Objective To discuss the clinical results after the gonadotropin - releasing hormone agonist(GnRHa)add - back therapy combined with moderate to severe endometriosis(EMS). Methods 96 cases of severe endometriosis(EMS)were randomly divided into treat-ment group and control group. The treatment group were treated with gonadotropin releasing hormone agonist(GnRHa)combined with reverse ad-dition treatment. The control group was treated with single gonadotropin releasing hormone agonist(GnRHa)treatment. Serum sex hormone levels were compared in patients with bone metabolic markers(serum calcium,phosphorus,and alkaline phosphatase levels). The lumbar spine bone mineral density(L - VMD)levels were observed between the two groups of patients after clinical remission situation. Results The serum levels of sex hormones of previous treatment decreased compared two groups of patients. The serum sex hormone levels were slightly lower than in the con-trol group after treatment,but the difference was not statistically significant( P > 0. 05). After treatment,the bone metabolic markers(calcium, phosphorus,alkaline phosphatase)and lumbar spine bone mineral density in the treatment group was significantly better than the control group. The difference was statistically significant( P 0.05）。治疗后治疗组患者血清中骨代谢生化指标（钙、磷、碱性磷酸酶）和腰椎骨密度的水平明显优于对照组，差异具有统计学意义（ P <0.05）。治疗组的临床缓解率高于对照组，而恶心、呕吐等不良反应发生率明显低于对照组，差异均具有统计学意义（ P <0.05）。结论中、重度 EMS 保守性手术后 GnRHa 联合反向添加治疗效果明显，可克服单一GnRHa 治疗的弊端，优化治疗效果。
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