芬吗通与替勃龙在围绝经期接受绝经激素治疗患者中的应用效果比较

Comparison of efficacy of fenmoston and tibolone in menopausal hormone therapy for perimenopausal women

目的比较芬吗通与替勃龙在围绝经期接受绝经激素治疗患者中的应用效果。方法随机对照研究。选取2020年1月至2022年1月郑州市妇幼保健院收治的围绝经期接受绝经激素治疗的患者144例,按照随机数字表法分为空白组、对照组和观察组,每组48例。空白组采用安慰剂进行对照,对照组采用替勃龙治疗,观察组采用芬吗通治疗。比较三组治疗前后血脂水平[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)],比较观察组和对照组治疗前后代谢指标[丙氨酸转氨酶(ALT)、血糖(GLU)、肌酐(Cr)]及临床症状(改良Kupperman评分),比较观察组和对照组不良反应发生情况。结果治疗后,对照组和观察组TC、TG、LDL-C水平均低于空白组,HDL-C水平高于空白组(P<0.05);观察组TC、TG、HDL-C、LDL-C水平与对照组比较差异未见统计学意义(P>0.05)。治疗前后,观察组ALT、GLU、Cr水平与对照组比较差异均未见统计学意义(P均>0.05)。治疗前及治疗1、3、6个周期后,观察组改良Kupperman评分与对照组比较差异均未见统计学意义(P均>0.05);治疗1、3、6个周期后,观察组和对照组改良Kupperman评分均低于同组治疗前(P均<0.05)。观察组不良反应发生率(12.50%,6/48)与对照组(18.75%,9/48)比较差异未见统计学意义(P>0.05)。结论芬吗通和替勃龙在围绝经期接受绝经激素治疗患者中的疗效相当,均能在不影响机体代谢指标的情况下改善血脂水平,缓解患者临床症状,且不良反应较少。

Objective To compare the effect of fenmoston and tibolone in menopausal hormone therapy for perimenopausal women.Methods Conducted as a randomized controlled trail,the study included 144 perimenopausal women who received menopausal hormone therapy in Women and Infants Hospital of Zhengzhou from January 2020 to January 2022.And the selected patients were divided into blank group,control group and observation group according to the random number table method,with 48 cases in each group.The blank group was treated with placebo,the control group was treated with tibolone,and the observation group was treated with fenmoston.The preoperative and postoperative levels of blood lipid evaluated by total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)were compared among the 3 groups.The metabolic indicators,including alanine transaminase(ALT),glucose(GLU)and creatinine(Cr),and clinical symptoms assessed by modified Kupperman score were compared between the observation group and the control group before and after treatment.The incidence of adverse reactions of the observation group and the control group were compared.Results After treatment,the levels of TC,TG and LDL-C in the control group and the observation group were lower than those in the blank group,while the levels of HDL-C in the two groups were higher than those in the blank group(P<0.05);however,there was no statistically significant difference in the levels of TC,TG,HDL-C and LDL-C between the observation group and the control group(P>0.05).There were no significant differences in levels of ALT,GLU and Cr between the observation group and the control group before and after treatment(all P>0.05).There was no significant difference in modified Kupperman score between the observation group and the control group before treatment and after 1,3 and 6 cycles of treatment(all P>0.05).The modified Kupperman scores after 1,3,and 6 cycles of treatment in the observation group and the control group were lower than the preoperative scores in the same group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group(12.50%,6/48)and the control group(18.75%,9/48),P>0.05.Conclusions Fenmoston and tibolone have similar efficacy in menopausal hormone therapy for perimenopausal women,both of which can improve blood lipid level,relieve clinical symptoms,but do not affect metabolic indexes,with fewer adverse reactions.