两种激素补充治疗方案对绝经后妇女更年期症状、血脂及骨代谢的影响

Effects of Two Hormone Supplementation Regimens on Menopausal Symptoms,Blood Lipids and Bone Metabolism in Postmenopausal Women

目的探究两种激素补充治疗方案对绝经后妇女更年期症状、血脂及骨代谢的影响。方法随机选取2019年1月—2021年12月青海省妇幼保健院接收的80名自然绝经后健康妇女作为研究对象,采取随机对照法将其分为对照组和观察组,每组40名。对照组采取口服醋酸甲孕酮治疗,观察组采取口服醋酸甲孕酮与结合型雌激素治疗,并观察疗效。结果用药之后两组患者Kupperman评分较治疗前均有降低趋势,差异有统计学意义(P<0.05);且观察组总分为(0.42±0.11)分,低于对照组的(4.33±1.31)分,差异有统计学意义(t=18.811,P<0.001)。两组治疗前后BMSD比较,差异无统计学意义(P>0.05)。对照组治疗后BGP升高,差异有统计学意义(P<0.05);Pyd/Cr升高,但变化较小,差异无统计学意义(P>0.05)。观察组治疗后血BGP升高,但变化较小,差异无统计学意义(P>0.05);尿Pyr/cr降低,差异有统计学意义(P<0.05)。治疗后两组BGP比较,差异无统计学意义(P>0.05);两组Pyd/Cr比较,差异有统计学意义(P<0.05)。观察组患者治疗后TG、HDL-C和ApoA升高,TC、LDL-C降低,差异有统计学意义(P<0.05);ApoB治疗前后比较,差异无统计学意义(P>0.05);两组治疗后LP均升高,但差异无统计学意义(P>0.05)。两组不良发生率比较,差异无统计学意义(P>0.05)。结论醋酸甲孕酮、结合型雌激素加醋酸甲孕酮对于更年期女性的症状均有一定的缓解效果,会轻度增加BMSD,结合型雌激素加醋酸甲孕酮对骨吸收有抑制效果,醋酸甲孕酮能够加快骨骼形成速度,不会影响血脂代谢。结合型雌激素加醋酸甲孕酮对血脂成分的改变有促进作用,从而能够预防一些心血管疾病的发生。

Objective To explore the effects of two hormone supplementation regimens on menopausal symptoms,blood lipids and bone metabolism in postmenopausal women.Methods 80 natural postmenopausal healthy women who were admitted to Qinghai Maternal and Child Health Hospital from January 2019 to December 2021 were randomly selected as the research subjects.They were randomly divided into a control group and an observation group,with 40 cases in each group.The control group received oral Medroxyprogesterone Acetate treatment,while the observation group received oral Medroxyprogesterone Acetate and Conjugated Estrogen treatment,and the therapeutic effect was observed.Results After treatment,the Kupperman scores of the two groups of patients showed a tendency to decrease compared with before treament,the difference was statistically significant(P<0.05);and the total score of the observation group was(0.42±0.11)points,lower than that of the control group(4.33±1.31)points,the difference was statistically significant(t=18.811,P<0.001).There was no statistically significant difference in BMSD changes between the two groups before and after treatment(P>0.05).The BGP in the control group increased significantly after treatment,the difference was statistically significant(P<0.05);Pyd/Cr increased,but the change was small and the difference was not statistically significant(P>0.05).After treatment,the blood BGP in the observation group increased,but the change was small and the difference was not statistically significant(P>0.05);Urinary Pr/cr decreased,the difference was statistically significant(P<0.05).After treatment,there was no statistically significant difference in BGP between the two groups(P>0.05);there was statistically significant difference between the two groups of Pyd/Cr(P<0.05).After treatment,the TG,HDL-C,and ApoA levels in the observation group increased,while TC and LDL-C levels decreased,,the difference was statistically significant(P<0.05);there was no statistically significant difference before and after ApoB treatment(P>0.05);after treatment,LP increased in both groups,but the difference was not statistically significant(P>0.05).There was no statistically significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion Medroxyprogesterone Acetate,Conjugated Estrogen plus Medroxyprogesterone Acetate can alleviate the symptoms of menopausal women.They can slightly increase BMSD,and Conjugated Estrogen plus Medroxyprogesterone Acetate can inhibit bone resorption.Medroxyprogesterone Acetate can accelerate bone formation,and will not affect blood lipid metabolism.Conjugated Estrogen plus Medroxyprogesterone Acetate can promote the change of blood lipid composition,which can prevent the occurrence of some cardiovascular diseases.