不同激素替代治疗对围绝经期综合征妇女的效果比较

Comparing the effects of different hormone replacement therapies on women with perimenopausal syndrome

目的比较不同激素替代治疗(HRT)对围绝经期综合征(PMS)妇女的效果。方法选择2012年9月至2016年12月期间在浙江省台州市第一人民医院妇科门诊就诊的150例PMS患者为研究对象,按照随机数字表法分为对照组和观察组,对照组采用月经后半周期孕激素治疗,观察组采用雌孕激素周期序贯治疗,比较两组患者血清性激素水平变化、改良Kupperman症状评分以及不良反应等。结果观察组患者治疗后血清FSH、LH水平均较治疗前显著下降(t值分别为3.276、4.447,均P<0.05),血清E2水平较治疗前显著上升(t=3.225,P<0.05),而对照组患者治疗前后上述指标无显著性差异(t值分别为1.003、1.068、1.007,均P>0.05)。观察组患者治疗后Kupperman症状评分显著低于治疗前(t=3.225,P<0.05),而对照组患者治疗前后无显著性差异(t=0.897,P>0.05)。观察组和对照组的不良反应发生率分别为10.67%和9.33%,两组比较无显著差异(χ2=0.074,P>0.05)。结论雌孕激素周期序贯治疗对缓解PMS妇女的临床症状效果显著,在排除禁忌证后应尽早开始HRT,并注意随访监测。

Objective To compare the effects of different hormone replacement therapy(HRT)on women with perimenopausal syndrome(PMS).Methods One hundred and fifty women with PMS in gynecology clinic of Taizhou First People’s Hospital from September 2012 to December 2016 were selected.These women were divided into control group and observation group according to random number table method.Women in the control group accepted progesterone therapy in the second half of menstruation,and women in the observation group accepted sequential treatment of estrogen and progesterone cycles.The serum sex hormone levels,modified Kupperman symptom scores and adverse reactions between two groups were compared.Results The serum FSH and LH levels after treatment in the observation group were significantly decreased(t value was 3.276 and 4.447,respectively,both P<0.05),but serum E2 level was significantly increased(t=3.225,P<0.05).There was no significant difference in these indicators in the control group before and after treatment(t value was 1.003,1.068 and 1.007,respectively,all P>0.05).The Kupperman symptom scores of patients in the observation group were significantly lower before and after treatment(t=3.225,P<0.05),while those in the control group showed no distinct difference(t=0.897,P>0.05).The incidence of adverse reactions in the observation group and the control group was 10.67%and 9.33%,respectively.There was no significant difference between two groups(χ2=0.074,P>0.05).Conclusion The sequential treatment of estrogen and progesterone cycles has a significant effect on alleviating the clinical symptoms of PMS women,and HRT should be started as soon as possible after the exclusion of contraindications,and follow-up monitoring should be conducted.