人工周期并心理治疗抗精神病药所致药源性闭经的疗效分析

Effect analysis of artificial cycle combined with psychotherapy on drug-induced amenorrhea induced by antipsychotics

目的探究人工周期并心理治疗抗精神病药所致药源性闭经的临床疗效。方法选择80例抗精神病药物所致药源性闭经患者,根据随机数字表法分为治疗组与对照组,每组40例。治疗组采用人工周期疗法并心理治疗,对照组采用单独人工周期疗法。比较两组治疗前后泌乳素(PRL)、雌二醇、孕酮、雄激素、子宫内膜厚度、月经量评分、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、近期疗效、远期疗效及不良反应发生情况。结果治疗前,两组PRL、雌二醇、孕酮及雄激素水平比较,差异无统计学意义(P>0.05);治疗后,两组PRL、雄激素水平均低于治疗前,雌二醇、孕酮水平均高于治疗前,且治疗组PRL、雄激素水平低于对照组,雌二醇、孕酮水平高于对照组,差异有统计学意义(P<0.05)。治疗前,两组子宫内膜厚度比较,差异无统计学意义(P>0.05);治疗后,两组子宫内膜厚度大于治疗前,且治疗组子宫内膜厚度大于对照组,月经量评分高于对照组,差异有统计学意义(P<0.05)。治疗前,两组SAS评分、SDS评分比较,差异无统计学意义(P>0.05);治疗后,治疗组SDS评分、SAS评分均低于治疗前与对照组,差异有统计学意义(P<0.05);对照组SDS评分、SAS评分与治疗前比较,差异无统计学意义(P>0.05).治疗组近期及远期总有效率均明显高于对照组,差异均有统计学意义(P<0.05)。治疗组不良反应发生率为5.0%(2/40),对照组不良反应发生率为25.0%(10/40),比较差异有统计学意义(P<0.05)。结论人工周期并心理治疗抗精神病药所致药源性闭经的临床疗效优于单独人工周期疗法,作用持久,不良反应少,值得临床推广与应用。

Objective To explore the clinical effect of artificial cycle combined with psychotherapy on drug-induced amenorrhea caused by antipsychotic drugs.Methods 80 patients with drug-induced amenorrhea caused by antipsychotics were divided into treatment group and control group according to random number table,with 40 cases in each group.The treatment group received artificial cycle therapy and psychotherapy,and the control group received single artificial cycle therapy.Prolactin(PRL),estradiol,progesterone,androgen,endometrial thickness,menstrual volume score,self-rating Anxiety Scale(SAS),selfrating depression Scale(SDS)score,short-term efficacy,long-term efficacy and incidence of adverse reactions were compared between the two groups before and after treatment.Results Before treatment,there were no significant differences in PRL,estradiol,progesterone and androgen levels between the two groups(P>0.05).After treatment,PRL and androgen levels in 2 groups were lower than before,and estradiol and progesterone levels were higher than before,and PRL and androgen levels in treatment group were lower than control group,while estradiol and progesterone levels were higher than control group,the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in endometrial thickness between the two groups(P>0.05).After treatment,the endometrial thickness of the two groups was greater than before,and the endometrial thickness of the treatment group was greater than that of the control group,and the menstrual volume score was higher than that of the control group,with statistical significance(P<0.05).Before treatment,there was no significant difference in SAS score and SDS score between the two groups(P>0.05).After treatment,SDS and SAS scores of the treatment group were lower than those of the control group,with statistical significance(P<0.05).SDS and SAS scores of the control group were not significantly different from those before treatment(P>0.05).The short-term and long-term total effective rate in the treatment group was significantly higher than that in the control group,and the difierences were statistically significant(P<0.05).The incidence of adverse reactions was 5.0%(2/40)in the treatment group and 25.0%(10/40)in the control group,and the diflerence was statistically significant(P<0.05).Conclusion The clinical efiect of artificial cycle therapy combined with psychotherapy on drug-induced amenorrhea induced by antipsychotics is better than that of artificial cycle therapy alone.