绝经早期低剂量激素治疗对乳腺的影响分析

Effect of Low-dose Hormone Therapy on Breast at the Early Stage of Menopause

目的：研究绝经早期低剂量激素治疗（HT）对乳腺的影响。方法：收集绝经早期妇女104例，随机分为激素组和中药组各52例，治疗1年，每3个月随访1次，由专人进行绝经期生存质量量表评分，受试者每日记录乳房胀痛情况。结果：绝经期生存质量量表中，激素组用药前评分为1．90±0．94分，用药后3月，6月，9月，12月评分较前均有显著性下降，分别为1．27±0．67分，1．08土0．62分，O．97±0．64分，0．69±0．50分；中药组用药后3月，6月，9月，12月评分也较用药前有显著性下降。激素组在用药3月，6月，9月，12月的乳房胀痛发生率分别为29．17％，14．63％，22．22％，9．09％，各时间点与中药组相比差异无统计学意义；在用药1～3月，激素组乳房胀痛程度为中度或重度的受试者占35．7％，显著多于中药组0％，其余各时间点两组在乳房胀痛程度上无统计学意义；激素组用药前乳腺小叶增生发生率为60％，用药后为91．4％，用药前后差异有统计学意义。结论：绝经早期低剂量HT和中药治疗1年均能有效提高生存质量，HT使乳腺小叶增生发生率增加，应用HT的过程中应加强乳房监测。

Objective： To study the effect of low-dose hormone therapy （HT） on breast at the early stage of menopause in women. Methods：A total of 104 perimenopausal women were enrolled in this trial. They were randomly divided into hormone group （HG） and Chinese traditional medicine group （CG）. 52 cases were in each group and given therapy for 1 year. Mammary swelling pain was recorded everyday by patient. Follow-up was 3 months, and scales of Menopause Specific Life Quality were scored by specialist. Results：In the scales of Menopause Specific Life Quality, the scores in the HG at beginning, 3 months, 6 months, 9 months, 12 months were 1.90±0.94, 1.27 ± 0.67, 1.08 ± 0.62, 0.97 ±0.64, 0.69± 0.50 respectively. The scores after therapy in both groups were obviously decreased than before. The incidences of mammary swelling pain in the HG at 3 months, 6 months, 9 months, 12 months were 29.17%, 14.63% ,22.22%, 9.09% respectively. There was no statistically difference in mammary swelling pain between the two groups during the treatment. During the first three months, the number of women who had mediate or severe mammary swelling pain （35.7%） in the HG was statistically larger than that in the CG （0%）. There was no statistically difference in the degree of mammary swelling pain between the two groups at the rest time points. The incidence of mammoplasia in the HG after treatment was 91.4%, statistically higher than that before treatment, which was 60%. Conclusions： Low-dose hormone therapy and Chinese traditional medicine therapy for 1 year are effective in improving life quality at the early stage of menopause. FIT can increase the incidance of mammoplasia, so breast should be checked regularly during HT.