激素替代联合局部用药治疗围绝经期女性萎缩性阴道炎的临床效果

Clinical effect of hormone replacement therapy combined with local medication in treatment of atrophic vaginitis in perimenopausal women

目的探讨激素替代联合局部用药治疗围绝经期女性萎缩性阴道炎的方法和效果。方法选取105例围绝经期萎缩性阴道炎患者为研究对象,随机分为A、B、C 3组,每组35例,按照不同的给药治疗方式设置为观察组(A、B组)和对照组(C组),A、B组予以雌激素联合甲硝唑泡腾片局部用药治疗,C组仅阴道放置甲硝唑泡腾片1片/d治疗,3组共给药3个月。3个月治疗结束后对所有患者随访6个月并观察治疗效果,比较观察和对照两组结果。结果 A、B两组患者治愈率显著高于C组(P<0.05);雌激素停止用药3个月后,A、B组萎缩性阴道炎复发率显著低于C组(P<0.05);雌激素停止用药6个月后,A、B组萎缩性阴道炎复发率接近于C组,且3组之间差异无统计学意义(P>0.05)。A、B组药物使用时间明显短于C组(P<0.05),用雌激素后A、B组E2值显著升高,子宫内膜厚度也显著增厚(P<0.05),A、B组pH值显著低于C组(P<0.05),但A和B组之间差异无统计学意义(P>0.05)。结论激素替代联合局部用药能够显著提高临床疗效,改善临床症状,降低复发率,且安全性高。

Objective To explore the method and effect of hormone replacement therapy combined with local medication in treatment of atrophic vaginitis in perimenopausal women. Methods A total of 105 patients with perimenopausal atrophic vaginitis were selected and randomly divided into group A,group B,and group C,35 patients in each group. According to different treatment methods,the patients in group A and group B were designed as observation group,while the patients in group C were designed as control group. The patients in group A and group B were treated by estrogen combined with local medication of metrozole effervescent tablet,and the patients in group C were treated by vaginal medication of metrozole effervescent tablet, one tablet per day. The patients in the three groups were treated for 3 months. After treatment,all the patients were followed up for 6 months to observe the curative effects,the results in observation group and control group were compared and observed. Results The cure rates in group A and group B were statistically significantly higher than that in group C（ P〈0. 05）; after drug withdrawal of estrogen for 3 months,the recurrence rates in group A and group B were statistically significantly lower than that in group C（ P〈0. 05）; after drug withdrawal of estrogen for 6 months,the recurrence rates in group A and group B were close to that in group C,there was no statistically significant difference among the three groups（ P〉0. 05）. The application time of drugs in group A and group B was statistically significantly shorter than that in group C（ P〈0. 05）; after application of estrogen,the levels of estradiol（ E2） in group A and group B increased significantly,endometrial thickness thickened significantly（ P〈0. 05）,pH values in group A and group B were statistically significantly lower than that in group C（ P〈0. 05）,but there was no statistically significant difference between group A and group B（ P〉0. 05）. Conclusion Hormone replacement therapy combined with local medication can significantly improve clinical efficacy and clinical symptoms,reduce recurrence rate,the safety is high.