结合雌激素治疗更年期综合征临床疗效及依从性的研究

CLINICAL STUDY FOR THE EFFECT AND COMPLIANCE OF CONJUGATED ESTROGEN IN THE TREATMENT OF CLIMACTERIC SYNDROME

目的 :探讨结合雌激素治疗更年期综合征的临床效果及依从性。方法 :将 114例更年期综合征患者分为研究组和安慰剂组。研究组 6 9例按联合序贯方案每天口服结合雌激素 0 .6 2 5 mg,2 8d为 1个周期 ,周期的第 15～ 2 8天每天加服醋酸甲孕酮 4mg;安慰剂组 45例每天服用安慰剂。两组分别用药半年以上 ,于用药前、后对更年期综合征症状进行综合评分 ,观察血 E2 、 FSH水平 ,子宫内膜厚度、乳腺、体重的变化 ,记录服药反应、中断治疗原因及继续服药意愿。结果 :研究组用药后更年期综合征症状评分显著下降 ,血中 E2 水平显著升高、FSH下降 (P <0 .0 5 ) ,安慰剂组用药后上述指标无显著变化 (P>0 .0 5 ) ;研究组因症状无明显好转而中断用药的比例明显少于安慰剂组 (P <0 .0 5 ) ,用药前、后体重和子宫内膜厚度的变化及两组间比较差异均无显著性 (P >0 .0 5 )。结论 :结合雌激素能有效缓解更年期综合征症状 ,症状明显缓解或消失是提高结合雌激素治疗更年期综合征临床依从性的关键。

Objective:To study the effect and compliance of onjugated estrogen in the treatment of climacteric syndrome Methods:114 patients with climacteric syndrome were randomly divided into two groups,the study group with 69 patients and the controlled group with 45 patients Patients of the study group intake conjugated estrogen orally 0 625 mg per day,28 days for a period,added with MPA(Medroxyprogesteme acetate)4 mg per day during the 15th to 28th days of every period.Patients of the controlled group intake placebo All patients took medicine over half year, and were asked to give general score of climacteric symptom before took medicine and after took medicine half year,Checked the change of E 2 、 FSH level in blood,as well as in body weight,recorded the reaction of medicine,the reason for interruption of the therapy and the willingness of continuing to take medicine Result:Within the study group ,reduction in Kupperman score and FSH and elevation in E\-2 occurred (P<0 05);there is no significant change in the controlled group(P>0 05)  Conclusion:Relief or disappearance of symptom is the key of the compliance of conjugated estrogen in the treatment of climacteric syndrome