低剂量雌、孕激素替代疗法对围绝经期综合征患者激素水平的影响

摘要

Objective:To explore the influence of low-dose estrogen-progesterone replacement therapy (EPRT)in the treatment of perimenopausal syndrome (PMS)and its impact on the hormone levels.Methods:Totally 103 cases of PMS were randomly divided into treatment group(n=52)and control group(n=51).Both groups were given symptomatic treatment.Based on this,the treatment group was given low-dose EPRT.Twenty-eight days were as a cycle,totally 3 cycles.The following indexes were respectively observed and compared,including clinical efficacy,levels of follicle-stimulating hormone (FSH),luteinizing hormone (LH)and estradiol (E2 ) as well as changes of Kupperman scores,endometrial thickness and uterine volume before and after treatment.The adverse reactions were also recorded.Results:The overall response rate (ORR)of treatment group was significantly higher than that of control group (92.31% vs.72.55%,P<0.01).After treatment,the levels of serum FSH and LH went down,while that of E2 up dramatically in both groups,but the decreased and increased degrees of treatment group were more significant (P<0.01).After treatment,Kupperman scores in two groups decreased,but the decreased degree of treatment group was more larger than that of control group (P<0.01 ). When compared with pretreatment,the endometrial thickness increased a little,and uterine volume shrank slightly,but the difference was not statistically significant(P>0.05).There was no statistical significance between two groups by comparison with the adverse re-actions (P>0.05).Conclusion:Low-dose EPRT can effectively ameliorate the hormone levels and clinical symptoms of patients with PMS,with promising efficacy and less adverse reactions.%目的：探讨低剂量雌、孕激素替代疗法治疗围绝经期综合征（perimenopausal syndrome，PMS）的疗效及对激素水平的影响。方法：将103例 PMS 患者随机分为治疗组52例和对照组51例。两组均采用对症治疗，在此基础上，治疗组给予低剂量雌、孕激素替代治疗，28 d为1个周期，共治疗3个周期。比较两组临床疗效，观察治疗前后卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）等激素水平，及 Kupperman评分、子宫内膜厚度、子宫体积的变化，并记录不良反应发生情况。结果：治疗组总有效率为92．31％，显著高于对照组的72．55％（P＜0．01）。治疗后，两组血清 FSH、LH 水平明显降低，E2水平明显升高，但治疗组降低及升高幅度更为显著（P＜0．01）。治疗后，两组 Kupperman评分降低，但治疗组降低幅度显著大于对照组（P＜0．01）；两组子宫内膜厚度均较治疗前略有增加，子宫体积略有缩小，但组间比较差异无统计学意义（P＞0．05）。两组不良反应比较差异亦无统计学意义（P＞0．05）。结论：低剂量雌、孕激素替代疗法能有效改善 PMS 患者体内性激素水平，缓解临床症状，疗效显著，且不良反应少。