小剂量雌激素替代疗法治疗绝经后骨质疏松症

Postmenopausal Osteoporosis Treated by Hormone Replacement Therapy (HRT) with Small Dose of Estrogen

目的观察小剂量雌孕激素联合使用防治绝经后骨质疏松症的临床疗效。方法对 195例绝经后骨质疏松患者 ,分别采用复方尼尔雌醇 ( 12 3例 )和安慰剂 ( 72例 )对比治疗。观察两组治疗一年后多种生化指标及骨密度等系数的变化。结果治疗组一年前后骨密度差值与对照组比较 ,在前臂处表现有显著性差异 (P <0 .0 5 ) ,即治疗组骨密度较高。在其他部位骨密度虽无显著性差异 (P>0 .0 5 ) ,但均有增加的趋势。其他观察指标如 :肝肾功能 ,乳腺红外线扫描、子宫大小及内膜B超、阴道脱落细胞找癌细胞、阴道流血、骨折等均无显著性差异 (P >0 .0 5 )结论小剂量雌孕激素联合使用具有疗效确切、副作用少、服用方便的优点。

ObjectiveTo observe clinical therapeutic efficacy of combining administration with small doses of estrogen and progesterone in the treatment and prophylaxis of postmenopausal osteoporosis.MethodsCompound Nilestriol tablet is a complex with a dosage of Nilestriol and levonorgestrel lower than that required for making normal menses or used in normal HRT of postmenopausal osteoporosis. It is a type 3-home made new drug of China and was permitted to try in clinical study in our hospital.Clinical observation was performed on 195 patients for 1 year. They were divided into two groups: (1) Group 1-123 patients were treated with complex tablet and (2) Group 2-72 patients treated with placebo served as control. The changes of various biochemical criteria and bony density were followed up after one year of treatment.ResultsThe bone loss in Group 1 was significantly lower than that in Group 2, which was especially prominent on forearms (P<0.05). There were no obvious differences of other parameters between both groups, such as the liver and kidney functions, the infrared scanning of the mammary glands, endometrium and size of uterus, carcinomatous changes in vaginal exfoliated cells, withdrawal bleeding of vagina,and the rate of fractures etc after one year's treatment. ConclusionDuring the treatment of postmenopausal osteoporosis, small dose of Nilestriol and levonorgestrel is effective, safe, and convenient.