激素间歇周期序贯疗法治疗围绝经期综合征

Observation of safety for hormone intermittence cycle sequential therapy for perimenopausal syndrome

目的观察激素间歇周期序贯疗法治疗围绝经期综合征的安全性。方法选择4（1～60岁围绝经期妇女90例，随机分为A、B、C3组，每组30例。A组为观察组，用激素间歇周期序贯法治疗，即每月口服雌二醇（补佳乐）21d，后10天加用安宫黄体酮，停药7d为一疗程。连用3个疗程，间歇1个月，疗程2年；B组为药物对照组，用连续周期序贯法治疗，其方法同A组疗程用药，但每月连续使用，不间歇，疗程2年；C组为空白对照组，不用药物，观察2年。观察指标：Kupperman评分、血清促卵泡素（FSH）、雌激素（E2）、子宫内膜厚度、乳腺腺体厚度及乳腺导管宽度等指标。结果A、B组治疗3个月、1年、2年，Kupperman评分、FSH、E2，与对照组相比有明显改善（P〈0．01），A、B两组间差异无统计学意义。A组治疗2年子宫内膜厚度、乳腺腺体层厚度及乳腺导管宽度均小于B组，差异有统计学意义（P〈0．05）。结论激素间歇周期序贯疗法治疗围绝经期综合征疗效确切．其对子宫内膜及乳腺刺激小于激素连续周期序贯疗法。

Objective The safety of hormone intermittence cycle sequential therapy was observed for perimenopausal syndrome. Methods 90 menopausal Syndrome women aged 40 -60 years old were randomly divided into groups A, B and C（ each of 30 cases）. The group A with hormone intermittence cycle sequential therapy for 2 years. The group B with hormone continual cycle sequential therapy for 2 years. The group C without drugs for 2 years. Kupperman score, serum follicle stimulating hormone （ FSH）, estradiol （E2） , endometrial and breast thicknesses, and width of mammary duct etc,were observed. Results Compared with the group C, kupperman score, FSH and E2 in group A and B improved after the treatment of three months, one year and two years, the difference was statistically significant （P 〈0.01 ）. Difference between group A and B was not statistically significant （P 〉0.05）. The thickness of endometrial and breast and width of mammary duct in group A with 2 years treatment were less than those in group B, the difference was statistically significant （ P 〈 0.05 ）. Conclusion The effectiveness of hormone intermittence cycle sequential therapy on menopausal syndrome is sure with less stimulation to endometrial and breast, and its safety is higher than that of continual cycle of sequential hormone therapy.