不同药物治疗方案对于改善GnRH-a致围绝经期症状及激素水平疗效观察

The Clinical Study of Different Drug Treatment Regimens on the Improvement of Perimenopausal Symptoms and Hormone Levels Induced by GnRH-a

为研究不同药物治疗方案对于改善GnRH-a致围绝经期症状及激素水平的效果,选取2018年3月—2019年3月于西宁市第一人民医院就诊的GnRH-a致围绝经期综合征患者100例,根据住院时间随机分为两组,每组50例,其中采用坤泰胶囊作为非激素治疗组,采用替勃龙作为激素治疗组,疗程为3个月。记录各组治疗前后血清性激素水平(FSH、E2)及骨量变化,采用生活质量评定量表(MENQOL)、焦虑自评量表(SAS)评价围绝经期症状,采用Kupperman评分(KI评分)评价临床疗效。结果显示:治疗后,两组FSH水平均较前降低、E2较前升高,非激素组更显著,差异有统计学意义(P<0.05);治疗后,两组腰椎(L2~L4)骨密度、激素组股骨颈(Neck)骨密度与治疗前相比差异无统计学意义(P>0.05),非激素组股骨颈(Neck)骨密度高于治疗前和激素组,差异有统计学意义(P<0.05);治疗后,两组KI评分、SAS评分、MENQOL评分均低于治疗前,且非激素组改善更显著,差异有统计学意义(P<0.05);非激素组与激素组临床总有效率分别为94.0%和70.0%,差异有统计学意义(P<0.05);非激素组与激素组不良反应发生率分别为10.0%和12.0%,差异无统计学意义(P>0.05)。研究表明:坤泰胶囊对GnRH-a所致围绝经期症状和激素水平的改善效果优于替勃龙。

This paper is to study the effect of different drug regimens on the improvement of perimenopausal symptoms and hormone levels induced by gonadotropin-releasing hormone agonist(GnRH-a).A total of 100 patients with GnRH-a-induced perimenopausal syndrome who visited The Xining First People's Hospital from March 2018 to March 2019 were randomly but equally divided into two groups according to their hospital stay as the non-hormonal treatment group receiving kuntai capsule and as the hormonal treatment group receiving tibolone for a course of 3 months.Serum sex hormone levels(FSH,E2)and bone mass changes were recorded before and after treatment in each group.Perimenopausal symptoms were evaluated by quality of life rating scale(MENQOL)and self-rating anxiety scale(SAS),and clinical efficacy was evaluated by Kupperman score(KI score).The results show that after treatment,the level of FSH in the two groups was lower and E2 was higher,and the difference was statistically significant in the non-hormone group(P<0.05).After treatment,there was no statistically significant difference in bone mineral density of lumbar spine(L2~L4)between the two groups and in femoral neck bone mineral density of the hormonal treatment group(P>0.05),while the bone mineral density of femoral neck in the non-hormonal group was higher than that before treatment and of hormone group(P<0.05).After treatment,KI score,SAS score and MENQOL score in the two groups all decreased,especially in the non-hormone group(P<0.05).The total clinical effective rate of the non-hormonal group and the hormonal group was 94.0%and 70.0%,respectively,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the non-hormonal group and the hormonal group was 10.0%and 12.0%,respectively,with no statistically significant difference(P>0.05).Therefore the effect of kuntai capsule on the improvement of perimenopausal symptoms and hormone levels caused by GnRH-a was better than that of tibolone.