结合雌激素加安宫黄体酮连续序贯应用治疗更年期综合征

CLINICAL STUDY OF TREATMENT OF MENOPAUSAL SYMPTOMS WITH CONTINUOUS SEQUENTIAL OF CONJUGATED ESTROGENS AND MEDROXAYPROGESTERONE ACETATE

目的：了解结合雌激素加安宫黄体酮连续序贯应用治疗更年期症状的疗效及安全性。方法：３９例患者服药４个周期（每周期２８ｄ），观察临床疗效、生化指标、激素测定、子宫内膜病理改变及阴道出血情况。结果：（１）服药后更年期症状明显缓解，Ｋｕｐｐｅｒｍａｎ评分由３０±９下降为７±９（Ｐ＜０．００１）；（２）服药后血高密度脂蛋白胆固醇显著上升（Ｐ＜０．００１），甘油三脂轻度上升，低密度脂蛋白胆固醇、总胆固醇轻度下降（Ｐ＞０．０５）；（３）服药后子宫内膜无明显增生；（４）主要副作用为阴道出血。结论：结合雌激素治疗更年期症状疗效显著，对心脏可能有保护作用，与安官黄体酮短期连续序贯使用安全可靠。

Objective:To know the effects of conjugated estrogens(Premarin)on menopausal symptoms and their safety. Methods:39 symptomatic postmenopausal women received premarin 0.625 mg daily(total 4 cycles),and medroxyprogesterone acetate(MPA)5 mg daily was added from 14～28 days in each treatment cycle(28 days per cycle).The menopausal symptoms,endometrial histology,incidence of vaginal bleeding,and 1ab test were evaluated before and at the end of therapy.Results:① Menopausal symptoms were relieved significantly,the score of symptoms decreased from 30±9 to 7± 9,P<0.001.②Serum high-density cholesterol increased significantly,P<0.001.Total cholesterol decreased,low-density ch0leoterol,triglycerids increased,P>0.05.③No endometrium hyperplasia was found.④The side effect was mainly bleeding. Couclusion:0.625 mg Premarin daily can relieve the menopausal symptoms effectively,and may have a protective effect on the heart. The continuous se-quential therapy of premarin and MPA is safe.