7-甲基异炔诺酮治疗女性更年期综合征临床观察

A clinical observation of therapeutic effects of 7-methylisothiourea norethisterone for climacteric syndrome in postmenopausal women

目的探讨7-甲基异炔诺酮治疗妇女绝经后更年期综合征的疗效及副作用。方法选择50例自然绝经后引起身体不适来就诊，并确诊为更年期综合征的妇女，其中同意接受激素治疗的35例为治疗组；随机选择同期就诊，且更年期症状明显，但拒绝激素治疗的妇女15例为对照组。所有病例经检查无子宫、卵巢恶性病变，子宫内膜〈5mm；乳腺检查无异常，治疗组予以7-甲基异炔诺酮2．5mg／d口服，疗程3个月；对照组给予维生素C60mg／d、维生素E50mg／d，口服连续3个月。结果应用7-甲基异炔诺酮治疗3个月后，患者更年期症状评分均有下降，与治疗前及对照组比较均有显著性差异（与治疗前比较t分别为3．51、3．55、3．11、2．67、2．46，均P〈0．05；与对照组比较t分别为2．04、2．29、2．09、2．36、2．13、均P〈0．05）；治疗组2例在治疗2个月后出现阴道流血，呈点滴状，1例在治疗1个月后出现乳房胀痛，继续服药后症状消失；治疗结束后x线钼靶摄影检查示乳腺无异常、子宫内膜厚度〈5mm。结论7-甲基异炔诺酮能有效改善绝经后妇女更年期症状，且副作用少，患者耐受性良好，值得临床进一步研究和探讨。

Objective To investigate therapeutic and side effects of 7-methylisothiourea norethisterone for climacteric syndrome in postmenopausal women. Methods 50 postmenopausal women with climacteric syndrome were assigned to hormonotherapy group （who agreed to receive hormonotherapy, n =35） and control group （who refused to receive hormonotherapy, n = 15） respectively. None of them had evidences of ovarian or uterine malignant tumors, their endometrial thickness was 〈 5mm and their breast examination result was normal. The postmenopausal women with climacteric syndrome in hormonotherapy group were given 2. 5mg/d of 7- methylisothiourea norethisterone orally for 3 months, while those postomenopausal women in the control group were given placebo---60mg/d of vitamin C and 50mg/d of vitamin E for 3 months. Results After 3 months of 7- methylisothiourea norethisterone treatment, scores in symptoms of climacteric syndrome of the women in the hormonotherapy group were significantly decreased, of which the symptoms sweating and hotflash disappeared in some of these patients, there were significant differences as compared with the control group and the scores before hormonotherapy （as compared with before hormonotherapy ： t = 3.51, 3.55, 3.11, 2.67, 2.46 respectively, all P 〈 0.05 ; as compared with those scores in the control group： t = 2.04, 2.29, 2. 09, 2. 36, 2. 13 respectively, all P 〈 0. 05）. Two patients in the hormonotherapy group experienced slight vaginal bleeding at the 2nd month of 7-methylisothiourea norethisterone treatment, one patient felt breast tenderness at the 1 st month of 7-methylisothiourea norethisterone treatment, such symptoms of 3 patients disappeared without withdrawal of 7-methylisothiourea norethisterone. At finishment of 5 months 7-methylisothiourea norethisterone therapy, radiography with molybdenum target tube showed breast of the patients in the hormonotherapy group was normal and their endometrial thickness was 〈 5mm. Conclusion 7-methylisothiourea norethisterone can relieve climacteric symptoms of postmenopausal women with less side effects and can be well tolerated by the patients. It is worthy to be studied in clinic further.