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臨床婦人科産科68巻2号

2014年03月発行

文献概要

今月の臨床 子宮筋腫―多様化した子宮温存療法 子宮温存療法の現況

7.―薬物療法―子宮筋腫の内分泌療法

著者: 楠木泉1 北脇城1

所属機関: 1京都府立医科大学大学院女性生涯医科学

ページ範囲:P.248 - P.253

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●子宮筋腫の治療法は,症状,大きさ,発生部位,患者の年齢,挙児希望の有無などにより個別に検討する.

●GnRHアゴニストが術前治療,逃げ込み療法として数多く使用され,評価は定まってきたが,手術回避効果は否定的である.

●新しい内分泌療法であるGnRHアンタゴニスト,アロマターゼ阻害薬,SPRMの効果が検討されてきている.

参考文献

1) 寺川直樹,水野正彦,矢嶋 聰,他 : 酢酸リュープロレリン徐放性製剤(TAP-144-SR)の子宮筋腫に対する至適用量の検討.産と婦62 : 569―596,1995
2) Chen I, Motan T, Kiddoo D : Gonadotropin-releasing hormone agonist in laparoscopic myomectomy : systematic review and meta-analysis of randomized controlled trials. J Minim Invasive Gynecol 18 : 303―309, 2011
3) Campo S, Garcea N : Laparoscopic myomectomy in premenopausal women with and without preoperative treatment using gonadotrophin-releasing hormone analogues. Hum Reprod 14 : 44―48, 1999
4) Rossetti A, Sizzi O, Soranna L, et al : Long-term results of laparoscopic myomectomy : recurrence rate in comparison with abdominal myomectomy. Hum Reprod 16 : 770―774, 2001
5) Engel JB, Audebert A, Frydman R, et al : Presurgical short term treatment of uterine fibroids with different doses of cetrorelix acetate : a double-blind, placebo-controlled multicenter study. Eur J Obstet Gynecol Reprod Biol 134 : 225―232, 2007
6) Parsanezhad ME, Azmoon M, Alborzi S, et al : A randomized, controlled clinical trial comparing the effects of aromatase inhibitor(letrozole) and gonadotropin-releasing hormone agonist(triptorelin) on uterine leiomyoma volume and hormonal status. Fertil Steril 93 : 192―198, 2010
7) Kriplani A, Awasthi D, Kulshrestha V, et al : Efficacy of the levonorgestrel-releasing intrauterine system in uterine leiomyoma. Int J Gynaecol Obstet 116 : 35―38, 2012
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9) DMagalhães J, Aldrighi JM, de Lima GR, et al : Uterine volume and menstrual patterns in users of the levonorgestrel-releasing intrauterine system with idiopathic menorrhagia or menorrhagia due to leiomyomas. Contraception 75 : 193―198, 2007
10) De Leo V, Morgante G, Lanzetta D,et al : Danazol administration after gonadotrophin-releasing hormone analogue reduces rebound of uterine myomas. Hum Reprod 12 : 357―360, 1997
11) Fiscella K, Eisinger S : CDB-2914 for uterine leiomyomata treatment : a randomized controlled trial. Obstet Gynecol 112 : 707, 2008
12) Esteve JL, Acosta R, Pérez Y,et al : Mifepristone versus placebo to treat uterine myoma : a double-blind, randomized clinical trial. Int J Womens Health 5 : 361―369, 2013
13) Donnez J, Tatarchuk TF, Bouchard P, et al : Ulipristal acetate versus placebo for fibroid treatment before surgery. N Engl J Med 366 : 409―420, 2012
14) Donnez J, Tomaszewski J, Vázquez F, et al : Ulipristal acetate versus leuprolide acetate for uterine fibroids. N Engl J Med 366 : 421―432, 2012
15) Tristan M, Orozco LJ, Steed A, et al : Mifepristone for uterine fibroids. Cochrane Database Syst Rev 8 : CD007687, 2012

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1294

印刷版ISSN:0386-9865

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