本文選題：替勃龍 + 雌二醇屈螺酮　； 參考：《上海醫(yī)學(xué)》2015年09期

【摘要】：目的探討替勃龍和雌二醇屈螺酮替代治療方案改善絕經(jīng)后婦女絕經(jīng)癥狀和生活質(zhì)量的效果和安全性。方法選取2012年1月—2013年5月就診于上海交通大學(xué)附屬第六人民院婦產(chǎn)科更年期門診的56例絕經(jīng)后婦女,分別接受替勃龍(36例,替勃龍組)和雌二醇屈螺酮(20例,雌二醇屈螺酮組)治療,連續(xù)用藥3個月。采用改良Kupperman評分量表(KMI)評價絕經(jīng)癥狀和嚴(yán)重程度,采用絕經(jīng)評定量表(MRS)評價絕經(jīng)后生活質(zhì)量。比較兩組患者治療前和治療后3個月兩種量表的評分,以及不良反應(yīng)的發(fā)生情況。結(jié)果替勃龍組和雌二醇屈螺酮組患者治療后KMI評分總分和MRS生活質(zhì)量評分總分均顯著低于同組治療前(P值均0.01)。替勃龍組治療后的性生活質(zhì)量下降評分和雌二醇屈螺酮組治療后的皮膚蟻走感、性生活質(zhì)量下降、情緒低落、焦慮、性生活問題、膀胱不適、陰道干澀評分與同組治療前的差異均無統(tǒng)計學(xué)意義(P值均0.05),兩組治療后的其他癥狀評分均顯著低于同組治療前(P值分別0.01、0.05)。雌二醇屈螺酮組治療前后皮膚蟻走感、情緒低落、焦慮、性生活問題的評分差值均顯著低于替勃龍組(P值均0.05),兩組間治療前后其余各癥狀評分差值、KMI評分總分差值、MRS生活質(zhì)量評分總分差值的差異均無統(tǒng)計學(xué)意義(P值均0.05)。替勃龍組患者非預(yù)期陰道出血發(fā)生率顯著低于雌二醇屈螺酮組(P0.05),體重增加發(fā)生率顯著高于雌二醇屈螺酮組(P0.05),兩組間乳房脹痛發(fā)生率的差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論應(yīng)用替勃龍和雌二醇屈螺酮進(jìn)行絕經(jīng)激素治療,均能夠有效改善患者的絕經(jīng)后相關(guān)癥狀,提高其生活質(zhì)量。在改善泌尿生殖道癥狀和精神神經(jīng)癥狀方面,替勃龍的療效優(yōu)于雌二醇屈螺酮;在藥物安全性方面,兩種藥物的不良事件發(fā)生率均較低,但表現(xiàn)不一。
[Abstract]:Objective to investigate the efficacy and safety of tibolone and estradiol diflurone replacement therapy in improving postmenopausal women's menopausal symptoms and quality of life (QOL). Methods from January 2012 to May 2013, 56 postmenopausal women admitted to the sixth people's Institute of the people's College of Shanghai Jiaotong University, received tibolone (36 cases) and estradiol (20 cases), respectively. Estradiol flexipirone group was treated for 3 months. The postmenopausal symptoms and severity were evaluated by the modified Kupperman scale (KMI) and the postmenopausal quality of life (QOL) was evaluated by the menopausal rating scale (MRS). The scores of the two scales before treatment and 3 months after treatment were compared between the two groups. Results the total score of KMI and the total score of Mrs quality of life in the tebolone group and the estradiol diflurone group were significantly lower than those in the same group before treatment (P = 0.01). After treatment, the score of sexual life quality in the tibolone group and the skin ants walking sensation, sexual life quality, depression, anxiety, sexual life problems, bladder discomfort in the estradiol flexionone group and the treatment group were decreased. There was no significant difference between the vaginal dry astringency score and that of the same group before treatment (P < 0.05). The scores of other symptoms in the two groups were significantly lower than those in the same group before and after treatment. Before and after treatment, the skin ants in the estradiol group had walking sensation, low mood and anxiety. The score difference of sexual life problem was significantly lower than that of tibolone group (P < 0.05). There was no significant difference between the two groups in the score difference of other symptoms and the total score difference of Mrs quality of life score and the total score difference of Mrs quality of life between the two groups before and after treatment. The incidence of unanticipated vaginal hemorrhage in tibolone group was significantly lower than that in estradiol flexionone group (P 0.05), and the incidence of weight gain was significantly higher than that in estradiol flexionone group (P 0.05). There was no significant difference in the incidence of breast distension pain between the two groups. Conclusion treatment of menopausal hormone with tibolone and estradiol diflurone can effectively improve postmenopausal symptoms and quality of life of postmenopausal patients. In improving the symptoms of genitourinary tract and psychoneurotic symptoms, the efficacy of tibolone was better than that of estradiol, and in the aspect of drug safety, the incidence of adverse events of the two drugs was lower, but the symptoms were different.
【作者單位】： 上海交通大學(xué)附屬第六人民醫(yī)院婦產(chǎn)科;
【分類號】：R711

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