围绝经期雌激素补充口服及阴道用药72例对比性研究

Comparison of the effects between oral and vaginal administration of hormone replacement therapy(HRT) in 72 women in perimenopausal period

目的 探讨不同途径给予结合型雌激素 (CE)对围绝经期妇女血清E2 、子宫内膜厚度和阴道细胞学及更年期症状的影响。方法 72例围绝经期妇女随机分为两组 ,口服给药组 37例 ,阴道给药组 35例 ,分别口服及阴道给予倍美力片剂 0 6 2 5mg及倍美力霜 2 g ,比较两组用药前后血清E2 、子宫内膜厚度和阴道细胞学评分 (V分 )的变化及症状改善程度。结果 用药后口服给药组血清E2 较用药前增加 (P <0 0 5 ) ,内膜厚度用药前后有显著改变 (P <0 0 1) ,而V分改变不显著 ;阴道给药组血清E2 及内膜厚度无明显改变 ,而V分较用药前明显提高 (P <0 0 1)。结论 围绝经期妇女全身症状以口服补充雌激素为佳 ,局部症状以阴道给药较好。

Objective To compare the effects between oral and vaginal administration of conjugated estrogen on serum concentrations of E 2, endometrial thickness,vaginal cytology and symptoms in perimenopausal period women Methods 72 women in perimenopausal period were divided into two groups randomly 37 women received Primarin 0 625mg orally (oral group) and 35 women received Primarin frost 2g vaginally (vaginal group) for three periods. Compare the level of E 2,endometrial thickness,vaginal cytology (V score)before and after treatment between two groups Results After treatment, the level of E 2 and endometrial thickness significantly increased in oral group (P<0 05),but there was no difference in V score In vaginal group, the V score was significantly higher (P<0 01),but there was no difference in the level of E 2 and endometrial thickness The symptoms were improved in both groups, but the general symptoms were more obviously improved in oral group than in vaginal group,and the local symptoms were more obviously improved in latter than former Conclusions Perimenopausal period women mainly with general symptoms had better be treated with HRT by oral administation,while those with mainly local symptoms should be treated with HRT by vaginal administation.