激素治疗雷公藤多甙所致闭经25例临床分析

Hormone Therapy on Patients with Amenorrhea Caused by Tripterygium Wilfordii Polyglycoside

目的探讨免疫性肾脏疾病用药雷公藤多甙（tripterygium wilfordii polyglycoside，TWP）所致闭经的临床特点及治疗。方法温州医学院第一附属医院2001年2月～2005年12月门诊因免疫性肾脏疾病使用TWP后引起继发性闭经患者25例，测定闭经后以及激素治疗后的性激素水平，两者进行比较，并观察用药前后患者的月经恢复情况、临床症状改变。结果①25例患者都有雌二醇（E2）下降〈73．2pmol／L、卵泡刺激素（FSH）升高〉40U／L，其中有24例符合卵巢早衰的诊断；②激素治疗后20例有效，其中17例恢复至正常月经，3例经量较前减少；5例无效；总有效率达80％；③20例治疗有效患者E2由治疗前（63．19±10．81）pmol／L升高至（365．45±161．60）pmol／L。FSH由治疗前（110．72±21．52）U／L升高至（11．46±17．70）U／L；④25例患者在治疗2个周期后围绝经期症状有明显改善。结论雷公藤多甙可能引起卵巢功能损害，但及时停药并应用激素治疗对可能可以恢复患者卵巢功能。

Objective To discuss the clinical characteristics and treatment of amenorrhea caused by Tripterygium Wilfordii polyglycoside （TWP）. Methods The sexual hormone levels of 25 outpatients of The First Affliated Hospital Of Wenzhou Medical College who suffered from secondary amenorrhea after the use of TWP were examined before and after the hormone therapy. In addition, the clinical presentations were observed. Results （1） The E2 level went down lower than 73.2pmol/L while FSH went up higher than 40U/L in all the 25 patients. Among them,24 patients were confirmed of the diagnosis of premature ovarian failure. （2）HT is an effective way for 20 patients. The total efficiency of the therapy was 80%. （3）The E2 secreted by ovary was higher [ （ 63. 19 ± 10.81 ） pmol/1 vs. （ 365.45 ± 161.60） pmol/L] and FSH[（110.72 ± 21.52）U/L vs. 11.46±17.70）U/L] secreted by pituitary was lower after therapy than before. （4）After the second period of therapy, the clinical perimenopausal symptoms of all the patients were improved to different degrees. Conclusion TWP may result in the disorders of ovarian functions, but and HT in time may be an effective therapy.