促进血液循环疗法对更年期女性性功能的影响

Effects of promoting blood circulation on the sexual function of perimenopausal women

目的探讨神经肌肉刺激促进血液循环对更年期女性性功能的影响。方法选择收治的80例更年期女性作为研究对象,按卵巢功能下降程度分为卵巢功能下降组[卵泡刺激素(FSH)>10 U/L,A组,n=40]与卵巢功能衰竭组[FSH>40 U/L且雌二醇(E2)<10~20 pg/ml,B组,n=40],A、B组组内随机分为A1、A2组与B1、B2组各20例,A1、B1组采用谷维素治疗,A2、B2组在此基础上加用仿生物神经电刺激促进血液循环方案治疗,测定2组治疗前后更年期症状及性功能的改善情况,检测患者子宫体积、子宫内膜厚度、卵巢容积、卵巢动脉阻力指数(RI)、卵巢血流搏动指数(PI)、卵巢间质收缩期峰值(PSV)及卵巢间质动脉血流收缩期最大流速(S)与舒张末期血流速度(D)比值,并留取外周静脉血,测定FSH、E2水平变化。结果治疗3个疗程后,各组更年期症状评分均降低,A2组、B2组评分降低幅度高于A1、B1组(P<0.05),A2组评分低于B2组(P<0.05)。治疗3个疗程后,各组性功能量表评分均上升,A2组、B2组评分上升幅度高于A1、B1组(P<0.05),A2组评分高于B2组(P<0.05)。治疗3个疗程后,A2组子宫内膜厚度增加,RI降低,PI、PSV、S/D上升,与A1组、B1组及B2组比较差异有统计学意义(P<0.05)。治疗前,B1、B2组FSH高于A1、A2组(P<0.05),E2水平低于A1、A2组(P<0.05),治疗3个疗程后,A2、B2组FSH水平均降低,E2水平均上升(P<0.05),A2组FSH低于B2组,E2水平高于B2组(P<0.05)。结论采用仿生物神经电刺激促进血液循环疗法可改善更年期卵巢功能下降与衰竭患者性功能及更年期症状,调节雌激素水平紊乱,且以更年期卵巢功能下降患者卵巢血供、性功能及更年期症状改善更明显。

Objective To investigate the effects of neuromuscular stimulation promoting blood circulation on the sexual function of perimenopausal women.Methods Eighty women in climacteric period who were treated in our hospital were selected as subjects,and according to the degree of ovarian function decline,they were divided into ovarian function decline group[the level of follicle stimulating hormone(FSH)>10U/L,group A,n=40]and ovarian function failure group[the levels of FSH>40U/L and the levels of estradiol(E2)<10~20pg/ml,group B,n=40].The patients in both groups were randomly redivided into group A1,A2,B1 and B2,with 20 patients in each group.The patients in group A1 and group B1 were treated by oryzanol,however,the patients in group A2 and group B2,on the basis of group A1 and group B1 were treated by bionic electrical nerve stimulation to promote blood circulation.The relief status of perimenopausal symptoms and improvement state of sexual function were observed.Moreover the uterine volume,endometrial thickness,ovarian volume,ovarian artery resistance index(RI),ovarian blood flow pulsatility index(PI),ovarian stromal peak systolic velocity(PSV)and ratio of ovarian stromal artery systolic peak velocity(S)/end diastolic velocity(D)were detected.In addition the FSH and E2 levels in peripheral venous blood were detected and compared among groups.Results After 3 treatment courses,the scores of climacteric symptom were decreased in all the groups,moreover,the decrease degree in group A2 and group B2 was significantly higher than that in group A1 and group B1(P<0.05),besides the scores in group A2 were significantly lower than those in group B2(P<0.05).After 3 treatment courses,the scores of sexual function scale were increased in all the groups,and the increase degree in group A2 and group B2 was significantly higher than that in group A1 and group B1(P<0.05),moreover,the scores in group A2 were significantly higher than those in group B2(P<0.05).After 3 treatment courses,the endometrial thickness was increased,however,RI was decreased,and PI,PSV and S/D were significantly increased in group A2,as compared with those in group A1,group B1 and group B2(P<0.05).Before treatment,FSH levels in group B1 and group B2 were significantly higher than those in group A1 and group A2(P<0.05),however,E2 levels were significantly lower than those in group A1 and group A2(P<0.05).After 3 treatment courses,the FSH levels were decreased in group A2 and B2,but E2 levels were significantly increased(P<0.05).In addition the levels of FSH in group A2 were lower than those in group B2,however,the levels of E2 were significantly higher than those in group B2(P<0.05).Conclusion Using bionic electrical nerve stimulation to promote blood circulation can improve the sexual function,relieve climacteric symptoms and regulate estrogen level disorders in menopausal women with ovarian function decline or ovarian function failure.Besides,the improvement degree of ovarian blood supply,sexual function and climacteric symptoms in patients with perimenopausal ovarian function decline is more obvious.