口服避孕药对卵巢早衰患者的内分泌影响

Effect of oral contraceptive marvelon on the endocrine profile of the women with premature ovarian failure

目的通过口服避孕药对卵巢早衰患者血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)水平及围绝经期症状的观察分析,探讨卵巢早衰的有效治疗方法。方法将114例卵巢早衰患者随机分为两组,每组57人,第一组单服妈富隆片(妈富隆组),第二组予补佳乐片+安宫黄体酮片(HRT组),于治疗后3、6、9月分别观察两组病人的潮热、盗汗、失眠、烦躁、注意力、乳房萎缩、生殖器萎缩等围绝经期症状以及血清FSH、LH、E_2的水平变化。并对治疗显效的患者进行促排卵+中药治疗,指导受孕。结果治疗后两组患者的围绝经期症状都显著改善,但组间无显著性差异;妈富隆组血清FSH、LH水平下降速度和幅度明显优于HRT组;E_2水平上升、卵巢排卵恢复在两组无显著性差异。结论口服妈富隆片对降低高水平的FSH、LH疗效显著,是治疗卵巢早衰的一种有效方法。

Objective： To study the effect of hormone （FSH）, luteinizing hormone premature ovarian failure （POF）. oral contraceptive marvelon on serum levels of follicle-stimulating LH） and estradiol （E2） and symptom relief in the patients with Methods： A total of 114 patients with diagnosed POF were randomly divided into two groups 57 for each, and treated with conventional hormone replacement therapy （progynova ＋ medroxyprogesterone acetate, HRT group） and oral contraceptive marvelon （Marvelon group）, respectively. Serum levels of FSH, LH and E2 were measured by radio immunoassay at 3, 6, 9 months after treatment. The symptoms of estrogen deficiency were also observed. Results： The symptoms were improved significantly in all patients after the treatment. The elevated serum FSH levels and LH levels significantly decreased and the declined serum E2 levels significantly in creased after treatment in both groups when compared with those before treatment （P〈0.05）. The serum levels of FSH and LH in marvelon group were significantly lower than those in HRT group at any time points of measurement （3,6,9 months after treatment） （P〈0.05）, while serum levels of E2 and the rate of resumption of ovulation were similar in two groups （P〉0.05）. Conclusions. Oral marvelon tablet is effective in reducing the elevated levels of FSH and LH and increasing E2 levels in the patients with POF. It could be an effective treatment for the patients with POF.