雌二醇片/雌二醇地屈孕酮片联合心理干预对围绝经期伴焦虑、抑郁患者的效果

Clinical effect of estradiol tablets/estradiol dexmedroxyprogesterone tablets combined with psychological intervention treatment on perimenopausal women with anxiety and depression

目的评估雌二醇片/雌二醇地屈孕酮片联合心理干预治疗对围绝经期伴焦虑/抑郁患者的临床效果。方法纳入2021年2月~2023年2月我院更年期专科门诊符合标准的研究对象120例,根据随机数字法分为对照组(心理干预组)59例与观察组(雌二醇片/雌二醇地屈孕酮片联合心理干预组)61例,并随访3个月。分别应用汉密尔顿14项焦虑量表(amilton anxiety rating scale,HAMA)、汉密尔顿17项抑郁量表(Hamilton depression rating scale,HAMD)评价焦虑/抑郁状态、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)评估睡眠质量、改良Kupperman评分表(Modified Kupperman Index,KMI)评估更年期症状。测量两组研究对象促卵泡生成素(Follicle stimulating hormone,FSH)、黄体生成素(Luteinizing hormone,LH)、雌二醇(Estradiol,E2)/5-羟色胺(5-hydroxy tryptamine,5-HT)、去甲肾上腺素(Norepinephrine,NE)水平的变化。比较两组研究对象在基线和治疗3个月时以上指标的差异。结果基线时:两组FSH、LH、E2、5-HT、NE水平、HAMA、HAMD、PSQI和KMI评分差异无统计学意义(P>0.05)。治疗3个月后:对照组FSH、LH和E2水平较基线时无明显变化(P>0.05),观察组FSH、LH水平明显降低,E2水平明显升高(P<0.05);两组5-HT、NE水平均升高,且观察组显著高于对照组(P<0.05);两组HAMA、HAMD、PSQI、KMI评分均降低,且观察组显著低于对照组(P<0.05)。结论对于围绝经期伴焦虑/抑郁女性,心理干预联合激素替代治疗可以明显改善围绝经期女性内源性激素水平,更有效缓解焦虑、抑郁程度和改善睡眠质量,是无禁忌证围绝经期女性的优选治疗方案。

Objective To evaluate the clinical effect of estradiol tablets/estradiol medroxyprogesterone tablets combined with psychological intervention treatment on perimenopausal anxiety/depression patients.Methods 120 study subjects who met the standards in our menopausal clinic from February 2021 to February 2023 were included.They were randomly divided into a control group(psychological intervention group)of 59 cases and an observation group(estradiol/estradiol dexamethasone combined psychological intervention group)of 61 cases,and were followed up for 3 months.The Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were used to evaluate anxiety/depression status,the Pitsburgh Sleep Quality Index(PSQI)was used to evaluate sleep quality,and the Modified Kupperman Index(KMI)was used to evaluate menopausal symptoms.Measure the changes in levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),5-hydroxytryptamine(5-HT),and norepinephrine(NE)in two groups of study subjects.Compare the differences in the above indicators between the two groups at baseline and at 3 months of treatment.Results At baseline,there was no statistically significant difference in FSH,LH,E2,5-HT,NE levels,HAMA,HAMD,PSQI,and KMI scores between the two groups(P>0.05).After 3 months of treatment:The levels of FSH,LH,and E2 in the control group showed no significant changes compared to baseline(P>0.05),while the levels of FSH,LH in the observation group decreased significantly,while E2 levels increased significantly(P<0.05).The levels of 5-HT and NE in both groups increased,and the observation group was significantly higher than the control group(P<0.05).The scores of HAMA,HAMD,PSQI,and KMI in both groups decreased,and the observation group was significantly lower than the control group(P<0.05).Conclusion For perimenopausal women with anxiety/depression,psychological intervention combined with hormone replacement therapy can significantly improve the endogenous hormone levels of perimenopausal women,more effectively alleviate anxiety and depression levels,and improve sleep quality.It is the preferred treatment plan for non contraindicated perimenopausal women.