusion Combination use of dydrogesterone and progestin has better effective rate in treatment of threatened abortion caused by uteal phase defect compared to single use of these two drugs,which has good safety and worth of clinical application.

Effect of active immunization combined with dydrogesterone on recurrent spontaneous abortion and its effect on LP and ADPN expression / 中国生化药物杂志

Objective To investigate the efficacy of active immunization combined with dydrogesterone in the treatment of recurrent spontaneous abortion,and the expression of serum leptin(LP)and adiponectin(ADPN).Methods 51 cases of inpatient and outpatient treatment of repeated abortion of 51 pregnant women from January 2014 to December 2015 in Ningbo Fenghua People's Hospital of Zhejiang Province were selected,and 50 cases of normal pregnant women and normal nonpregnant women 50 cases as a control object.Depending on the treatment method,patients with recurrent spontaneous abortion were divided into combination group(n=26)and monotherapy group(n=25).The levels of LP,ADPN and β-HCG were measured before and after treatment,and the number of successful pregnancies.Results The levels of LP and ADPN in serum were measured in three groups of women,there were statistically significant differences between the two groups(P<0.05).The serum levels of β-HCG in the pregnant women with recurrent spontaneous abortion group were(3914.5±2548.2)mIU,and the normal pregnancy group was(7124.5±2847.6)mIU,the difference was statistically significant(P<0.05).After treatment,the levels of LP,ADPN and β-HCG in the combination group were significantly increased,and successful pregnancy as high as 88.46％,better than the level of monotherapy group,the difference was statistically significant(P<0.05).Conclusion Serum LP,ADPN lower levels of pregnant women prone to recurrent spontaneous abortion,through active immunization combined with dexamethasone treatment,can significantly improve the hormone level,improve the success rate of pregnancy.

Curative efficacy of dydrogesterone in treatment of Climacteric syndrome and its effects on sex hormone and blood fat / 中国生化药物杂志

Objective To study the curative efficacy of dydrogesterone in treatment of Climacteric syndrome and its effects on sex hormone, blood fat.Methods104 patients of Climacteric syndrome who received therapy from February 2014 to November 2016 in our hospital were selected as research objects, according to different divided into observation group and control group, treatment group used to bend progesterone therapy, the control group using a placebo.one month after treatment to observe the two groups of clinical curative effect, compare two groups before and after the treatment and testing level of estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH),total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C).ResultsAfter treatment, the clinical total effective rate in the two groups to compare have no significant difference;Compared with before treatment, the control group in estrogen level and blood lipid levels in patients with no significant change, the observation group of patients with E2 and HDL-C level increased significantly, and significantly higher than the control group (P<0.05);FSH, LH, TC, TG, LDL levels significantly decreased, and significantly lower than the control group (P<0.05).ConclusionUsing of dydrogesterone short time the clinical curative effect of treatment of menopausal syndrome with placebo, but can effectively improve patient sex hormone levels, adjust blood lipid levels, to reduce the incidence of cardiovascular disease (CVD) patients, improve their quality of life.

Live birth rates and safety profile using dydrogesterone for luteal phase support in assisted reproductive techniques

<p><b>INTRODUCTION</b>Assisted reproductive techniques (ARTs) result in a deficient luteal phase, requiring the administration of intramuscular, intravaginal or oral exogenous progesterone. Dydrogesterone, an oral retroprogesterone with good bioavailability, has been used in assisted reproductive cycles with outcomes that are comparable to those of vaginal or intramuscular progesterone. However, there are limited reviews on its use for luteal phase support in ARTs, in terms of pregnancy outcomes and associated fetal anomalies. This study aimed to review the live birth rates and associated fetal anomalies of women who were given dydrogesterone for luteal phase support in assisted reproductive cycles at a tertiary hospital in Singapore.</p><p><b>METHODS</b>This retrospective descriptive study included 1,050 women who underwent in vitro fertilisation/intracytoplasmic sperm injection at the Centre for Assisted Reproduction of Singapore General Hospital between 2000 and 2011. The women were given dydrogesterone for luteal phase support. The main outcome measures were rates of pregnancy, live birth, miscarriage and fetal anomalies.</p><p><b>RESULTS</b>The pregnancy and live birth rates were 34.7% and 27.7%, respectively. Among those who achieved pregnancy, 17.0% miscarried, 0.8% had ectopic pregnancies and 0.3% had molar pregnancies. Fetal anomalies were detected in 1.9% of pregnancies, all of which were terminated by choice.</p><p><b>CONCLUSION</b>Since the outcomes of dydrogesterone are comparable to those of intramuscular and vaginal progesterone, it is a reasonable option to provide luteal phase support for women who are uncomfortable with injections or vaginal insertions. Randomised controlled studies are needed to determine the optimal dosage of dydrogesterone for luteal phase support in ARTs.</p>

Clinical Observation of Yunkang Granule Combined with Dydrogesterone in the Treatment of Early Threat-ened Abortion / 中国药房

OBJECTIVE:To explore the clinical efficacy and safety of Yunkang granule combined with dydrogesterone in the treatment of early threatened abortion. METHODS:128 patients with early threatened abortion were randomly divided into single drug group and combined medication group,64 cases in each group. Single drug group received Dydrogesterone tablet with first dose of 40 mg,then 10 mg,q 12 h until vaginal bleeding;combined medication group additionally received 8 g Yunkang granule, tid,until symptoms disappeared. Human chorionic gonadotropin (HCG),clinical symptoms remission time and disappearance time,pregnancy/childbirth complications,pregnancy outcome and neonatal adverse outcome,and the incidence of adverse reac-tions in 2 groups were compared. RESULTS:After treatment,HCG in 2 groups significantly increased,and combined medication group was higher than single drug group,the differences were statistically significant(P0.05). The incidence of adverse reactions in combined medication group was 10.9%, which was significantly lower than single drug group (40.6%),the difference was statistically significant (P<0.05). CONCLU-SIONS:Both dydrogesterone alone and Yunkang granule combined with dydrogesterone show good efficacy in the treatment of ear-ly threatened abortion,but the remission time and disappearance time of clinical symptoms and adverse reactions in combined medi-cation group are less than that in single drug group.

Clinical Observation of Medroxyprogesterone or Dydrogesterone Combined with Hysteroscopic Electrosur-gery in the Treatment of Early Estrogen-dependent Endometrial Cancer / 中国药房

OBJECTIVE:To compare the efficacy and safety of medroxyprogesterone or dydrogesterone combined with hystero-scopic electrosurgery in the treatment of early estrogen-dependent endometrial cancer. METHODS:42 patients with early estro-gen-dependent endometrial cancer were randomly divided into medroxyprogesterone group (21 cases) and dydrogesterone group (21 cases). All patients received hysteroscopic electrosurgery. Medroxyprogesterone group received 100 mg Medroxyprogesterone acetate tablet,3 times a day. Dydrogesterone group received 100 mg Dydrogesterone tablet,twice a day. The treatment course for both groups was 6 months. Clinical efficacy,carbohydrate antigen CA125(CA125),body mass and the incidence of adverse reac-tions in 2 groups were observed. RESULTS:After 3 months of treatment,the total effective rate in dydrogesterone group was sig-nificantly lower than medroxyprogesterone group,the difference was statistically significant(P0.05). Before treatment,there were no significant differences in CA125 and body mass in 2 groups (P>0.05). After 3 and 12 months,CA125 levels in 2 groups were significantly lower than before,12 months was lower than 3 months,and dydrogesterone group was higher than medroxyprogesterone group after 3 months,the differ-ences were statistically significant (P0.05). After treatment,the body mass in medroxyprogesterone group was significantly higher than before,the difference was statis-tically significant (P0.05). And the incidence of adverse reactions in dydrogesterone group was significantly lower than medroxyprogesterone group,the difference was statistically significant(P<0.05). CONCLUSIONS:The short-term efficacy of medroxyprogesterone combined with hysteroscopic electrosurgery is superior to dydrogesterone combined with hysteroscopic electrosurgery in the treatment of early estro-gen-dependent endometrial cancer,but medroxyprogesterone combined with hysteroscopic electrosurgery shows high incidence of adverse reactions. Long-term effects of both Dydrogesterone and Medroxyprogesterone are equivalent.

Therapeutic effects of dydrogesterone and gestrenene on endometriosis after operation / 中国综合临床

Objective To compare the clinical effects of dydrogesterone and gestrinone on postoperative endometriosis and the rate of pregnancy in patients with infertility. Methods One hundred and fifty patients with postoperative endometriosis were enrolled in the current study who were hospitalized in fuzhou General Hospital of Nanjing Command from Jan. 2009 to Aug. 2013. They were randomly divided into dydrogesternne group(76 cases)and gestrenone groups(54 cases)based on progestogent treatment. The situation of pain symptoms improvement,the recurrence rate of 1 year,side effects and postoperative pregnancy rate were observed in order to evaluate the drug efficacy. Results There were a high rate of postoperative pain remission rate and a low recurrence rate of the two groups,and the difference was not significant( P ﹥0. 05 ). The main adverse reaction of patients in dydrogesterone group was breast pain and the incidence rate was 3. 9%( 3/76 ),while there was no breast pain in gestrinone group,and the difference was not significant( P =0. 140 ). The main adverse reaction of patients in gestrinone group was liver function damage and the incidence rate was 25. 9%(7/54),while the dydrogesterone group hadn't liver function damage,and the difference between two groups was significant( P =0. 000 ). The abnormal uterus bleeding incidence rate in dydrogesterone group was 15. 8%(12/76),higher than that of gestrinone group(13. 0%(7/54)),and the difference was significant(P=0. 038) . The serum carbohydrate antigen-125(CA-125)level in two groups were down to normal after operation,and still declined after drug treatment for 3 months. But there was no obvious change after 6 months. One year pregnancy rate of dydrogesterone pregnancy was 80%(24/30),higher than that of gestrinone group(48%,12/25),and the difference was significant( P =0. 038 ). Conclusion There is no significant difference in therapeutic effect between two groups. However,dydrogesterone therapy have no significant liver damage,and a higher postoperation pregnancy rate.

Clinical efficacy and safety of gonadotropin releasing hormone agonist combined with estrogen-dydrogesteronea in treatment of endometriosis / 中华妇产科杂志

Objective To compare clinical effect of gonadotropin releasing hormone agonist(GnRH-a) alone and GnRH-a combined with low-dose dydrogesteronea and estradiol valerate on sex hormone, hypoestrogenic symptoms, quality of life and bone mineral density (BMD)in treatment of endometriosis.Methods Seventy patients with moderate or severe endometriosis, who were diagnosed by laparotomy or laparoscopic surgery within two months, were randomly assigned into two groups.35 patients in GnRH-a group were treated by goserelin (3.6 mg)for three months, and 35 patients in add-back group were treated by goserelin (3.6 mg)combined with estradiol valerate 0.5 mg and dydrogesteronea 5 mg daily.Before and after the treatment, clinical parameters were recorded and analyzed, including visual analog scale (VAS), medical outcomes survey short form 36 (SF-36), Kupperman menopausal index(KMI), BMD, the serum level of follicle stimulating hormone (FSH), estradiol (E_2) and bone gla-protein (BGP) .The first menstruation and VAS were also followed up after treatment.Results Every 3 cases in two groups lost follow-up.(1)Reproductive hormone: the level of E_2 in add-back group [(94 ± 71) pmol/L]was significantly higher than (54±52) pmol/L in GnRH-a group(P <0.01).The level of FSH in add-back group [(3.0 ± 1.9) U/L]was significantly lower than (5.7 ± 2.9) U/L in GnRH-a group (P < 0.05).(2) VAS: after treatment, VAS in both group decreased significantly when compared with that before treatment(P < 0.05), and remained until menstruated.(3) KMI: KMI in add back-group (10 ± 8) was significantly lower than (14 ± 6) in GnRH-a group (P < 0.05).(4) BMD: compared with that before treatment, BMD decreased significantly after treatment in GnRH-a group (P < 0.05), no remarkable difference of BMD was observed before and after treatment in add-back group.Before treatment, serum BGP in both groups did not show statistical difference.After treatment, the level of BGP in GnRH-a group [(7932±5206) ng/L]was significantly higher than (5419±2917) ng/L in add-back group (P <0.05).Conclusions GnRH-a combined with estrogen-progesterone regimen could relieve pain from endometriosis as effectively as GnRH-a alone and reduce hypoestrogenic symptoms and bone loss.Therefore,it is a safe and effective treatment.

The Effects of Conjugated Equine Estrogens Plus Dydrogesterone on Lipid and Bone Metabolism inPostmenopausal Women / 대한산부인과학회잡지

The addition of a monthly course of progesterone decrease the incidence of endometrialhyperplasia and endometrial carcinoma. The progesterones used in hormonal replacementtherapy(HRT) differ markedly in their progesteronic, androgenic and even estrogenicactivities. These characteristics may influence both symptomatic and metabolic side effects.The purpose of this study was to examine effect of bone and lipid metabolism inpostmenopausal women treated with conjugated equine estrogens plus dydrogesterone.A total 131 postmenopausal women(surgical menopause=95, natural menopause=36)and not-treated postmenopausal women(control=22) were invited to participate in thisstudy. Patients were divided into groups which had received conjugated equine estrogen(CEE)0.625 mg/day 21-day-cycle each month(n=20), CEE 0.625 mg/day plus Dydrogesterone 10mg/day 10-day-cycle each month(n=111), and no treatment control group(n=20).Serum lipid and lipoprotein(Triglyceride, Total cholesterol, High density lipoprotein, Lowdensity lipoprotein) and serum osteocalcin, urinary Deoxypyridinoline were examined in allpatients.There were no significant differences in bone and lipid metabolism between CEE andCEE plus Dydrogesterone groups.In conclusion, Dydrogesterone may be used safely in postmenopausal women withoutMetabolic side effect.