联合雌激素治疗对神经性厌食症患者的疗效

Effects of combined estrogen therapy on patients with anorexia nervosa

目的:探索联合雌激素治疗对年轻未治疗女性神经性厌食症(AN)患者临床常规治疗的增效作用。方法:将80例符合《美国精神障碍诊断与统计手册》第4版(DSM-IV-TR)中AN诊断且处于低雌激素状态的女性患者随机分为雌激素治疗组(A组:雌激素治疗+常规治疗,n=38)与常规治疗组(B组,n=42),并在治疗4周、12周后进行随访评估,使用体质量指数(BMI)、进食障碍检查问卷(EDE-Q)总分、进食态度量表(EAT-26)总分、贝克抑郁量表(BDI)总分、贝克焦虑量表(BAI)总分(该4个量表总分简称症状量表总分)评估患者的临床症状,比较治疗前后两组疗效及差异。A组分别有25例和20例患者完成4周和12周随访,B组分别有23例和21例患者完成4周随访和12周随访。结果:两组AN患者在治疗前后的临床症状总分的减分率变化均差异无统计学意义(P>0.05);两组AN患者的临床症状总分随时间均有显著变化(P<0.05)。结论:对低体质量女性AN患者联合雌激素治疗并不能明显增加疗效。

Objective:To explore the synergistic effect of combined estrogen therapy on the conventional treatment of untreated young female anorexia nervosa(AN)patients.Method:Totally 80 AN patients meeting the criteria of Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition,Text Revision(DSM-IV-TR)and in the hypoestrogenemia status were randomly divided into the combined estrogen therapy group(group A:combined estrogen therapy+conventional treatment,38 subjects)and the conventional treatment group(group B:42 subjects)group.The changes of Body Mass Index(BMI),and the total scores of the Eating Disorders Questionnaire(EDE-Q),eating attitude test(EAT-26),Beck Depression Inventory(BDI)and Beck Anxiety Inventory(BAI)in both groups before and after 4 weeks and 12 weeks treatment were measured to compared the synergistic effect of combined estrogen therapy on the conventional treatment.Twenty five and 20 cases completed the 4 weeks and 12 weeks follow-up respectively in group A;23 and 21 cases completed the 4 weeks and 12 weeks follow-up respectively in group B.Results:In both groups,the total scores of the EDE-Q,EAT-26,BDI and BAI changed significantly during 12 weeks of treatment(P<0.05).There was no significant difference in the changes of the reduction rates of the BMI and the total scores of the four scales before and after treatment between group A and group B(P>0.05).Conclusion:The short time of the combined estrogen therapy couldn't significantly increase the therapeutic effect on the conventional treatment for low BMI female AN patients.