维生素D3联合绝经激素治疗对绝经综合征的疗效

Therapeutic effect of vitamin D3 combined with menopausal hormone therapy on menopausal syndrome

目的探讨维生素D3联合绝经激素治疗(MHT)对绝经综合征的疗效。方法回顾性分析2016年1月至2018年12月就诊于浙江中医药大学附属温州中医院的100例患者的临床资料,根据治疗方案不同分为对照组和观察组,每组各50例,对照组采用MHT,观察组在对照组基础上联合维生素D3治疗,比较两组患者的治疗前后改良Kupperman评分、骨密度及骨折事件发生情况、药物不良反应。结果观察组患者治疗后3个月、6个月、9个月Kupperman评分均显著低于对照组,差异有统计学意义(t值分别为2.675、2.890、2.613,均P<0.05),而两组患者治疗后12个月Kupperman评分比较差异无统计学意义(t=0.349,P>0.05)。观察组患者治疗后12个月右股骨颈、腰椎正侧(L_(2~4))、Ward’s区骨密度均显著高于对照组(t值分别为3.053、2.364、2.751,均P<0.05),且腰椎压缩骨折发生率均显著低于对照组(P<0.05)。对照组有1例患者发生股骨颈骨折(2.00%),观察组无1例患者发生股骨颈骨折,两组患者比较差异无统计学意义(P>0.05)。两组患者药物不良反应总发生率比较差异无统计学意义(χ^(2)=0.122,P>0.05)。结论维生素D3联合MHT可有效缓解女性绝经相关症状,特别是对患者骨健康的疗效优于单一使用MHT,值得临床关注和应用。

Objective To observe therapeutic effect of vitamin D3 combined with menopausal hormone therapy(MHT)on menopausal syndrome.Methods The clinical data of 100 patients who were treated in Wenzhou TCM Hospital of Zhejiang University of TCM from January 2016 to December 2018 were analyzed retrospectively.The patients were divided into control group and observation group according to treatment regimen(in each group,n=50).The patients in the control group were treated by MHT,and those patients in the observation group were treated by MHT combined with vitamin D3.The improved Kupperman score,bone mineral density(BMD)and incidence of fracture events,adverse drug reactions were compared between the two groups before and after treatment.Results The Kupperman scores at 3,6 and 9 months after treatment of the patients in the observation group were significantly lower than those in the control group(t=2.675,2.890 and 2.613 respectively,all P<0.05),while there was no significant difference in Kupperman scores at 12 months after treatment between the two groups(t=0.349,P>0.05).At 12 months after treatment,the BMDs in right femoral neck,anterior lumbar vertebrae(L_(2~4)),Ward’s zone of the patients in observation group were significantly higher than those of the patients in the control group(t=3.053,2.364 and 2.751 respectively,all P<0.05),and the incidence of lumbar compression fracture was significantly lower than that in the control group(P<0.05).1 patient in the control group developed femoral neck fracture(2.00%),and no patient developed femoral neck fracture in the observation group,there was no statistically significant difference between the two groups(P>0.05).Also,there was no statistical significance in the total incidence of adverse drug reactions between the two groups(χ^(2)=0.122,P>0.05).Conclusions Vitamin D3 combined with MHT can effectively relieve the symptoms of women in menopausal period,especially the therapeutic effect on the bone health of the patients is better than the use of MHT alone,thereby it is worthy to be attended and applied in clinic.