Sonographic assessment of carotid artery in postmenopausal women receiving long-term low-dose hormone replacement therapy

Objective: The aim of this study was to determine the influence of long-term low-dose hor mone replacement therapy (HRT) on the intima-media wall of the carotid artery in postmenopa usal women by ultrasound.Methods: 146 postmenopausal women were divided into the HRT group(n= 68, HRT over 5years after menopause) and the control group(n= 78, no HRT). The intima-media thickness (IMT) of the carotid arteries was measured bilaterally, the characteristics of the atherosclerotic plaques were described, the peak systolic velocity (PSV) and resistance index (RI) were measured by ultrasound examination.Results: The IMT of HRT group was significantly smaller than that of the control group,(0. 089±0. 22) cm vs (0. 093±0.29) cm, (P＜0. 01). The occurrence of plaques was reduced in HRT group than the control group (7.7% vs 12.7%, P＜0. 05). The plaques were most frequently found at the bifurcation of the arteries. The soft and mixed plaques in HRT group were found significantly less than that of the control group (soft 1.7% vs 4. 5%, mixed 3.1% vs 6. 7%, both P＜0.05), while the hard plaques in HRT group were more than those of the control group(2.6% vs 1.3%, P＜0. 05). The maximum plaque thickness of HRT group was less than that of control group (0. 191±0. 057) cm vs (0. 226±0. 073) cm, (P＜0.05). The internal carotid artery PSV and RI in the two groups were similar [PSV (65.61±26.55) cm/s vs (64.82±27. 22) cm/s, RI (0.67±0. 082) vs (0. 68±0. 075), both P＞0.05].Conclusion: Our study indicated that HRT may has an effect to reduce the carotid IMT thickness, inhibit the plaque formation, and make the plaques harder and more stable. The long-term low-dose HRT may protect the postmenopausal women against the artherosclerosis of the carotid artery.

Effect of Menopausal Hormone Replacement Therapy on Cytokine Patterns in a Perimenopausal Mouse Model Established by the Ovarian Castration Method

Objective: To investigate the effect of perimenopausal hormone replacement therapy(HRT) on cytokine patterns in a perimenopausal mouse model established by ovarian castration. Methods: The mice were divided into natural menopause group,ovariectomy group and HRT group, with 15 mice in each group, and the estrous cycle, estrous frequency and menopausal time of the mice were determined by vaginal cytology,and the estrous cycle, estrous frequency and menopausal time were compared among the three groups. The serum levels of estradiol(E2) and progesterone(P4) in each group were detected by double-antibody sandwich ELISA, and the levels of interferon gamma(IFN-γ), interleukin-2(IL-2), IL-4 and IL-10 in the spleen γ tissues of mice were detected by ELISA. Results: The time of menopause(53.07±3.99) d in the HRT group was between that of the natural menopause group(80.80±3.26) d and that of the ovariectomy group(16.27±4.35) d, with a statistically significant difference in the two-by-two comparison of the three groups(P<0.05). The levels of serum E2(694.4±128.3) ng/L and P4(14.2 ±6.0) ng/L in the HRT therapy group are between those of the ovariectomy group and the natural menopause group, with statistically significant differences between the groups(P<0.05). The levels of IL-2(30.9±5.3) pg/ml, IL-4(9.4±1.6) pg/ml, IL-10(19.7±3.1) pg/ml, IFN-γ(22.0±3.7) pg/ml in the HRT group were all between those of natural menopause group and ovariectomy group. The Th1/Th2 ratio in the ovariectomy group was 7.55±1.57, higher than that in the natural menopause group(1.53±0.48) and HRT group(2.38 ±0.44), with statistically significant differences(P<0.05). Conclusion:Menopausal HRT can partially correct the imbalance of Th1/Th2 cytokines, which is able to provide an experimental basis for the regulation of menopause-related immune imbalance by HRT.

Low dose and short-term therapy of tibolone reduces the cardiovascular disease risk in postmenopausal women

Objective:To investigate the effects of low dose tibolone short-term therapy on clinic, endocrine and markers of cardiovascular disease in healthy postmenopausal women.Methods: A prospective study involved a total of 42 eligible postmenopausal women. 22 cases as group A and 20 cases as group B. Complete baseline work-up including Kupperman score,body mass index (BMI), gonadotropin (FSH, LH), estrogen (E2), testosterone (T), sex hormone binding globulin (SHBG), plasminogen activator inhibitor type 1 (PAI-1), tissue plasminogen activator (tPA), high-sensitivity C-response protein (hs-CRP), nitrogen oxide (NO)and fasting lipid, glucose(FPG), insulin(FINS) were performed in all subjects. Postmenopausal women in group A were treated with 1.25 mg tibolone daily. Women in group B were treated with 0. 625 mg tibolone daily. Women both in group A and group B were given calcium 600 mg with vitamin D 125IU per day. At the end of the 12-weeks therapy, subjects were re-evaluated and above parameters were measured.Results:No significant differences between group A and group B were found at baseline.Twenty-eight cases (fourteen cases in each group) completed the study. Kupperman score decreased from (22.1±8.0) and (25.4±7.5) to (7.7±4.5) and (5.2±4.5) and plasminogen activator inhibitor type 1 decreased from (95.8±32.4)μg/L and (102.9±42.6)μg/L to (72.2±39.6)μg/L and (79.9±30. 1) μg/L significantly in group A and group B respectively after treatment. In group A, Blood pressure decreased significantly from (120 ± 10)/(83 ± 6) mmHg to (110±14)/(77± 9) mmHg (P＜0.05), testosterone increased significantly from (0. 6 ±0. 4)nmol/L to (1.3 ± 1.1) nmol/L (P＜0. 05), free testosterone increased from (0. 001 ±0. 002)nmol/L to (0. 003±0. 003) nmol/L significantly (P＜0.01), SHBG decreased from (7.6±4. 9)nmol/L to (4. 3±2.9) nmol/L significantly (P＜0.05), total cholesterol decreased from (5.4±0. 8) mmol/L to (5.0±0.8) mmol/L significantly (P＜0.01), ApoA decreased from (1.8±0.3)mg/dl to (1.7±0. 3) mg/dl significantly (P＜0.05), fasting glucose decreased from (5. 6±0.8)mmol/L to (3.9±1.1) mmol/L significantly (P＜0.01) and no significant differences in BMI,FSH, LH, E2, tPA, hs-CRP, NO, TG, HDL-C, LDL-C, apoB were found after treatment. In group B, there were no significant differences in other parameters found after treatment except Kupperman score and PAI-1.Conclusions: 1.25 mg/d tibolone short-term therapy was associated with improved fibrinolytic factors and decreased Kupperman score, blood pressure, total cholesterol and fasting blood glucose level. 0. 625 mg/d tibolone therapy resulted in decrease Kupperman score and improvement of fibrinolytic factors. These changes relieve climacteric symptoms and may have some benefits on preventing the development of cardiovascular disease. An increased testosterone and free testosterone levels in 1.25 mg dose of tibolone therapy may increase energy level, general wellbeing and sexual desire in postmenopausal women. Low dose tibolone replacement therapy is a convenient effective HRT for postmenopausal

Effects of low-dose long-term HRT on serum lipids in postmenopausal women

Objective: To study the effects of low-dose and long-term hormone replacement therapy (HRT) on blood lipids in postmenopausal women.Methods: (1) 141 postmenopausal female medical staffs aged from 50 to 87 years with average 68 years were from Peking Union Medical college Hospital, among them 63 were treated with low-dose HRT for 5-31 years as HRT group, and other 78 postmenopausal women matched with age as the control group. (2) withdrew vein blood from objects on fasting for 12-14 h and serum was separated for determining serum concentration of lipid, lipoprotein and apolipoprotein. (3)data were analyzed with SPSS statistical software for statistical significance by P＜0.05.Results:In comparison with control, the levels of TG, HDL-C, LDL-C, apoA I , Lp(a) of HRT group had no statistical significance,but the levels of TC, TC/HDL-C, ApoE, ApoCⅢ and ApoB were significantly lower.Conclusion: The levels of TC, LDL-C, ApoB, ApoC Ⅲ, ApoE decreased significantly in postmenopausal women receiving low-dose and long-term HRT. The decrease in the levels of blood lipids may provide cardiovascular protection and reduce the risk of cardiovascular events.

北京地区围绝经期妇女激素替代疗法(HRT)使用情况调查及疗效分析

目的:了解北京地区围绝经期妇女激素替代治疗的使用情况和疗效。方法:采用分层整群概率比率的流行病学方法在北京地区抽取城区、郊区两层的10个样本群中40-65岁围绝经期妇女进行问卷调查,部分妇女进行血脂、骨密度测定。结果:激素替代治疗明显减少各种更年期症状(P<0.01),减少高血压的发生率(P<0.05),明显减少糖尿病、肝病、甲亢、肾病等内科疾病的发生率(P<0.01),而胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白却极显著增高(P<0.01)。结论:激素替代疗法可以有效地减轻各种更年期症状,减少高血压、糖尿病、肝病、甲亢、肾病等内科疾病的发生。但在使用过程中应密切观察血脂变化,防止血栓形成。

中药联合激素治疗卵巢早衰的网状Meta分析

【目的】运用网状Meta分析方法筛选中药联合激素治疗卵巢早衰(POF)的最优方案,为POF的临床治疗提供循证依据。【方法】计算机检索知网(CNKI)、维普数据库(VIP)、万方(Wanfang)数据库、中国生物医学文献服务系统(CBM)、PubMed、Cochrane、Embase、Web of Science等国内外主要数据库中有关中药联合激素治疗卵巢早衰的临床随机对照试验(randomized controlled trials,RCTs)。采用Cochrane推荐的质量评价工具与Jadad量表以评估文献质量。采用Rstudio、StataSE 15.1统计软件对数据进行网状Meta分析并绘制图表。【结果】共纳入文献50篇,涉及8种干预措施。纳入研究总体偏倚风险较低,但文献质量总体偏低。网状Meta分析结果显示,在有效率方面,7种中药联合激素干预措施均优于对照组的常规治疗(激素替代疗法),暖宫七味散+常规治疗均优于其余6种中药联合激素干预措施;基于累积排序概率曲线下面积(SUCRA)值,8种干预措施有效率的疗效排序由高到低依次为暖宫七味散+常规治疗(SUCRA=81.2)、滋肾育胎丸+常规治疗(SUCRA=80.0)、左归丸加减+常规治疗(SUCRA=66.1)、安坤种子丸+常规治疗(SUCRA=49.6)、坤泰胶囊+常规治疗(SUCRA=45.2)、二仙汤加减+常规治疗(SUCRA=39.5)、六味地黄丸+常规治疗(SUCRA=37.4)、常规治疗(SUCRA=1.0)。在改善血清卵泡刺激素(FSH)水平方面,左归丸加减+常规治疗优于其余7种干预措施;疗效排序为左归丸加减+常规治疗(SUCRA=97.0)、常规治疗(SUCRA=77.9)、六味地黄丸+常规治疗(SUCRA=76.6)、坤泰胶囊+常规治疗(SUCRA=46.5)、暖宫七味散+常规治疗(SUCRA=38.9)、安坤种子丸+常规治疗(SUCRA=29.9)、二仙汤加减+常规治疗(SUCRA=18.1)、滋肾育胎丸+常规治疗(SUCRA=15.1)。【结论】与常规治疗(激素替代治疗)相比,各种中药联合激素的干预措施在改善卵巢早衰(POF)患者的主要结局指标方面,疗效均较佳。具有最优方案概率最大值的提高有效率的干预措施为暖宫七味散+常规治疗,具有最优方案概率最大值的降低血清FSH水平的干预措施为左归丸加减+常规治疗。但由于纳入研究的质量较低,未来需要开展更多设计严谨的大样本、高质量的随机对照试验,以提供确凿的循证依据。

围绝经期及绝经后女性睡眠障碍相关风险因素及治疗研究进展

睡眠障碍是指睡眠量的异常、质的异常或在睡眠时发生某些临床症状,严重影响人体功能及健康。睡眠障碍的发病与年龄呈正相关,由于绝经综合征、代谢相关疾病而高发,女性围绝经期通常是女性睡眠障碍发生的转折点。围绝经期及绝经后睡眠障碍主要表现为入睡困难和睡眠维持障碍、日间功能障碍,严重情况下出现焦虑、抑郁情绪。根据相关风险因素对症治疗,缓解绝经相关症状,改善睡眠质量,增加有效睡眠时间,恢复社会功能,提高生活质量,是治疗围绝经期睡眠障碍的目标。围绝经期及绝经后睡眠障碍的治疗措施包括非药物治疗(睡眠卫生教育、失眠认知行为疗法)和药物治疗(绝经激素治疗、精神类及镇静催眠药、褪黑素、中医中药等)。综述围绝经期及绝经后女性睡眠障碍相关风险因素及诊断治疗研究进展。

HRT对绝经后妇女甲状腺功能及肾上腺功能的影响

目的:了解绝经后妇女甲状腺功能及肾上腺功能的变化,以及激素替代疗法(HRT)对甲状腺功能及肾上腺功能的影响。方法:60例绝经后妇女分为两组,HRT组30例,并以30例绝经后妇女作为对照,测定HRT前及12个月后tT3、tT4、fT3、fT4、TSH及肾上腺皮质醇节律。结果:绝经后妇女HRT前后血tT3、tT4、fT3、fT4、TSH及肾上腺皮质醇均无显著差异(P>0.05),且均属于正常范围内。结论:绝经后妇女甲状腺功能和肾上腺皮质功能不如性腺功能的变化明显,且HRT对其影响不大。

小剂量HRT在临床中的应用及监测

目的观察小剂量激素替代治疗(HRT)的应用及监测。方法观察更年期门诊117例围绝经期及绝经后妇女使用小剂量倍美力利维爱及安宫黄体酮治疗更年期相关症状及骨质疏松的效果,并通过B超等方法监测其安全性。结果通过3个月至5年的治疗,潮热出汗等症状均得到改善,骨质疏松或骨丢失者骨量丢失减缓,在治疗过程中未见子宫内膜增生,伴子宫小肌瘤者未见肌瘤增大。结论小剂量HRT应用于围绝经期及绝经后妇女的治疗是安全有效的。

替勃龙治疗绝经后女性耳鸣的疗效及对其神经递质水平和睡眠质量的影响

目的探讨替勃龙对绝经后女性耳鸣患者的疗效及对神经递质水平和睡眠质量的影响。方法将106例收治的绝经后耳鸣患者随机分为对照组和观察组各53例。两组均接受围绝经期综合管理,对照组口服谷维素片,观察组口服替勃龙片+谷维素片。比较两组临床疗效及治疗前后改良Kupperman指数(KMI)、耳鸣障碍指标评估量表(THI)、匹兹堡睡眠质量指数(PSQI)评分,并对患者血清雌二醇(E 2)、卵泡刺激素(FSH)、黄体生成素(LH)、5-羟色胺(5-HT)、去甲肾上腺素(NE)水平进行检测。结果观察组临床总有效率高于对照组(P<0.05)。治疗后,两组KMI、THI及PSQI评分均降低,且观察低于对照组;两组血清E 2水平及5-HT水平均升高,且观察组高于对照组,FSH水平、LH水平及NE水平均降低,且观察组低于对照组(P<0.05)。结论替勃龙可明显缓解绝经后女性耳鸣症状,改善其睡眠质量,对性激素和神经递质的调节可能是其作用机制。

上海市中老年女性绝经相关症状及绝经相关知识认知现状调查

目的了解上海市40岁以上中老年女性绝经相关症状的发生情况及对绝经相关知识的认知现状,为加强绝经过渡期及绝经后期女性健康保健及管理工作提供参考。方法2021年1月—2021年12月,随机选择上海市年龄≥40岁的女性进行问卷调查,并以改良Kupperman评分量表评估其绝经相关症状发生情况。结果共收调查问卷5441份,其中有效问卷5200份,有效率95.57%。受调查人群平均年龄为(51.7±7.0)岁,平均身高(160.42±5.07)cm,平均体质量(58.94±8.01)kg,平均BMI(22.55±2.75)kg/m^(2)。出现绝经综合征者达77%,其中重度占10.15%,中度占34.37%,绝经综合征的主要症状报告率居前五位的依次为疲乏,易激动,肌肉、骨关节痛,失眠和头痛。23.03%~36.55%对绝经相关知识认识不清或存在错误认知,41.63%的调查对象不知道绝经激素治疗;46.31%调查对象不接受绝经激素治疗;48.23%不会推荐身边的适龄女性或者亲友进行绝经激素治疗;影响受调查人群接受激素治疗的主要原因中依次是不了解安全性和有效性(66.60%)与激素治疗的风险(45.94%)等。结论40岁以上女性中绝经综合征的报告率较高,但在一定程度上存在认知缺乏,尤其是对激素补充治疗;不了解安全性和有效性与激素治疗的风险是影响接受激素治疗的主要原因,加强科普宣教和健康管理非常重要。

1999～2003年浙江大学医学院附属妇产科医院HRT用药分析

目的 :分析激素替代治疗 (hormone replacement therapy,HRT)药物在浙江大学医学院附属妇产科医院 (浙医妇院 )的用药情况 ,了解其与人们对更年期疾病的重视程度。方法 :收集了浙医妇院 1999～ 2 0 0 3年 HRT用药以及医保前后的用药比较 ,进行纵向比较。采用趋势检验与卡方检验。结果 :1999～ 2 0 0 3年浙医妇院的 HRT用药量的格局有显著变化 ,尼尔雌醇片的用量均呈逐年减少 (P<0 .0 1) ,而补佳乐片的用量逐年增多 (P<0 .0 1) ,倍美力片的用量逐年增加 (P<0 .0 1) ;医保前后各类 HRT用药有显著变化。结论 :HRT用药发生显著变化 。

Effect of hormone replacement therapy on heart rate variability in postmenopausal women

To assess the characteristics of autonomic control of heart rate in postmenopausal women before and after hormone replacement therapy (HRT) Methods Time domain and spectral domain heart rate variability (HRV) were performed in 58 postmenopausal women before and after HRT Results Compared with examinations at baseline, values of all HRV measurements in subjects given HRT were increased at the fourth month ( P <0 05), while they remained unchanged in the control group ( P >0 05) Results showed an inverse correlation between all measures of HRV and mean R R interval in the treatment group Conclusion HRT reduces sympathetic drive in postmenopausal symptomatic women HRV may be an index of imbalance of autonomic control in perimenopausal women

影响激素依赖性肿瘤患者生存的因素——激素替代治疗(HRT)

目的:探讨激素替代疗法对子宫内膜癌、卵巢癌、乳腺癌的危险性及患者生存的影响。HRT并不支持增加及依赖性肿瘤的危险性,对患者生存也无不利影响。HRT不应成为这类肿瘤的绝对禁忌。

How to explore the effects of sex hormone on blood vessels

The risk of cardiovascular disease increases along with aging. There are increasing interests in researches on the protective effects of hormone replacement therapy (HRT)on cardiovascular system in postmenopausal women. In this article we will review how we have explored the evidence of different sex hormones on blood vessels since 1996. The results showed that low-dose HRT significantly protected cardiovascular system in postmenopausal women.However, the high-dose 17β-estradiol (E2), with or without progesterone (P) or testosterone (T), or any hormone alone, as their concentrations increase, may even inhibit the protective effects of low-dose HRT on blood vessels.

更年期综合征患者绝经激素治疗中医患共同决策质量的影响因素研究

背景绝经激素治疗(MHT)可以有效缓解更年期症状,但其治疗方案多种多样,做出符合女性需求的治疗决策至关重要,但目前对MHT中的医患共同决策(SDM)质量的调查有待补充。目的分析更年期综合征患者MHT中的SDM质量并探讨其影响因素,为实现对更年期群体更优质的临床照护提供理论依据。方法采用便利抽样法,于2022年10月—2023年1月抽取北京协和医院妇科内分泌与生殖中心的更年期综合征患者101例为研究对象。使用问卷调查法进行研究,问卷内容包括三部分,分别为一般人口资料、治疗相关信息及SDM质量调查。采用中文版共同决策问卷患者版(SDM-Q-9)评估患者的SDM质量。采用多元线性回归分析探讨更年期综合征患者MHT中SDM质量的影响因素。结果更年期综合征患者MHT中SDM质量的平均分为89.75分。有子女,MHT效果主观感受非常好,有潮热多汗、失眠、情绪波动症状,医生建议使用MHT的患者SDM质量得分更高(P<0.05)。多元线性回归分析结果显示,有子女(β=0.26,P=0.005)、潮热多汗(β=0.19,P=0.044)、失眠(β=0.23,P=0.017)、医生建议使用(β=0.21,P=0.025)是更年期综合征患者MHT中SDM质量的影响因素,可解释SDM质量23.7%的变异。结论更年期综合征患者MHT中SDM质量较好,有子女、潮热多汗、失眠、医生建议使用是更年期综合征患者MHT中SDM质量的影响因素,医生应更主动将患者纳入SDM中,使患者意识到自己是第一健康负责人,与医生共同做出符合患者需求与价值观的SDM。

Comparison of the effect and safety of Kuntai capsule and hormone replacement therapy in patients with perimenopausal syndrome:a systematic review and Meta-analysis

OBJECTIVE: To assess the effectiveness and safety of Kuntai capsule and hormone replacement therapy in treatment of perimenopausal syndrome.METHODS: Articles were retrieved from the databases Cochrane Database of Systematic Reviews,Pub Med, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database. Only randomized controlled trials were included; 15 trials involving1243 patients were identified from January 2005 to April 2015. A systemic review and Meta-analysis of publications was performed. The review was limit-ed to randomized controlled trials that compared Kuntai capsule and hormone replacement therapy to treat perimenopausal syndrome for at least 3months. The primary outcome assessed was the treatment efficacy at 3 months, including effective rate of Kupperman menopausal scores, Kupperman menopausal scores, and blood estradiol(E2) or blood follicle stimulating hormone(FSH) levels.Other outcomes assessed were safety or adverse events, such as gastrointestinal complaints, breast distending pain, or vaginal bleeding.RESULTS: Kupperman menopausal scores showed no significant difference in effective rate [odds ratio(OR): 1.05, 95% confidence intervals(CI): 0.71 to1.55] and changes in FSH level [mean difference(MD): 2.14, 95% CI:-2.36 to 6.65]. There was a significant statistical difference in Kupperman menopausal scores(MD:-1.14, 95% CI:-2.03 to-0.25)and changes in E2level(MD:-16.41, 95% CI:-18.83to-13.69). There were fewer adverse events in the Kuntai capsule group than in the hormone replacement therapy group(OR: = 0.35, 95% CI: 0.25 to0.48, P < 0.01).CONCLUSION: Compared with hormone replacement therapy, Kuntai capsule can improve perimenopausal symptoms and blood E2 levels, and reduce the incidence of adverse events.

阿仑膦酸钠与激素替代疗法治疗骨质疏松症的比较

背景:研究表明雌激素、双膦酸盐、降钙素等可在一定程度上提高骨密度和降低骨折发生率,其中阿仑膦酸钠作为临床最常用的双膦酸盐类药物得到人们的关注。目的:对比分析阿仑膦酸钠与激素替代疗法治疗绝经后骨质疏松症的疗效。方法:绝经后骨质疏松症患者198例随机平均分为2组,每组99例,阿仑膦酸钠组口服阿仑膦酸钠,每周70 mg,连续1年;激素代替疗法组口服替勃龙片2.5 mg/d,连续1年,比较治疗前后2组的骨密度、性激素水平,并比较2组患者的不良发应发病率及对骨代谢标志物的影响,同时进行疼痛改善评价。结果与结论:(1)治疗之后2组的股骨颈及L1-4的骨密度均较治疗前有所改善(P<0.05);(2)激素代替疗法组治疗后血清雌激素和孕酮浓度均有下降的趋势,皮质醇有升高的趋势(P<0.05);(3)目测类比评分阿仑膦酸钠组优于激素代替疗法组(P<0.05);(4)阿仑膦酸盐组血清Ⅰ型原骨胶原N端肽、血清β胶原降解产物治疗后较激素代替疗法组下降明显(P<0.05)、阿仑膦酸钠组血清骨源性碱性磷酸酶和血清骨钙素较激素代替疗法组上升(P<0.05);(5)激素替代疗法组的恶心、乏力等不良发应发病率高于阿仑膦酸钠组(P<0.05);(6)结果说明,阿仑膦酸钠与激素替代疗法治疗绝经后骨质疏松症均可有效的提高骨密度,促进骨形成,阿仑膦酸钠对患者激素水平影响较小且不良反应小,其治疗效果更佳。

绝经期骨质疏松雌激素替代治疗临床研究

1995～ 1998三年中 ,对绝经期骨质疏松 (MOP) 111例进行为期 2年的前瞻性雌激素替代治疗 (HRT)研究 ,其中 56人应用利维爱 (Livial)为研究组 ,55人应用尼尔雌醇为对照组 ,经过 2年随诊 ,终点结论是 HRT对缓解更年期症状 ,提高患者生活质量 ,增加骨密度 (BMD)都有效果 ,但研究组明显优于对照组 ,具有统计学意义。 HRT的副作用为出血 :治疗组 5.35% ,对照组 10 .9% ,乳房胀痛 :治疗组7.14% ,对照组 9.0 9%。经济承受力差 ,中途退出治疗组 8.92 % ,对照组 3.6 3%。从而证实 L ivial作为HRT,对 MOF治疗的正作用强 ,副作用少 ,是 HRT首选药 ,今后如能降低药价 ,更适合我国医疗改革的国情 ,使患者经济承受力能够接受 ,将会在更多 MOR治疗中起到积极作用。

短期激素替代疗法治疗更年期综合征疗效和安全性分析

目的:评价短期激素替代疗法(HRT)治疗绝经后妇女更年期综合征的疗效及安全性。方法:选择绝经后有更年期综合征症状的妇女40例,给予结合雌激素片剂0.625mg+安宫黄体酮4mg(周期方案),连续用药4个周期,同期选择相同条件的40例妇女作为对照组。观察改良Kupperman评分、血清促卵泡素(Fsh)、雌二醇(E2)、子宫内膜厚度等指标。结果:用药第1、3、4个月及停药1个月与治疗前及对照组相比,Kupperman评分均有明显下降,差异均有统计学意义(P<0.01);停药第2、3个月与治疗前及对照组相比,Kupperman评分差异无统计学意义(P>0.05)。血清Fsh、E2水平在用药后有明显改善,与用药前相比,差异有统计学意义(P<0.01);但在停药1周后又恢复到治疗前水平;经B超检查,治疗后的妇女子宫内膜厚度较治疗前有所增加,差异有统计学意义(P<0.01),但内膜宫腔镜检查及内膜活检均在正常范围。结论:短期HRT治疗绝经后妇女更年期综合征的疗效明显,安全可靠。