PDF(Pubmed)
Abstract：
Leiomyomas, or fibroids, are benign uterine tumors that are commonly associated with abnormal uterine bleeding-L particularly heavy menstrual bleeding (HMB). Treatment options include expectant, medical, image-guided, and surgical. Medical management of HMB is the preferred first-line treatment and includes nonsteroidal anti-inflammatory drugs, contraceptive hormones, tranexamic acid, levonorgestrel intrauterine system, gonadotropin-releasing hormone (GnRH) antagonists and antagonists, selective progesterone receptor modulators, selective estrogen receptor modulators, and aromatase inhibitors. Although alternatives such as vitamins and supplements have been suggested, there is currently a lack of robust evidence of their efficacy. Many of these therapies treat the symptoms rather than the underlying pathology. Progestin-based therapies are the most commonly utilized, although research supporting their effectiveness in the treatment of HMB is modest. Although GnRH agonists and antagonists, which are federal drug administration-approved therapies, provide substantial improvement in abnormal uterine bleeding-L with HMB, the effects typically last for the duration of therapy. Patients may also face financial barriers to GnRH analog therapy. Future studies are required to delineate the nonhormonal treatment options and the long-term management of leiomyoma-associated HMB.
摘要：
平滑肌瘤,或肌瘤，是良性子宫肿瘤，通常与异常子宫出血有关，特别是重度月经出血（HMB）。治疗选择包括期待，medical,图像引导，和外科手术。HMB的医疗管理是首选的一线治疗，包括非甾体抗炎药，避孕激素,氨甲环酸,左炔诺孕酮宫内节育系统，促性腺激素释放激素（GnRH）拮抗剂和拮抗剂，选择性孕酮受体调节剂，选择性雌激素受体调节剂，和芳香化酶抑制剂.尽管已经提出了维生素和补充剂等替代品，目前缺乏有力的证据证明其疗效.这些疗法中的许多治疗症状而不是潜在的病理。基于孕激素的治疗是最常用的，尽管支持其治疗HMB有效性的研究不多。虽然GnRH激动剂和拮抗剂，这是联邦药物管理局批准的疗法，为HMB的异常子宫出血提供实质性改善，效果通常持续治疗的持续时间。患者还可能面临GnRH类似物治疗的经济障碍。未来的研究需要描述非激素治疗方案和平滑肌瘤相关HMB的长期管理。
