fa مقایسه تأثیر داینوژست به‌تنهایی و داینوژست همراه زینک در درد و کیفیت زندگی بیماران اندومتریوز زنان و مامايي Obstetrics & Gynecology پژوهشي Original <span style="font-size:12pt"><span style="text-autospace:none"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.1pt">سابقه و هدف:</span></span></span></span></span></span></b>&nbsp;<span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">اندومتریوز نوعی بیماری مزمن و التهابی است که در آن بافتی مشابه آندومتر در خارج از رحم رشد می‌کند.</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">این مطالعه با هدف مقایسه تأثیر داینوژست به &rlm;تنهایی و داینوژست همراه با مکمل زینک در نمره درد و کیفیت زندگی بیماران</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">اندومتریوز انجام شد.</span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.15pt">مواد و روش‌‌ها</span></span></span></span></span></span></b><b><span b="" lang="AR-SA" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.15pt">:</span></span></span></span></span></b><b>&nbsp;</b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">این کارآزمایی بالینی تصادفی یک&rlm;سوکور روی 72 بیمار مراجعه&rlm; کننده به درمانگاه بیمارستان فاطمیه همدان در سال 1404 انجام شد. بیماران واجد شرایط به روش تصادفی به دو گروه </span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">A</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"> و </span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">B</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"> تقسیم شدند. گروه </span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">A</span></span><span style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"> داینوژست (۲ میلی‌گرم روزانه) و گروه </span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">B</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"> داینوژست همراه با زینک (۵۰ میلی‌گرم روزانه) به &rlm;مدت چهار ماه دریافت کردند. شدت درد با استفاده از مقیاس بصری آنالوگ (</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">VAS</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) و کیفیت زندگی با پرسش&rlm;نامه </span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">EHP-30</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"> در ابتدا و پس از چهار ماه ارزیابی شد. تجزیه‌وتحلیل داده‌ها با نرم‌افزار </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">SPSS</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">نسخه ۲۶ انجام شد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.2pt">یافته‌ها</span></span></span></span></span></span></b><b><span b="" lang="AR-SA" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.2pt">: </span></span></span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">در گروه داینوژست به&rlm; تنهایی و داینوژست همراه زینک به &rlm;ترتیب میانگین نمره </span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">VAS</span></span><span style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"> قبل از درمان 0.50</span></span><span lang="AR-SA" style="font-size:10.0pt"><span cambria="" style="font-family:">&plusmn;</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">6.42 و 0.56</span></span><span lang="AR-SA" style="font-size:10.0pt"><span cambria="" style="font-family:">&plusmn;</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">6.53 (0.304=</span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) و پس از درمان 0.69</span></span><span lang="AR-SA" style="font-size:10.0pt"><span cambria="" style="font-family:">&plusmn;</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">2.92 و 0.65</span></span><span lang="AR-SA" style="font-size:10.0pt"><span cambria="" style="font-family:">&plusmn;</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">2.08 بود (0.001></span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">). بهبود کیفیت زندگی در تمام حیطه‌های پرسش&rlm;نامه </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">EHP</span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">-</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">30</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">در گروه ترکیبی به &rlm;طور معنی‌داری بهتر بود (0.05></span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">). فراوانی عوارض جانبی داروها در گروه داینوژست به &rlm;تنهایی و درمان ترکیبی به &rlm;ترتیب 16.7</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">و 11.1</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">درصد بود (496/0=</span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">).</span></span></span></span></span></span></span><br> <b><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:-.15pt">نتیجه‌گیری: </span></span></span></span></span></span></b><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:black">به نظر می&shy;رسد</span></span></span><b> </b><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:black">مصرف مکمل روی به &rlm;همراه داینوژست در بیماران مبتلا به اندومتریوز، باعث کاهش درد و بهبود کیفیت زندگی ناشی از اندومتریوز شود.</span></span></span> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3"><span style="letter-spacing:.15pt">Background and Objective:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="font-family:Optima">Endometriosis is a</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">chronic</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">and</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">inflammatory</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">disease</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">in</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">which</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">an</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">endometrial-like</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">tissue</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">develops</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">outside</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">the</span></span> <span style="font-size:9.0pt"><span style="font-family:Optima">uterus. This study was conducted to compare the effects of dienogest alone and dienogest combined with zinc supplementation on pain score and quality of life in patients with endometriosis.</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3">Materials and Methods: </span></span></span></b><span style="font-size:9.0pt"><span style="font-family:Optima">This single-blind randomized clinical trial was conducted on 72 patients who were referred to the outpatient clinic of Fatemieh Hospital in Hamadan, Iran, in 2025. Eligible patients were randomly assigned to two groups, A and B. Group A received dienogest (2 mg daily), while Group B received dienogest combined with zinc (50 mg daily) for 4 months. Pain severity was assessed using the Visual Analog Scale (VAS), and quality of life was evaluated using the Endometriosis Health Profile‑30 (EHP-30) questionnaire at baseline and after 4 months. Data were analyzed using SPSS software (version 26).</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3"><span style="letter-spacing:.15pt">Results:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="font-family:Optima">In the dienogest-alone and dienogest-plus-zinc groups, the mean VAS score before treatment was 6.42 &plusmn; 0.50 and 6.53 &plusmn; 0.56 (P = 0.304), and after treatment, it was 2.92 &plusmn; 0.69 and 2.08 &plusmn; 0.65 (P < 0.001), respectively. Improvement in quality of life across all domains of the EHP-30 questionnaire was significantly better in the combination group (P < 0.05). The frequency of side effects was 16.7% and 11.1% in the dienogest-alone and combination therapy groups, respectively (P = 0.496).</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3"><span style="letter-spacing:-.1pt">Conclusion:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="font-family:Optima">It appears that the use of zinc supplementation in combination with dienogest in patients with endometriosis may lead to a reduction in pain and an improvement in endometriosis-related quality of life.</span></span></span></span></span></span> اندومتریوز, داینوژست, درد لگن, روی, کیفیت زندگی Dienogest, Endometriosis, Pelvic Pain, Quality of Life, Zinc 21 28 http://sjh.umsha.ac.ir/browse.php?a_code=A-12-3099-1&slc_lang=fa&sid=1 Maryam Ahmadi مریم احمدی Ma.ahmadi@umsha.ac.ir 100319475328460024782 100319475328460024782 No Department of Obstetrics and Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran گروه زنان و زایمان، دانشکده پزشکی، دانشگاه علوم پزشکی همدان، همدان، ایران Zahra Mozaffari زهرا مظفری zahramozaffari172@yahoo.com 100319475328460024783 0009-0004-3454-5030 Yes Department of Obstetrics and Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran گروه زنان و زایمان، دانشکده پزشکی، دانشگاه علوم پزشکی همدان، همدان، ایران Elaheh Talebi Ghane الهه طالبی قانع e.talebi@umsha.ac.ir 100319475328460024784 100319475328460024784 No Modeling Noncommunicable Disease Research Center, Hamadan University of Medical Sciences, Hamadan, Iran مرکز تحقیقات مدل‌سازی بیماری‌های غیرواگیر، دانشگاه علوم پزشکی همدان، همدان، ایران