戊酸雌二醇对建立人工周期的作用

Effect of progynova in patients with irregular menstruation

目的：通过观察戊酸雌二醇（商品名称为补佳乐）、安宫黄体酮序贯疗法对月经不调的疗效，探讨其对建立人工周期的作用。方法：将2003年3月-2005年2月来我院门诊的192例月经不调患者按病因不同分为青春期功血、卵巢早衰性闭经及围绝经期功血3组，采用戊酸雌二醇（补佳乐）、安宫黄体酮序贯治疗3-6个周期后，观察患者症状及用药前后血清激素水平。结果：所有病例停药后均发生少、中量撤退性出血，出血时间（5±2．5）天，青春期功血组停药后月经周期恢复正常者占56，9％；卵巢早衰组占9．3％；围绝经期功血组为20．2％，与用药前相比，各组血清激素水平有显著性变化（P〈0．05），后两组更年期症状明显改善（P〈0．05）。结论：戊酸雌二醇（补佳乐）人工周期治疗月经不调患者可使其恢复正常月经周期，调节H-P-O轴功能，同时对卵巢早衰和围绝经期的全身并发症亦有显著疗效。

Objective： To evaluate the effect of progynova and medroxyprugesterune acetate in patients with irregular menstruation. Methods： 192 patients with irregular menstruation were divided into 3 groups by etiopathogenisis, group of adolescent dysfunctional uterine bleeding, group of premature ovarian failure and group of perimenopausal. All patients received 1 mg progynova and 8 mg medroxyprogesterone acetate daily in cyclic sequential regimen. The duration of treatment was 3-6 cycles. Climacteric symptoms were scored before and after treatment. Serum FSH, LH, estradiol and progestogen level were measured at the same time. Results： Withdrawal bleeding occurred in each patient. Time of bleeding was 5±2. 5 days. After stopping cyclic sequential regimen, the recovery rate of normal menstruation cycle in group of adolescent dysfunctional uterine bleeding, group of premature ovarian failure and group of perimenopausal were 56.9% , 9. 3% and 20. 2% respectively. Serum hormone level increased significantly （ P 〈 0. 05 ） pre- and post -therapy in each group. Climacteric symptoms were relieved significantly （P 〈 0. 05 ） both in group of premature ovarian failure and group of perimenopausal. Conclusion： Progynova can adjust cycle of menstruation and relieve climacteric symptoms.