medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2016-2-86-91medsovet-46Research ArticleПрактикаPracticeМедикаментозная терапия в лечении эндометриозаDrug therapy in the treatment of endometriosisПоповА. А.PopovA. A.noemail@neicon.ruСлободянюкБ. А.SlobodyanyukB. A.noemail@neicon.ruМананниковаТ. Н.ManannikovaT. N.noemail@neicon.ruФедоровА. А.FedorovA. A.noemail@neicon.ruЧантурияТ. З.ChanturiaT. Z.noemail@neicon.ruЗинганШ. И.ZinganS. I.noemail@neicon.ruМосковский областной научно-исследовательский институт акушерства и гинекологииРоссияMoscow Regional Research Institute of Obstetrics and GynecologyRussian Federation201630122016028691Copyright © Попов А.А., Слободянюк Б.А., Мананникова Т.Н., Федоров А.А., Чантурия Т.З., Зинган Ш.И., 20162016Попов А.А., Слободянюк Б.А., Мананникова Т.Н., Федоров А.А., Чантурия Т.З., Зинган Ш.И.Popov A.A., Slobodyanyuk B.A., Manannikova T.N., Fedorov A.A., Chanturia T.Z., Zingan S.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/46

Описаны клинические исследования медикаментозного и хирургического методов лечения эндоме-триоза. Несмотря на то что эндометриоз был описан еще в XIX в., полностью причины его появления и распространения не изучены. Также многие вопросы относительно методов лечения остаются далекими от решения. В связи с хроническим и часто рецидивирующим характером течения заболевания Комитет врачебной практики Американского общества репродуктивной медицины (ASRM) заключил следующее: «эндометриоз должен рассматриваться как хроническое заболевание, требующее пожизненного плана ведения, приоритетом которого является медикаментозное лечение и профилактика повторных хирургических процедур». Таким образом, лечение эндометриоза должно быть не только комплексным, но и адаптированным под особенности организма каждой женщины.

Clinical studies of medicine-based and surgical methods for the treatment of endometriosis are described. Although endometriosis was described as early as in the XIX century, the causes for its emergence and spread have not been fully investigated. Also, many questions regarding methods of treatment remain far from being solved. Due to the chronic and often relapsing nature of the disease, Practice Committee of the American Society for Reproductive Medicine (ASRM) has concluded the following: "endometriosis should be viewed as a chronic disease that requires a lifelong management plan with the goal of maximizing the use of medical treatment and avoiding repeated surgical procedures." Thus, treatment of endometriosis should not only be comprehensive but also adapted to the specifics of each woman's organism.

эндометриозгонадотропин-рилизинг-гормоныдиеногесткомбинированные оральные контрацептивылапароскопияendometriosisgonadotropin-releasing hormonesdienogestcombined oral contraceptiveslaparoscopyReferencesHoloch KJ., Lessey B.A. Endometriosis and infertility. Clin. Obstet. Gynecol., 2010, 53(2): 429-438.Holoch KJ., Lessey B.A. Endometriosis and infertility. Clin. Obstet. Gynecol., 2010, 53(2): 429-438.Practice Committee of American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis. Fertil. Steril., 2008, 90: 260.Practice Committee of American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis. Fertil. Steril., 2008, 90: 260.Попов А.А., Слободянюк Б.А., Мананникова Т.Н. и соавт. Медикаментозная терапия в лечение эндометриоза, РМЖ, 2014, 14, 1010.Попов А.А., Слободянюк Б.А., Мананникова Т.Н. и соавт. Медикаментозная терапия в лечение эндометриоза, РМЖ, 2014, 14, 1010.Kennedy S., Bergqvist A., Chapron C. et al. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum. Reprod., 2005, 20(10): 2698-2704.Kennedy S., Bergqvist A., Chapron C. et al. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum. Reprod., 2005, 20(10): 2698-2704.Allen C, Hopewell S, Prentice A, Gregory D. Nonsteroidal antiinflammatory drugs for pain in women with endometriosis. Cochrane Database Syst. Rev. 2009. Vol. 2:CD004753.Allen C, Hopewell S, Prentice A, Gregory D. Nonsteroidal antiinflammatory drugs for pain in women with endometriosis. Cochrane Database Syst. Rev. 2009. Vol. 2:CD004753.Vercellini P, Eskenazi B, Consonni D et al. Oral contraceptives and risk of endometriosis: A systematic review and meta-analysis. Hum. Reprod. Update, 2011, 17(2): 159-170.Vercellini P, Eskenazi B, Consonni D et al. Oral contraceptives and risk of endometriosis: A systematic review and meta-analysis. Hum. Reprod. Update, 2011, 17(2): 159-170.Telimaa S, Puolakka J, Ronnberg L, Kauppila A. Placebo-controlled comparison of danazol and high-dose medroxyprogesterone acetate in the treatment of endometriosis. Gynecol. Endocrinol, 1987, 1(1): 13-23.Telimaa S, Puolakka J, Ronnberg L, Kauppila A. Placebo-controlled comparison of danazol and high-dose medroxyprogesterone acetate in the treatment of endometriosis. Gynecol. Endocrinol, 1987, 1(1): 13-23.Barbieri RL, Evans S, Kistner RW. Danazol in the treatment of endometriosis: analysis of 100 cases with a 4-year follow-up. Fertil. Steril., 1982, 37: 737.Barbieri RL, Evans S, Kistner RW. Danazol in the treatment of endometriosis: analysis of 100 cases with a 4-year follow-up. Fertil. Steril., 1982, 37: 737.Selak V, Farquhar C, Prentice A, Singla A. Danazol for pelvic pain associated with endo-metriosis // Cochrane Database Syst. Rev. 2007. :CD000068.Selak V, Farquhar C, Prentice A, Singla A. Danazol for pelvic pain associated with endo-metriosis // Cochrane Database Syst. Rev. 2007. :CD000068.Muneyyirci-Delale O, Karacan M. Effect of nore-thindrone acetate in the treatment of symptomatic endometriosis. Int. J. Fertil. Womens Med., 1998, 43(1): 24-27.Muneyyirci-Delale O, Karacan M. Effect of nore-thindrone acetate in the treatment of symptomatic endometriosis. Int. J. Fertil. Womens Med., 1998, 43(1): 24-27.Sasagawa S, Shimizu Y, Kami H et al. Dienogest is a selective progesterone receptor agonist in transactivation analysis with potent oral endometrial activity due to its efficient pharmacokinetic profile. Steroids, 2008, 73(2): 222-231.Sasagawa S, Shimizu Y, Kami H et al. Dienogest is a selective progesterone receptor agonist in transactivation analysis with potent oral endometrial activity due to its efficient pharmacokinetic profile. Steroids, 2008, 73(2): 222-231.Sasagawa S, Shimizu Y, Nagaoka T et al. Dienogest, a selective progestin, reduces plasma estradiol level through induction of apop-tosis of granulosa cells in the ovarian dominant follicle without follicle-stimulating hormone suppression in monkeys. J. Endocrinol. Invest, 2008, 31(7): 636-641.Sasagawa S, Shimizu Y, Nagaoka T et al. Dienogest, a selective progestin, reduces plasma estradiol level through induction of apop-tosis of granulosa cells in the ovarian dominant follicle without follicle-stimulating hormone suppression in monkeys. J. Endocrinol. Invest, 2008, 31(7): 636-641.Mueck AO. What makes dienogest a unique progestogen for the treatment of endometrio-sis? Gynaecol. Forum, 2010, 15(2): 18-23.Mueck AO. What makes dienogest a unique progestogen for the treatment of endometrio-sis? Gynaecol. Forum, 2010, 15(2): 18-23.Katayama H, Katayama T, Uematsu K et al. Effect of dienogest administration on angio-genesis and hemodynamics in a rat endometri-al autograft model. Hum. Reprod, 2010, 25(11): 2851-2858.Katayama H, Katayama T, Uematsu K et al. Effect of dienogest administration on angio-genesis and hemodynamics in a rat endometri-al autograft model. Hum. Reprod, 2010, 25(11): 2851-2858.Strowitzki T, Faustmann T, Gerlinger C, Seitz C. Dienogest in the treatment of endometriosis associated pelvic pain: a 12 week, randomized, double blind, placebo controlled study. Eur. J. Obstet. Gynecol. Reprod. Biol., 2010, 151: 193-198.Strowitzki T, Faustmann T, Gerlinger C, Seitz C. Dienogest in the treatment of endometriosis associated pelvic pain: a 12 week, randomized, double blind, placebo controlled study. Eur. J. Obstet. Gynecol. Reprod. Biol., 2010, 151: 193-198.McCormack PL. Dienogest: a review of its use in the treatment of endometriosis. Drugs, 2010, 70: 2073-2088.McCormack PL. Dienogest: a review of its use in the treatment of endometriosis. Drugs, 2010, 70: 2073-2088.Strowitzki T, Marr J, Gerlinger C et al. Dienogest is as effective as leuprolide acetate in treating the painful symptoms of endometriosis: a 24 week, randomized, multicentre, openlabel trial. Hum. Reprod, 2010, 25: 633-641.Strowitzki T, Marr J, Gerlinger C et al. Dienogest is as effective as leuprolide acetate in treating the painful symptoms of endometriosis: a 24 week, randomized, multicentre, openlabel trial. Hum. Reprod, 2010, 25: 633-641.Strowitzki T, et al. Eur J Obstet Gynecol Reprod Biol, 2010, 151: 193-198. Petraglia F, et al. Arch Gynecol Obstet, 2012, 285: 167-173.Strowitzki T, et al. Eur J Obstet Gynecol Reprod Biol, 2010, 151: 193-198. Petraglia F, et al. Arch Gynecol Obstet, 2012, 285: 167-173.Ota Y, Kurashiki, Japan. Postoperative treatments with progestins and prevention of endo-metriosis recurrence: effectiveness of dien-ogest and combined oral contraceptives (COCs), VIII International Congress on Reproductive Medicine, Jan, 2014.Ota Y, Kurashiki, Japan. Postoperative treatments with progestins and prevention of endo-metriosis recurrence: effectiveness of dien-ogest and combined oral contraceptives (COCs), VIII International Congress on Reproductive Medicine, Jan, 2014.Guzick DS, Huang LS, Broadman BA et al. Randomized trial of leuprolide versus continuous oral contraceptives in the treatment of endometriosis-associated pelvic pain. Fertil. Steril, 2011, 95: 1568.Guzick DS, Huang LS, Broadman BA et al. Randomized trial of leuprolide versus continuous oral contraceptives in the treatment of endometriosis-associated pelvic pain. Fertil. Steril, 2011, 95: 1568.Hornstein MD, Surrey ES, Weisberg GW, Casino LA. Leuprolide acetate depot and hormonal add-back in endometriosis: a 12-month study. Lupron Add-Back Study Group. Obstet. Gynecol, 1998, 91: 16.Hornstein MD, Surrey ES, Weisberg GW, Casino LA. Leuprolide acetate depot and hormonal add-back in endometriosis: a 12-month study. Lupron Add-Back Study Group. Obstet. Gynecol, 1998, 91: 16.Hurst BS, Gardner SC, Tucker KE et al. Delayed oral estradiol combined with leuprolide increases endometriosis-related pain. JSLS, 2000, 4: 97.Hurst BS, Gardner SC, Tucker KE et al. Delayed oral estradiol combined with leuprolide increases endometriosis-related pain. JSLS, 2000, 4: 97.Surrey ES, Hornstein MD. Prolonged GnRH agonist and add-back therapy for symptomatic endometriosis: long-term follow-up. Obstet. Gynecol, 2002, 99: 709.Surrey ES, Hornstein MD. Prolonged GnRH agonist and add-back therapy for symptomatic endometriosis: long-term follow-up. Obstet. Gynecol, 2002, 99: 709.Kitawaki J, Kusuki I, Yamanaka K, Suganuma I. Maintenance therapy with dienogest following gonadotropin-releasing hormone agonist treatment for endometriosis-associated pelvic pain. Eur. J. Obstet. Gynecol. Reprod. Biol., April 5, 2011.Kitawaki J, Kusuki I, Yamanaka K, Suganuma I. Maintenance therapy with dienogest following gonadotropin-releasing hormone agonist treatment for endometriosis-associated pelvic pain. Eur. J. Obstet. Gynecol. Reprod. Biol., April 5, 2011.Attar E, Bulun SE. Aromatase inhibitors: the next generation of therapeutics for endometri-osis? Fertil. Steril, 2006, 85: 1307.Attar E, Bulun SE. Aromatase inhibitors: the next generation of therapeutics for endometri-osis? Fertil. Steril, 2006, 85: 1307.Razzi S, Fava A, Sartini A et al. Treatment of severe recurrent endometriosis with an aro-matase inhibitor in a young ovariectomised woman. BJOG, 2004, 111: 182.Razzi S, Fava A, Sartini A et al. Treatment of severe recurrent endometriosis with an aro-matase inhibitor in a young ovariectomised woman. BJOG, 2004, 111: 182.Takayama K, Zeitoun K, Gunby RT et al. Treatment of severe postmenopausal endome-triosis with an aromatase inhibitor. Fertil. Steril., 1998, 69: 709.Takayama K, Zeitoun K, Gunby RT et al. Treatment of severe postmenopausal endome-triosis with an aromatase inhibitor. Fertil. Steril., 1998, 69: 709.Ailawadi RK, Jobanputra S, Kataria M et al. Treatment of endometriosis and chronic pelvic pain with letrozole and norethindrone acetate: a pilot study. Fertil. Steril, 2004, 81: 290.Ailawadi RK, Jobanputra S, Kataria M et al. Treatment of endometriosis and chronic pelvic pain with letrozole and norethindrone acetate: a pilot study. Fertil. Steril, 2004, 81: 290.Shippen ER, West WJ. Jr. Successful treatment of severe endometriosis in two premenopausal women with an aromatase inhibitor. Fertil. Steril, 2004, 81: 1395.Shippen ER, West WJ. Jr. Successful treatment of severe endometriosis in two premenopausal women with an aromatase inhibitor. Fertil. Steril, 2004, 81: 1395.Amsterdam LL, Gentry W, Jobanputra S et al. Anastrazole and oral contraceptives: a novel treatment for Endometriosis. Fertil. Steril, 2005, 84: 300.Amsterdam LL, Gentry W, Jobanputra S et al. Anastrazole and oral contraceptives: a novel treatment for Endometriosis. Fertil. Steril, 2005, 84: 300.Hefler LA, Grimm C, van Trotsenburg M, Nagele F. Role of the vaginally administered aromatase inhibitor anastrozole in women with rectovaginal endometriosis: a pilot study. Fertil. Steril, 2005, 84: 1033.Hefler LA, Grimm C, van Trotsenburg M, Nagele F. Role of the vaginally administered aromatase inhibitor anastrozole in women with rectovaginal endometriosis: a pilot study. Fertil. Steril, 2005, 84: 1033.Fatemi HM, Al-Turki HA, Papanikolaou EG. et al. Successful treatment of an aggressive recurrent post-menopausal endometriosis with an aromatase inhibitor. Reprod. Biomed. Online, 2005, 11: 455.Fatemi HM, Al-Turki HA, Papanikolaou EG. et al. Successful treatment of an aggressive recurrent post-menopausal endometriosis with an aromatase inhibitor. Reprod. Biomed. Online, 2005, 11: 455.Soysal S, Soysal ME, Ozer S et al. The effects of post-surgical administration of goserelin plus anastrozole compared to goserelin alone in patients with severe endometriosis: a prospective randomized trial. Hum. Reprod, 2004, 19: 160.Soysal S, Soysal ME, Ozer S et al. The effects of post-surgical administration of goserelin plus anastrozole compared to goserelin alone in patients with severe endometriosis: a prospective randomized trial. Hum. Reprod, 2004, 19: 160.Nawathe A, Patwardhan S, Yates D et al. Systematic review of the effects of aromatase inhibitors on pain associated with endometrio-sis. BJOG, 2008, 115: 818.Nawathe A, Patwardhan S, Yates D et al. Systematic review of the effects of aromatase inhibitors on pain associated with endometrio-sis. BJOG, 2008, 115: 818.Lu D, Song H, Shi G. Anti-TNF-а treatment for pelvic pain associated with endometriosis. Cochrane Database Syst. Rev. 2013; 3: CD008088.Lu D, Song H, Shi G. Anti-TNF-а treatment for pelvic pain associated with endometriosis. Cochrane Database Syst. Rev. 2013; 3: CD008088.Lu D, Song H, Li Y et al. Pentoxifylline for endometriosis. Cochrane Database Syst. Rev., 2012, 1:CD007677.Lu D, Song H, Li Y et al. Pentoxifylline for endometriosis. Cochrane Database Syst. Rev., 2012, 1:CD007677.Popov A.A., Slobodyanyuk B.A., Manannikova T.N. et al. Medicine-based therapy in the treatment of endometriosis, RMZ, 2014, 14, 1010.Popov A.A., Slobodyanyuk B.A., Manannikova T.N. et al. Medicine-based therapy in the treatment of endometriosis, RMZ, 2014, 14, 1010.

The authors declare that there are no conflicts of interest present.