安今益和替勃龙激素补充疗法对围绝经期综合征患者脂、骨代谢及性激素的影响

Effects of Anjinyi and Tibolone supplementation on lipid,bone metabolism and sex hormones in patients with perimenopausal syndrome

目的探讨安今益和替勃龙激素补充疗法对围绝经期综合征(PMS)患者脂、骨代谢及性激素的影响。方法选取2018年1月至2019年12月江门市妇幼保健院收治的200例PMS患者为研究对象,按照随机数表法分为对照组和观察组各100例,对照组给予替勃龙激素治疗,观察组给予安今益治疗,疗程均3个月,比较治疗前后两组患者的子宫内膜厚度、Kupperma评分、性激素指标[促卵泡成熟素(FSH)、雌二醇(E2)、促黄体酮生成素(LH)]、脂代谢指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、骨密度、骨代谢指标[骨碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶(TRAP)]及不良反应发生情况。结果治疗后,观察组患者的子宫内膜厚度为(4.89±1.26)mm,明显高于对照组的(4.27±0.93)mm,Kupperma评分为(9.55±2.10)分,明显低于对照组的(18.55±3.24)分,差异均具有统计学意义(P<0.05);治疗后,观察组患者的E2为(25.67±8.40)mmol/L,明显高于对照组的(22.19±6.23)mmol/L,LH为(21.31±3.14)IU/L、FSH为(35.20±4.17)mmol/L,明显低于对照组的(38.56±6.01)IU/L、(26.37±5.22)mmol/L,差异均具有统计学意义(P<0.05);治疗后观察组患者的TC、TG和LDL-C明显低于对照组,HDL-C明显高于对照组,差异均具有统计学意义(P<0.05);治疗后,观察组患者的L2~L4、股骨颈和大粗隆骨的密度明显高于对照组,差异均具有统计学意义(P<0.05);治疗后,观察组患者的BALP和TRAP分别为(58.61±5.30)U/L、(4.85±1.02)U/L,明显低于对照组的(61.23±6.88)U/L、(5.77±1.30)U/L,差异均具有统计学意义(P<0.05);两组患者的不良反应比较差异无统计学意义(P>0.05)。结论安今益治疗PMS患者疗效较好,可缓解临床症状,增加子宫内膜厚度,改善脂、骨代谢及性激素。

Objective To investigate the effects of Anjinyi and Tibolone supplementation on lipid,bone metabolism and sex hormones in patients with perimenopausal syndrome(PMS).Methods A total of 200 PMS patients,who admitted to Jiangmen Maternal and Child Health Hospital from January 2018 to December 2019,were selected as study subjects.According to random number table method,the patients were divided into the control group and the observation group,with 100 cases in each group.The control group was given Tibolone hormone therapy,and the observation group was given Anjinyi therapy,both for 3 months.The endometrial thickness,Kupperma score,sex hormone index(mature follicle stimulating hormone[FSH],estradiol[E2],promote the progesterone hormone[LH]),lipid metabolism index(total cholesterol[TC],triglyceride[TG],low density lipoprotein cholesterol[LDL-C]),(high-density lipoprotein cholesterol[HDL-C]),bone mineral density and bone metabolism index(bone alkaline phosphatase[BALP],tartrate resistant acid phosphatase[TRAP])and the occurrence rate of adverse reactions of the two groups of patients before and after treatment for 3 months were compared.Results After treatment,endometrial thickness in the observation group was(4.89±1.26)mm,which was significantly higher than(4.27±0.93)mm in the control group(P<0.05);Kupperma score of the observation group was(9.55±2.10)points,which was significantly lower than(18.55±3.24)points in the control group(P<0.05);E2 of the observation group was(25.67±8.40)mmol/L,which was significantly higher than(22.19±6.23)mmol/L of the control group(P<0.05);LH and FSH of the observation group were(21.31±3.14)IU/L and(35.20±4.17)mmol/L,which were significantly lower than corresponding(38.56±6.01)IU/L and(26.37±5.22)mmol/L of the control group(P<0.05);TC,TG and LDL-C in the observation group were significantly lower than those in the control group,and HDL-C was significantly higher than that in the control group,with statistically significant differences(all P<0.05);the density of L2-L4,femoral neck and trochanter in the observation group were significantly higher than those in the control group,with statistically significant differences(all P<0.05);BALP and TRAP in the observation group were(58.61±5.30)U/L and(4.85±1.02)U/L,which were significantly lower than corresponding(61.23±6.88)U/L and(5.77±1.30)U/L in the control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion Anjinyi has a good therapeutic effect on PMS patients,which can relieve clinical symptoms,increase endometrial thickness,improve lipid,bone metabolism and sex hormones.