绝经后妇女低剂量激素替代治疗更年期症状的前瞻性研究

PROSPECTIVE STUDY OF LOWDOSE HORMONAL REPLACEMENT THERAPYON THE TREATMENT OF CLIMACTERIC SYMPTOMA IN POSTMENOPAUSAL WOMEN

目的探讨低剂量结合型雌激素（ＣＥ）和安宫黄体酮（ＭＰＡ）对更年期症状的治疗作用。方法３４例绝经后妇女随机分为２组，试验组１７例，隔日口服ＣＥ０．６２５ｍｇ与ＭＰＡ２ｍｇ交替应用；对照组１７例，口服结合型雌激素０．６２５ｍｇ／ｄ，每月连续服用２５ｄ，后１０ｄ加用ＭＰＡ４ｍｇ。２组均连续服用４周期。结果实验组１例退出，对照组２例退出。两组比较治疗效果无差异（Ｐ＞０．０５），治疗前后更年期症状均明显改善（Ｐ＜０．０１）。两组用药后无血压升高、乳腺增生及子宫内膜增生，试验组无阴道出血及乳房胀痛，对照组６例（４０％）有规则性阴道出血、４例（２７％）有乳房胀痛（Ｐ＜０．０１，Ｐ＜０．０５）。结论绝经后妇女低剂量激素替代治疗（ＨＲＴ）具有用量小、副作用少、有效、安全、经济等优点。

Objective To investigate effects of elowdose estrogen and progestogen on the climacteric symptoms.Method 34 cases of postmenopausal women(PMW) were divided randomly into trail (17 cases) and control group (17 cases). The train group received lowdose estrogen and progestogen: conjugated estrogen(CE) 0.625mg and medroxyprogesterone acetate(MPA) 2mg QOD alternately. The control group was treated with CE 0.625mg daily for 25 days in combination with cycle MPA 4mg daily ,the last 10 days for four cycles.Results The climacteric symptoms were significantly improved in both of group; 6 cases of bleeding and 4 cases breast pain occured in control group, where as no taken place in train group(P<0.01, P<0.05).Conclusion The lowdose hormonal replacement therapy gave in improving eclimacteric symptoms and lower side effects than largedose.