激素替代治疗对围绝经期综合征患者骨密度的影响分析

Effect of Hormone Replacement Therapy on Bone Mineral Density in Patients with Perimenopausal Syndrome

目的探讨对围绝经期综合征患者实施激素替代治疗后对其骨密度等产生的影响。方法随机抽取2019年1月—2021年4月来自常熟市中医院的围绝经期患者80例,采用随机数表法分为常规组(单用地屈孕酮片)和研究组(雌二醇/雌二醇地屈孕酮复合包装),各40例;比较两组患者血清性激素水平、Kupperman症状评分、内膜厚度、子宫体积、骨密度水平。结果治疗前,两组LH、FSH及E2水平比较,差异无统计学意义(P>0.05);治疗后,研究组LH水平(21.93±4.79)IU/L、FSH水平(32.32±6.97)IU/L较常规组明显降低,研究组E2水平较常规组明显提升,差异有统计学意义(t=3.764、10.553、5.897,P<0.05)。治疗前,两组Kupperman症状评分比较,差异无统计学意义(P>0.05);治疗后,研究组Kupperman症状评分较常规组明显降低,差异有统计学意义(P<0.05);治疗前后,两组内膜厚度、子宫体积比较,差异无统计学意义(P>0.05);治疗前后,两组股骨颈骨密度、L1~4骨密度比较,差异无统计学意义(P>0.05)。结论在地屈孕酮片基础上,加用雌激素雌二醇片,可使围绝经期综合征患者获得良好预后,对血清性激素水平有明显改善效果。

Objective To investigate the effect of hormone replacement therapy on bone mineral density in patients with perimenopausal syndrome.Methods Eighty perimenopausal patients from Changshu Hospital of Traditional Chinese Medicine were randomly selected from January 2019 to April 2021.Random number table method was used to divide the conventional group into dydrogesterone tablets alone,and the study group into estradiol/dydrogesterone complex packaging,forty cases each.Serum sex hormone levels[LH(luteinizing hormone),FSH(follicle-stimulating hormone),E2(estradiol)],Kupperman symptom score,endometrial thickness,uterine volume,bone mineral density(femoral neck bone mineral density,L1-4 bone mineral density)of the two groups were compared.Results Before treatment,there were no statistically significant differences in LH,FSH and E2 levels in two study groups(P>0.05).After treatment,LH level(21.93±4.79)IU/L and FSH level(32.32±6.97)IU/L in the study group were significantly lower than those in the conventional group,while the E2 level was significantly increased compared to the conventional group,the difference was statistically significant(t=3.764,10.553,5.897,P<0.05).Before treatment,there was no statistically significant difference in Kupperman symptom score between two groups(P>0.05).After treatment,Kupperman symptom score in the study group was significantly lower than that in the conventional group,the difference was statistically significant(P<0.05).There was no statistically significant differences in endometrial thickness and uterine volume between two groups before and after treatment(P>0.05).There were no statistically significant differences in bone mineral density of femoral neck and bone mineral density of L1 to L4 in two groups before and after treatment(P>0.05).Conclusion On the basis of dydrogesterone tablets,the addition of estrogen estradiol tablets can achieve a good prognosis in patients with perimenopausal syndrome and significantly improve serum sex hormone levels.