自然绝经后妇女泌尿生殖系统疾病症状分析与诊治

CLINICAL SYMPTOMS AND THERAPEUTIC EFFECT OF UROGENITAL DISEASES IN POSTMENOPAUSAL WOMEN

目的分析自然绝经后妇女泌尿生殖系统疾病的临床表现,探讨雌三醇乳膏局部给药的疗效。方法①将100例绝经后期的具有泌尿生殖症状的门诊患者按绝经时间≤5年和>5年分为二组,比较二组患者泌尿生殖系统疾病症状和体征;②将100例患者随机分成二组,A组每晚雌三醇乳膏(欧维婷,南京欧加农制药有限公司)阴道局部给药,每次0.5g(含0.5mg雌三醇);B组应用甲硝唑200mg放入阴道,每晚1次。用药2周后观测泌尿生殖道症状改善情况及妇科检查情况。结果①绝经时间>5年的患者,阴道干涩、外阴瘙痒等症状的发生率与绝经时间≤5年的患者相比差异无统计学意义(P>0.05),但尿急、尿痛等尿道刺激症状、脓性白带等症状的发生率显著高于绝经时间≤5年患者(P<0.05);绝经时间>5年的患者阴道粘膜充血、溃疡的发生率明显高于绝经时间≤5年患者(P<0.05)。阴道粘膜萎缩、伴宫颈糜烂或附件炎的发生率二组差异无统计学意义(P>0.05);与甲硝唑阴道局部给药治疗相比,局部用欧维婷处理2周后,在阴道干涩、阴道瘙痒、粘膜充血等方面的治愈率有显著提高(P<0.01或<0.05),但在尿道刺激症状和阴道触痛的疗效方面差异无统计学意义(P>0.05)。结论绝经5年后妇女泌尿系统疾病的症状及病情比绝经后≤5年的发生率更高、更严重;雌三醇局部给药疗效比甲硝唑抗菌消炎治疗更好。

Objective To analyze the clinical symptoms and therapeutic effect of estriol E3 on urogenital diseases in postmenopausal women. Methods The clinical symptoms and physical signs of 100 postmenopausal women with urogenital disease in outpatient were analyzed by dividing into two groups, menopausal time 45 years and menopausal time 〉5 years. The therapeutic effect of estriol E3 ointment treated with 0.5mg in vagina each night was analyzed by comparing 200mg diethylstibestrol treatment for 2 weeks. Results The incidence rate of urethra stimulative symptoms and pussy vaginal discharge of urogenital diseases in menopausal time 〉5 years women were significantly higher than that of in menopausal time 45 years women（P〈0.05）. No differences of overdried vagina, vaginal itching and painful sexual intercourse were observed between two group（P〉0. 05） ; the incidence rate of vaginal mucosa congestion and ulcer in menopausal time 〉5 years group were significantly higher than that of 45 years group （P〈0.05）. No differences of vaginal mucosa atrophy, cervix and uterine applicator inflammation were presented between two group women（P^0.05）; The symptoms of over-dried vagina, vaginal itching and vaginal mucosa congestion after 2 weeks 0.5mg estriol E3 treatment were significantly improved than that of diethylstibestrol treatment （P〈0.01 or P〈0.05）. Whereas, no difference of urethra stimulative symptoms and vagina tenderness pain improvement were observed between estriol E3 treatment and diethylstibestrol treatment（P〉0.05）. Conclusion The incidence rate of clinical symptoms and pathogenetic condition of urogenital disease in 〉5 years postmenopausal women are increased and serious than that in 45 years postmenopausal women. The therapeutic effect of estriol E3 treatment on vagina is better than that of diethylstibestrol treatment.