替勃龙与尼尔雌醇治疗绝经后更年期症状临床疗效比较

Comparison of clinical efficacies between tibolone and nylestriol on menopausal symptoms of postmenopausal women

目的:比较替勃龙(2.5mg/片)和尼尔雌醇(2mg/片)治疗绝经后妇女更年期症状的疗效及其对脂代谢、雌激素水平、子宫内膜和乳腺的影响。方法:将87例更年期患者随机分为替勃龙组(2.5mg/次,1次/日)和尼尔雌醇组(2mg/次,1次/2周)治疗6个月,记录两组临床症状的变化及不良反应,测定治疗前后甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)及血清雌二醇(E2)水平,B超监测乳腺及测量子宫内膜厚度。结果:①两组方面在缓解潮热、盗汗、心悸、失眠、尿频及阴道干涩症状方面差异无统计学意义,在缓解腰背痛、功能性消化不良症状、抑郁等精神症状方面差异有统计学意义。②两组治疗前后TG、LDL、E2水平差异均无统计学意义,HDL水平治疗后均较治疗前显著上升,P<0.05。③治疗前后子宫内膜和乳腺体层厚度的变化两组间差异无统计学意义。结论:替勃龙和尼尔雌醇治疗6个月均能有效改善女性绝经后更年期症状,对脂代谢和雌激素水平无不良影响,亦未显示对子宫内膜和乳腺产生不良影响。替勃龙临床综合疗效优于尼尔雌醇,不良反应的发生率低。

Objective： To compare the clinical efficacy and effect of tibolone （2.5mg per tablet） and nylestriol （2 mg per tablet） on lipoid metabolism, serum estrogen level, the thickness of endometrium and mammary glands. Methods： 87 postmenopausal women were divided into tibolone group （2. 5 mg, once a day） and nylestriol group （2mg, every two weeks） and observed for six months, the changes of clinical symptoms and adverse reactions of two groups were recorded, the levels of glycerin trilaurate （TG） , low density lipoprotein （LDL） , high density lipoprotein （HDL） and serum estrogen （ E2 ） before and after treatment were detected, the thickness of endometrium and mammary glands were measured by B type ultrasound. Results： ①There was no significant difference in relieving symptoms, such as hot flashes, night sweat, palpitation, insomnia, frequent micturition and dry vagina between tibolone group and nylestriol group; but there was significant difference in relieving low - back pain, functional dyspepsia and depression. ②There was no significant difference in the levels of TG, LDL and E2 before and after treatment in the two groups, but the level of HDL after treatment was higher than that before treatment （ P 〈 0. 05 ） . ③There was no significant difference in the thickness of endometrium and mammary glands before and after treatment in the two groups. Conclusion： After treatment for six months, fibolon and nylestriol can improve menopausal symptoms of postmenopausal women effectively, not affecting endometrium and mammary, glands. The clinical efficacy of tibolon is superior to that of nylestriol, and the incidence of tibolon is lower.