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两种不同雌激素治疗方案对绝经妇女症状及生活质量改善的效果分析
The analysis effect of two different kinds of menopause hormone therapy on the improvement of the life quality of postmenopausal women
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DOI:
作者:
王莺瑾 陶敏芳
Wang Yingjin,Tao minfang
作者单位:
上海市第六人民医院
Shanghai Jiaotong University Affiliated Sixth People’s Hospital
关键词:
替勃龙;雌二醇屈螺酮;绝经期
Tibolone;Estradiol and drospirenone;Menopause
摘要:
【摘要】目的:探讨替勃龙和雌二醇屈螺酮片在改善绝经后妇女绝经症状,提高生活质量的疗效和安全性。方法:选取2012年1月到2013年5月就诊于上海交通大学附属第六人民院妇产科更年期门诊的绝经后妇女作为研究对象,分成替勃龙组(n=36)和雌二醇屈螺酮组(n=20),分别给予替勃龙和雌二醇屈螺酮治疗,连续治疗3个月,采用改良Kupperman绝经期指数(KMI)评分评价绝经症状及严重程度;采用MRS生活质量评分量表评价绝经生活质量。比较两种药物治疗前及治疗3个月的评分变化。结果:与治疗前比较,替勃龙组和雌二醇屈螺酮组治疗后KMI评分、MRS评分总分均出现明显降低,均有显著的统计学差异(P<0.01);替勃龙组和雌二醇屈螺酮在泌尿生殖道症状、精神神经症状方面的改善存在统计学差异(P<0.01)。替勃龙组的不良事件以乳房胀痛、体重增加常见,其中体重增加的发生率与雌二醇屈螺酮组比较差异有统计学意义(P<0.05);雌二醇屈螺酮组以非预期的阴道出血、乳房胀痛常见,其中非预期的阴道出血的发生率与替勃龙组比较差异有统计学意义(P<0.05)。结论:应用替勃龙和雌二醇屈螺酮进行绝经激素治疗,均能够有效改善绝经后相关症状,提高生活质量。但在改善泌尿生殖道症状及精神神经症状方面,替勃龙疗效优于雌二醇屈螺酮。在药物安全性方面,两组药物均有较低的不良事件发生,但表现不一。
【Abstract】Objective: To investigate the efficacy and safety of tibolone and estradiol drospirenoneon the improvement of the life quality of postmenopausal women.Methods:The postmenopausal women who had treatment at Shanghai Jiaotong University Affiliated Sixth People’s Hospital of Obstetrics and Gynecology menopause clinic from 2012 Jan to 2013 May were divided into tibolone group (36 women) and estradiol drospirenone group (20 women), receiving tibolone and estradio drospirenone respectively for three months, and then the scores of KMI、MRSand the incidence of adverse events between the two groups were assessed.Result:Compared with the treatment before,KMIand MRS scores of the two groups were significantly decreased after 3 months’ treatment,the difference was statistically significant (P<0.01),and there was no difference between the two groups.But there was significant difference on the scores about urogenital tract symptoms and mental & nervous symptoms between the two groups(P<0.01).The main adverse reaction in tibolone group contained breast swelling and weight gain, while those in estradiol drospirenone group were vaginal bleeding and breast swelling.And there was significant difference on the incidence of weight gain and vaginal bleeding between the two groups (P<0.05). Conclusion:Application of tibolone and estradiol drospirenone can be effective in treating women menopausal syndrome,but the efficacy of tibolone in the treatment of urogenital tract symptoms,mental & nervous symptom is better than the efficacy of estradiol drospirenone.In the aspect of drug safety,the two groups both have different adverse effects.
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