两种绝经激素治疗方案改善绝经后妇女绝经症状和生活质量的效果分析

发布时间：2018-06-21 06:35

本文选题：替勃龙 + 雌二醇屈螺酮　；参考：《上海医学》2015年09期

【摘要】：目的探讨替勃龙和雌二醇屈螺酮替代治疗方案改善绝经后妇女绝经症状和生活质量的效果和安全性。方法选取2012年1月—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56例绝经后妇女,分别接受替勃龙(36例,替勃龙组)和雌二醇屈螺酮(20例,雌二醇屈螺酮组)治疗,连续用药3个月。采用改良Kupperman评分量表(KMI)评价绝经症状和严重程度,采用绝经评定量表(MRS)评价绝经后生活质量。比较两组患者治疗前和治疗后3个月两种量表的评分,以及不良反应的发生情况。结果替勃龙组和雌二醇屈螺酮组患者治疗后KMI评分总分和MRS生活质量评分总分均显著低于同组治疗前(P值均0.01)。替勃龙组治疗后的性生活质量下降评分和雌二醇屈螺酮组治疗后的皮肤蚁走感、性生活质量下降、情绪低落、焦虑、性生活问题、膀胱不适、阴道干涩评分与同组治疗前的差异均无统计学意义(P值均0.05),两组治疗后的其他症状评分均显著低于同组治疗前(P值分别0.01、0.05)。雌二醇屈螺酮组治疗前后皮肤蚁走感、情绪低落、焦虑、性生活问题的评分差值均显著低于替勃龙组(P值均0.05),两组间治疗前后其余各症状评分差值、KMI评分总分差值、MRS生活质量评分总分差值的差异均无统计学意义(P值均0.05)。替勃龙组患者非预期阴道出血发生率显著低于雌二醇屈螺酮组(P0.05),体重增加发生率显著高于雌二醇屈螺酮组(P0.05),两组间乳房胀痛发生率的差异无统计学意义(P0.05)。结论应用替勃龙和雌二醇屈螺酮进行绝经激素治疗,均能够有效改善患者的绝经后相关症状,提高其生活质量。在改善泌尿生殖道症状和精神神经症状方面,替勃龙的疗效优于雌二醇屈螺酮;在药物安全性方面,两种药物的不良事件发生率均较低,但表现不一。
[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.
【作者单位】：上海交通大学附属第六人民医院妇产科;
【分类号】：R711

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