子宫腺肌病是一种良性疾病,其特征是子宫肌层中存在子宫内膜样上皮和基质组织。已经提出了几种医疗方法,但仍然,目前尚无指导子宫腺肌病治疗的指南.虽然子宫切除术通常被认为是子宫腺肌病的最终治疗方法,高质量数据的缺乏使希望生育的患者只能获得有限的保守选择.根据现有数据,左炔诺孕酮宫内节育器似乎提供了最有利的结果。其他治疗,包括GnRH拮抗剂,Dienogest,催乳素,和催产素调节剂,显示承诺;然而,需要进一步的数据来确定其疗效.此外,有许多新兴的疗法已经开发出来,似乎值得考虑在不久的将来。这篇叙述性综述的目的是探索当前可用于子宫腺肌病的医学治疗方法,并提供正在评估的未来治疗方法的一瞥。对于这个范围,我们在PubMed和Medline上进行了文献检索,从接受到2022年9月,使用关键词:“医疗”,“非甾体抗炎药”,“孕酮宫内节育器”,\"Dienogest\",“联合口服避孕药”,“促性腺激素释放激素激动剂”,“促性腺激素释放激素拮抗剂”,\"达那唑\",“芳香化酶抑制剂”,“醋酸乌利司他”,“抗血小板治疗”,\"多巴胺\",“催产素拮抗剂”,\"STAT3\",\"KRAS\",\"MAPK\",“微RNA”,\"米非司酮\",\"丙戊酸\",“左旋-四氢帕马汀”,和“穿心莲内酯”。搜索仅限于英文文章,随后对摘要进行筛选。筛选摘要以选择相关研究。
Uterine Adenomyosis is a benign condition characterized by the presence of endometrium-like epithelial and stromal tissue in the myometrium. Several medical treatments have been proposed, but still, no guidelines directing the management of adenomyosis are available. While a hysterectomy is typically regarded as the definitive treatment for adenomyosis, the scarcity of high-quality data leaves patients desiring fertility with limited conservative options. Based on the available data, the levonorgestrel-IUD appears to offer the most favorable outcomes. Other treatments, including GnRH antagonists, dienogest, prolactin, and oxytocin modulators, show promise; however, further data are required to establish their efficacy definitively. Furthermore, there are many emerging therapies that have been developed that seem worthy of consideration in the near future. The aim of this narrative
review was to explore the current medical treatments available for adenomyosis and to provide a glimpse of future therapies under assessment. For this scope, we performed a literature search on PubMed and Medline from incept to September 2022 using the keywords: \"medical treatment\", \"non-steroidal anti-inflammatory\", \"progesterone intrauterine device\", \"dienogest\", \"combined oral contraceptives\", \"gonadotropin releasing hormone agonist\", \"gonadotropin releasing hormone antagonist\", \"danazol\", \"aromatase inhibitors\", \"ulipristal acetate\", \"anti-platelet therapy\", \"dopamine\", \"oxytocin antagonists\", \"STAT3\", \"KRAS\", \"MAPK\", \"micro-RNA\", \"mifepristone\", \"valproic acid\", \"levo-tetrahydropalamatine\", and \"andrographolide\". The search was limited to articles in English, with subsequent screening of abstracts. Abstracts were screened to select relevant studies.