Effects of hormone replacement therapy on mood and sleep quality in menopausal women

BACKGROUND Hormone replacement therapy is an effective treatment strategy for the management of symptoms in naturally menopausal women.However,some patients report experiencing adverse effects.AIM To analyze the effects of hormone replacement therapy in menopausal female patients.METHODS A total of 152 menopausal female patients admitted to the Gynecology Department of the Ganzhou Maternal and Child Health Hospital between January 2021 and December 2023 were divided into the observation group(n=76,conventional treatment+hormone replacement therapy)and the control group(n=76,conventional treatment only)via random casting.The improvement observed in the following items were compared between the groups:Kupperman menopausal index(KMI),emotional state[The Positive and Negative Affect Scale(PANAS)],sleep quality[Self-Rating Scale of Sleep(SRSS)],treatment effectiveness,and treatment safety.RESULTS The modified KMI and SRSS scores of the observation group were lower than those of the control group after three rounds of treatment.The improvement in the PANAS score observed in the observation group was greater than that observed in the control group(P<0.05).The total treatment effectivity rate in the observation group was higher than that in the control group(86.84%vs 96.05%,χ2=4.121,P=0.042).The incidence rate of adverse reactions in the two groups was comparable(6.58%vs 9.21%,χ2=0.361,P=0.547).CONCLUSION Hormone replacement therapy effectively improved the clinical symptoms,actively channeled negative emotions,and improved the quality of sleep in menopausal patients,indicating its effectiveness and safety.

Research status of hormone replacement therapy on mood and sleep quality in menopausal women

Menopausal syndrome is a common disease of clinical women,which refers to a series of physical and mental symptoms caused by the fluctuation or reduction of sex hormones before and after menopause.Many of these patients have sleep and mood abnormalities that affect their health and quality of life.At present,the understanding of it is gradually improving.This paper mainly analyzes its back-ground and current treatment.

Hormone replacement therapy for menopausal mood swings and sleep quality:The current evidence

Marked alterations in the normal female hormonal milieu in the perimenopausal period significantly affect women’s health,leading to decreased well-being,psychological distress,and impaired quality of life.Common menopausal symp-toms include hot flashes,sleep and mood changes,fatigue,weight gain,and urogenital disturbances.Clinicians often neglect mood swings and disrupted sleep,although those can significantly limit the productivity of women and impair their cognitive function and mental health.Evidence-based management should include a personalized,holistic approach to alleviate symptoms and careful consideration of the risks vs benefits of hormone replacement therapy(HRT),with due consideration of personal preferences.A research paper in the recent issue of the World Journal of Psychiatry by Liu et al investigated the role of HRT in altering mood changes and impaired sleep quality in menopausal women,which helps us to understand the benefits of this treatment approach.

The effects of long-term low-dose hormone replacement therapy on blood pressure and vasoactive factors in postmenopausal women

Objective:To investigate the effects of long-term low-dose hormone replacement therapy(HRT)on blood pressure,the plasma renin activity(PRA),plasma angiotensin Ⅱ(AngⅡ)leveland serum nitric oxide(NO)concentration in postmenopausal women.Methods:A total of 140 postmenopausal women were selected from the medical staff of thePeking Union Medical College Hospital.Of these,63 subjects who had been treated with low-dose sex hormone for over 5(5-32)years were set up as HRT group,and 77 age-matched sub-jects who had never received HRT were designed as control group.The levels of serum estradiol(E_2),follicle stimulating hormone(FSH)and nitric oxide(NO),the concentration of plasma an-giotensin Ⅱ(AngⅡ),plasma rennin activity(PRA)and the blood pressure were evaluated inthese two groups.Results:The serum level of estradiol in HRT group was significantly higher than that in con-trol group(median,interquartile range;124.0 pmol/L,113.4 vs.78.2 pmol/L,121.8)(P<0.05)and systolic blood pressure in HRT groups was significantly lower than that in control group[(126.7±14.4)mmHg vs.(132.4+19.8)mmHg](P<0.05).Diastolic blood pressure[(79.7±7.9)mmHg vs.(79.6±10.4)mmHg],the serum level of FSH[(54.4±18.9)IU/L vs.(60.4±24.4)IU/L],the plasma level of PRA(median,interquartile range;0.14 pg/L/hr,0.11vs.0.12 pg/L/hr,0.10),AngⅡ(median,interquartile range;46.0,31.1 pg/ml vs.44.4,33.0pg/ml)and serum level of NO(median,interquartile range;63.8 μmol/L,58.9 vs.56.0 μmol/L,94.8)showed no significant difference between HRT and control groups(P>0.05).Conclusions:Long-term low-dose HRT decreased the systolic blood pressure,but showed noeffects on the diastolic blood pressure,plasma level of AngⅡ,PRA,and serum level of NO inpostmenopausal women.

Effects of hormone replacement therapy on endothelial function in menopausal women

Objective To observe the effects of hormone replacement therapy (HRT) on endothelial function in menopausal women. Methods A total of 30 menopausal women were treated with 2.5 mg of Tibolone (Livial) daily. At the same time,30 women with natural menopause without any treatment served as the control group. Endothelium-dependent (EDD),endothelium-independent (NID) vasodilatation function,and estradiol (E2) were examined by the non-invasive high-resolution ultrasonography before the treatment and at 12th,24th,36th and 48th week of treatment,respectively. Results After hormone treatment,E2 increased significantly and EDD was improved significantly (P<0.05),and E2 was positively related with EDD (r=0.8092,P<0.001). No change of EDD was observed in the control group whereas a significant increase was observed in the treatment group. Conclusion Endothelium-dependent vasodilatation dysfunction is prominent in menopausal women. Tibolone can help improve the condition.

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.

Effects of hormone replacement therapy on platelet activation in postmenopausal women

Objective To assess the effects of hormone replacement therapy (HRT) on platelet activation in postmenopausal women compared with premenopausal women. Methods The expressions of CD41 and CD62P in fifteen postmenopausal women before and after HRT were detected using flow cytometry (FCM),with fifteen premenopausal women with a mean age of 47 years as controls.Results The expressions of CD41 and CD62P in postmenopausal women were higher than those in the control group. CD62P(%),CD62P(I) and CD41 were reduced from 36.40±5.9,37.75±5.8,and 470.11±74.0 to 27.97±5.6,26.64±4.9,and 303.23±72.8 after six months of HRT ( P <0.05). Conclusions Platelet activation in postmenopausal women was higher than in premenopausal women and was reduced significantly after six months of HRT. HRT may have a favorable effect on reduction of platelet activity.

Risk of venous thromboembolic disease in postmenopausal women taking oral or transdermal hormone replacement therapy

Objective: The influence of hormone replacement therapy (HRT) on hemostasis processes depends on the type of hormone,the combination of doses,the time of taking HRT,and the route of administration (oral,transdermal,implanted).The aim of the current study was to assess some parameters of coagulation,especially tissue factor pathway inhibitor (TFPI) and tissue factor (TF) in postmenopausal women using oral or transdermal HRT.Methods: The study was conducted on 76 healthy women,including 46 women aged 44–58 years who were taking oral (26) or transdermal (20) HRT,and 30 women aged 44–54 years who did not take HRT as the control group.Plasma concentrations of TF,TFPI,thrombin-antithrombin complex (TAT),and D-dimer were performed by enzyme-linked immunosorbent assay (ELISA).Moreover,the concentration of fibrinogen and activity of protein C were measured by chromogenic and chronometric methods.Results: We observed a significantly higher concentration of TF and a significantly lower concentration of TFPI in women taking oral and transdermal HRT in comparison with the control group.We also found a significantly lower concentration of fibrinogen in women taking oral HRT vs.the control group.Moreover,no statistically significant changes in concentrations of TAT and D-dimer,or activity of protein C were noted.Conclusions: In this study,the occurrence of an increased TF concentration simultaneously with a decreased concentration of TFPI in women taking HRT indicates hypercoagulability.No significant modification of TAT or D-dimer occurred,and thus there may not be increased risk of thrombosis.

Gynecological malignancies and hormonal therapies: Clinical management and recommendations

Every year in the world a large number of women receive a diagnosis of gynecological cancer and undergo a therapy such as surgery, chemotherapy and radiotherapy to the pelvic region. A large portion of these patients are already in menopause, but for younger patients therapies are responsible of early menopause. The physical and psychological symptoms due to iatrogenic menopause significantly reduce the quality of life; however hormone replacement therapy(HRT) has a high efficacy in reducing menopausal symptoms. The prescription of HRT in patients with story of gynecological cancer is debated because its safety has not been completely proven. The main criticism is based on the theory that the hormone replacement could stimulate growth of residual cancer cells increasing the risk of recurrence.

A comparison of two different dosages of conjugated equine estrogen in continuous combined hormone replacement therapy with progestin

To investigate the effects of two different dosages of conjugated equine estrogen (CEE) on preventing bone loss and relieving the symptoms of menopausal syndrome in women at an early stage of menopause Methods A total of 236 postmenopausal women were randomly allocated to one of the following groups: Group A: 0 625 mg CEE+2 mg medroxyprogesterone acetate (MPA)+1 tab Caltrate-D per day; Group B: 0 3 mg CEE+2 mg MPA+1 tab Caltrate-D per day; Group C: 1 tab Caltrate-D per day as the control group The study was continued for 2 years The following parameters were monitored: ① L2-4 bone mineral density (BMD) (measured with dual energy X-ray absorptiometry (DEX)), ② menopausal syndr ome improvement (assessed by comparing Kupperman scores), ③ vaginal bleeding rate, and the thickness of the endometrium and breast in each group Results Overall, 213 cases (90%) completed the 1-year study and 176 cases (75%) completed the 2-year study The percentage changes in L2-4 BMD at the 12th and 24th month in Group A were +2 3% and +3 7%, respectively, with the posttreatment values being significantly higher than pretreatment values (P<0 001) The percentage changes were +2 7% at 12th month (P<0 05) and +0 7% at 24th month (P>0 05) in Group B And that of Group C were -0 4% at 12t h month and -1 6% at 24th month (P>0 05) L2-4 BMD in both Group A and B w as significantly higher than that in Group C at 12th and 24th month (A vs C, P<0 001; B vs C, P<0 05) Kupperman Sco res were significantly reduced after 1, 3, 6 ,12 and 24 months in all 3 groups when compared with baseline (P<0 001) Scores in Group A and Group B were significantly lower than that in Group C (P<0 001) However, the vaginal bleeding rates in Group A were significantly higher than that in Group B or in Group C There was no atypical hyperplasia of endometrium in the 3 groups by the end of the study One p atient in Group A developed superficial thrombophlebitis by the end of 12th month Conclusion Continuous combination of CEE and MPA is effective in preventing bone loss and relieving the symptoms of menopausal syndrome in women at an early stage of menopause The vaginal bleeding rates in the Group treated with 0 625 mg/d CEE were significantly higher than those treated with 0 3 mg/d CEE

激素替代疗法联合气道正压通气治疗绝经后女性阻塞性睡眠呼吸暂停疗效观察

目的 观察激素替代疗法(HRT)联合气道正压通气(CPAP)治疗绝经后女性阻塞性睡眠呼吸暂停(OSA)的临床效果。方法 选择2022年2月至2023年5月在上海市第八人民医院治疗的100例绝经期女性OSA患者作为研究对象,按随机数表法分为观察组和对照组各50例。对照组患者给予CPAP治疗,观察组患者给予HRT+CPAP治疗。一个疗程为28 d,治疗28 d后常规开展门诊随访。治疗前及治疗28 d后,比较两组患者的睡眠图(PSG)、性激素指标[雌二醇(E2)、孕激素(P)]及生存质量测定简表(WHOQOL-BREF)变化,并比较两组患者对诊疗效果的满意率。结果 治疗后,两组患者的低通气指数、呼吸暂停次数、呼吸紊乱指数、最长呼吸暂停次数均降低,且观察组患者的上述指标分别为(10.27±2.10)次/h、(6.21±1.02)次/h、(26.10±3.28)次/h、(24.28±4.18) s,明显低于对照组的(14.28±2.17)次/h、(9.73±2.10)次/h、(31.29±4.12)次/h、(35.19±3.95) s,而两组患者治疗后的睡眠最低SaO2均升高,且观察组患者的睡眠最低SaO2为(91.31±8.21)%,明显高于对照组的(79.26±7.31)%,差异均有统计学意义(P<0.05);治疗后,两组患者的E2、P水平均升高,且观察组患者的E2、P分别为(35.13±2.25) pmol/L、(2.01±0.31)μmol/L,明显高于对照组的(18.93±2.10) pmol/L、(1.66±0.42)μmol/L,差异均有统计学意义(P<0.05);治疗后,两组患者的生理领域、心理领域、社会关系、环境领域评分均升高,且观察组患者的上述评分分别为(16.10±2.31)分、(15.31±2.04)分、(16.28±3.31)分、(16.29±2.12)分,明显高于对照组的(12.28±2.01)分、(12.01±1.94)分、(13.28±2.74)分、(12.88±1.89)分,差异均有统计学意义(P<0.05);观察组患者对诊疗效果的满意率为96.00%,明显高于对照组的82.00%,差异有统计学意义(P<0.05)。结论 HRT联合CPAP治疗绝经期女性OSA可有效改善睡眠质量、呼吸功能及激素水平,提高患者生存质量及对诊疗效果的满意度。

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。

Patterns of medication use for the treatment of menopausal symptoms before and after the women’s health initiative;implications for decision-making practices of women and women’s health professionals

Background: The Women’s Health Initiative (WHI) published findings in 2002 that changed the perception of the use of hormone replacement therapy (HRT) for the reduction of cardiovascular risks. Menopausal women using HRT for the relief of vasomotor symptoms were advised to use the lowest possible dose of HRT over the shortest possible duration. Objective: This study sought to examine patterns of HRT use for the treatment of menopausal symptoms before and after the WHI among women at least 40 years of age. Methods: A retrospective analysis was performed on a total of 1367 women in the pre-WHI group and 6467 women in the post-WHI group using the U.S. General Electric (GE) Centricity electronic medical record database. Menopause diagnosis was assessed using ICD-9 codes. Clinical characteristics and medication use were assessed for women with at least 3 years of enrollment (1 year baseline, 2 years follow-up). Results: The proportion of women in the post-WHI group that initiated HRT was significantly less than that of women in the pre-WHI group (31.3% vs. 56.9%, respectively;p < 0.001). Combination HRT use declined significantly (21.9% pre-WHI cohort vs. 7.2% post- WHI cohort, p < 0.001) among increases in non-HRT use, namely SSRIs (15.2% pre-WHI cohort v. 22.3% post-WHI cohort, p < 0.001) and tranquilizers (9.5% pre-WHI cohort v. 15.8% post-WHI cohort, p < 0.001). Conclusion: The results of the WHI 2002 publication made an impression on the perception of HRT’s role in the relief of menopausal symptoms. Decision-making on the part of women seeking treatment for vasomotor symptoms and women’s health professionals demonstrates that despite HRT precautions, women continue to exhibit a need for HRT use. This study’s findings suggest that women seeking treatment for menopausal symptom relief and women’s health professionals continue to work together to find the appropriate balance between therapy use and adherence to therapy use guidelines.

Study on drug retention in menopausal women with sequential hormone therapy and tibolone

In the present study, we aimed to retrospectively analyze the medication prescriptions of menopausal women diagnosed with menopausal syndrome in our hospital from 2015 to 2018, and compare the retention rate of estrogen and progesterone sequential therapy and hormone continuous therapy in menopausal women. The rational drug management system of Ningbo Women and Children’s hospital was used to screen the prescriptions of menopausal syndrome in 4 years. After the age, year included in the study, and prescription cost were adjusted, Kaplan-Meier regression analysis was performed to compare the prescription retention rates of the two drug regimens. The distribution of the two HRT regimens in the 4 years showed an increasing trend year by year, and the age groups of the two HRT regimens were mainly distributed between 41 and 60 years old, accounting for 97.1% and 87.06%, respectively. The cost distribution for the other two HRT regimens was approximately the same. Compared with the two HRT regimens, the drug retention rate of hormone continuous regimens was higher than that of hormone sequential regimens within 4 years. Kaplan-Meier regression analysis showed that the trend was significant(Tarone-Ware, Chi-square value = 3.857, P = 0.050). This study found that the median retention time of HRT therapy in menopausal women in our hospital was about half a year, which was significantly lower than that reported in previous studies of 1 year or longer. In addition, the present study found that compared with Femoston, the tibolone regimen significantly increased retention time in the treatment of menopausal syndrome.

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。

氟哌噻吨美利曲辛辅助激素替代疗法对更年期综合征伴焦虑抑郁患者的临床疗效

目的:探究氟哌噻吨美利曲辛辅助激素替代疗法对更年期综合征(MS)伴焦虑抑郁患者的临床疗效。方法:选取2020年9月-2021年9月于赣州市第三人民医院就诊的80例MS伴焦虑抑郁患者,按随机数字表法分为两组,各40例。对照组采用激素替代疗法,观察组在此基础上加用氟哌噻吨美利曲辛。比较两组性激素[促黄体生成素(LH)、雌二醇(E_(2))、卵泡刺激素(FSH)]水平、Kupperman量表、抑郁自评量表(SDS)、焦虑自评量表(SAS)及不良反应症状量表(TESS)评分。结果:两组治疗3个疗程的FSH、LH均低于治疗前,观察组均比对照组低,两组E_(2)均高于治疗前,观察组比对照组高(P<0.05)。两组治疗3个疗程的Kupperman量表、SAS、SDS评分均低于治疗前,观察组均比对照组低(P<0.05)。两组TESS评分比较,差异无统计学意义(P>0.05)。结论:氟哌噻吨美利曲辛辅助激素替代疗法可改善MS伴焦虑抑郁患者的性激素水平,减轻更年期焦虑抑郁症状,且不良反应较少,安全性较高。

应用性激素替代疗法和常规治疗在更年期综合征治疗中的应用效果评价

目的比较常规疗法与应用性激素替代疗法在改善更年期综合征患者临床症状方面的效果。方法选取2021年6月—2023年5月于山东省滕州市妇幼保健院收治的更年期综合征患者80例,按照入组顺序的奇偶数分组,奇数与偶数分属于对照组(常规治疗)与观察组(性激素替代治疗),每组40例。对比指标分别为激素水平、症状评分以及生活质量评分。结果治疗后,观察组雌激素指标水平优于对照组,差异有统计学意义(P<0.05);治疗后,观察组的症状评分为(10.87±2.26)分,低于对照组的(15.72±2.93)分,差异有统计学意义(t=8.290,P<0.001);治疗后,观察组生活质量(Menopause Quality of Life Scale,MENQOL)评分低于对照组,差异有统计学意义(P<0.05)。结论与常规疗法相比,更年期综合征患者经性激素替代疗法治疗的效果更佳。

补肾活血法治疗卵巢储备功能减退的临床疗效Meta分析

目的系统评价补肾活血法治疗卵巢储备功能减退(Decreased ovarian reserve,DOR)的临床疗效及安全性。方法检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据库)、中文科技期刊数据库(维普网)、中国生物医学数据库(CBM)、PubMed、Embase、Cochrane Library自建库至2022年12月31日补肾活血法治疗卵巢功能减退的随机对照试验。采用RevMan 5.3进行Meta分析,评价补肾活血法对促卵泡生成素(Follicle stimulation hormone,FSH)、促卵泡生成素/促黄体生成素(Follicle stimulation hormone/luteinizing hormone,FSH/LH)、雌二醇(Estradiol,E_(2))、中医症候积分、临床综合疗效及不良反应的影响。结果共纳入11篇文献,纳入781例患者。Meta分析结果显示:与对照组比较,观察组可有效降低中医症候积分[RR(95%CI)=-2.82(-3.57,-2.07),Z=7.35,P<0.00001],提高E_(2)值[SMD(95%CI)=0.33(0.14,0.52),Z=3.41,P=0.0006]和临床综合疗效[RR(95%CI)=1.18(1.06,1.33),Z=2.89,P=0.004],对改善FSH/LH无显著优势[MD(95%CI)=-0.04(-0.17,0.08),Z=0.67,P=0.50],对FSH值的影响因各亚组结果不同因此无法判断优势,不良反应报告较少。结论补肾活血法可有效改善DOR患者的E_(2)水平,降低中医症候积分,改善临床症状,是具有应用前景的治疗方法,其安全性有待进一步评估。但纳入文献的数量和质量有限,还需更高质量的研究进一步佐证。

两种激素补充治疗方案对绝经后妇女更年期症状、血脂及骨代谢的影响

目的探究两种激素补充治疗方案对绝经后妇女更年期症状、血脂及骨代谢的影响。方法随机选取2019年1月—2021年12月青海省妇幼保健院接收的80名自然绝经后健康妇女作为研究对象,采取随机对照法将其分为对照组和观察组,每组40名。对照组采取口服醋酸甲孕酮治疗,观察组采取口服醋酸甲孕酮与结合型雌激素治疗,并观察疗效。结果用药之后两组患者Kupperman评分较治疗前均有降低趋势,差异有统计学意义(P<0.05);且观察组总分为(0.42±0.11)分,低于对照组的(4.33±1.31)分,差异有统计学意义(t=18.811,P<0.001)。两组治疗前后BMSD比较,差异无统计学意义(P>0.05)。对照组治疗后BGP升高,差异有统计学意义(P<0.05);Pyd/Cr升高,但变化较小,差异无统计学意义(P>0.05)。观察组治疗后血BGP升高,但变化较小,差异无统计学意义(P>0.05);尿Pyr/cr降低,差异有统计学意义(P<0.05)。治疗后两组BGP比较,差异无统计学意义(P>0.05);两组Pyd/Cr比较,差异有统计学意义(P<0.05)。观察组患者治疗后TG、HDL-C和ApoA升高,TC、LDL-C降低,差异有统计学意义(P<0.05);ApoB治疗前后比较,差异无统计学意义(P>0.05);两组治疗后LP均升高,但差异无统计学意义(P>0.05)。两组不良发生率比较,差异无统计学意义(P>0.05)。结论醋酸甲孕酮、结合型雌激素加醋酸甲孕酮对于更年期女性的症状均有一定的缓解效果,会轻度增加BMSD,结合型雌激素加醋酸甲孕酮对骨吸收有抑制效果,醋酸甲孕酮能够加快骨骼形成速度,不会影响血脂代谢。结合型雌激素加醋酸甲孕酮对血脂成分的改变有促进作用,从而能够预防一些心血管疾病的发生。

更年期女性保健应用性激素替代疗法的价值研析

目的分析更年期女性保健应用性激素替代疗法的临床价值。方法选取92例更年期患者,基于入组时间分为对照组与干预组,各46例。对照组采用常规保健干预,干预组在对照组基础上采用性激素替代疗法。比较两组干预效果。结果干预组患者临床疗效优于对照组,差异有统计学意义(P<0.05)。干预前,两组卵泡刺激素(FSH)、雌二醇(E)及促黄体生成素(LH)水平比较,差异无统计学意义(P>0.05);干预后,干预组FSH、LH水平低于对照组,E_(2)水平高于对照组,差异具有统计学意义(P<0.05)。干预前,两组焦虑自评量表(SAS)抑郁自评量表(SDS)评分比较,差异无统计学意义(P>0.05);干预后,干预组SAS评分、SDS评分分别为(49.33±2.05)分、(48.41±1.05)分,均明显低于对照组的(52.49±2.25)分、(51.42±1.89)分,差异具有统计学意义(P<0.05)。干预组的生活质量评分高于对照组,差异有统计学意义(P<0.05)。结论在更年期女性保健干预中,性激素替代疗法的临床应用价值显著,可有效改善性激素水平,促进预后,具有临床推广价值。