Levetiracetam for treatment of premenstrual dysphoric disorder: A pilot,open-label study

Kindling and impaired electroencephalophysiology have been suggested to play a role in the pathophysiology of premenstrual dysphoric disorder (PMDD). Levetiracetam is a novel antiepileptic drug which has shown strong anti-kindling activity in animal models of epilepsy. In this preliminary prospective study we examined the safety and efficacy of levetiracetam for the treatment of PMDD. One hundred twenty-three potential patients were prospectively screened to enroll seven patients into the open-label treatment phase of the study. PMDD was diagnosed per DSM-IV-TR criteria and two consecutive months of prospective ratings of Daily Record of Severity of Problems (DRSP). The Mini International Neuropsychiatric Interview (MINI) was used to exclude any co-morbid conditions. Levetiracetam was started at 250 mg qhs at the end of the first week of the follicular phase. Dosage was gradually increased up to 1,500 mg bid as tolerated or clinically effective. The treatment phase lasted 4 months. Response to treatment was evaluated by Clinical Global Impression (CGI) and DRSP scores. Six out of seven patients experienced a considerable decrease in their DRSP scores with levetiracetam, starting from the first treatment cycle. One patient dropped out of the study due to lack of efficacy after one cycle. Medication was fairly well tolerated. Improvements in food cravings and premenstrual headaches were also noted as unexpected benefits. Anticonvulsant medications, specifically levetiracetam, could be effective in the treatment of PMDD. Future double-blind, placebo controlled, randomized studies are warranted and should include larger number of patients.     

曼月乐节育环对子宫腺肌病患者月经模式和性生活质量影响的临床研究

目的探讨曼月乐节育环治疗子宫腺肌病后对患者的月经模式和性生活质量的影响。方法选择2009年8月至2009年12月子宫腺肌病放置曼月乐节育环的患者56例,采用月经失血图法,痛经评分法,国际女性性功能评估量表评价患者治疗前、治疗后1、3、6、9、12个月月经模式、子宫体积和性功能情况。结果53例患者顺利完成随访,随访率94．6％。56例子宫腺肌病患者在放置曼月乐环后3、6、9、12个月痛经程度较放置曼月乐前减轻[放置前：（3．15±0．91）分;放置后：（1．41±0．51）分,（0．22±0．09）分,（0．07±0．01）分,0分,P〈0．05）],月经量减少[放置前：（12．0±57．5）分;放置后：（71±23．1）分,（29±19．4）分,（18±10．5）分,（10±4．7）分,P〈0．05];治疗1个月性功能各项指标均无明显改善（P〉0．05）,治疗3个月后仅D2指标有明显改善（P〈0．05）,治疗6个月后性功能各项指标均有改善（P〈0．05～0．01）。结论曼月乐节育环对子宫腺肌病患者的月经模式和性功能恢复疗效好。     

Menstrual characteristics and night work among nurses

Night work has been associated with adverse effects in terms of reproductive health. Specifically, menstruation has been suggested to be negatively impacted by night work, which again may influence fertility. This study investigated whether working nights is related to menstrual characteristics and if there is a relationship between shift work disorder (SWD) and menstruation. The study was cross-sectional, response rate 38%. The sample comprised female nurses who were members of the Norwegian Nurses Association; below 50 yr of age, who were not pregnant, did not use hormonal pills or intrauterine devices and who had not reached menopause (n=766). The nurses answered a postal survey including questions about night work and menstrual characteristics. Fifteen per cent reported to have irregular menstruations. Thirty-nine per cent of the nurses were classified as having SWD. Logistic regression analyses concerning the relationship between irregular menstruations and night work did not show any associations. Furthermore, no associations were found between cycle length or bleeding period and night work parameters. No associations were found between menstrual characteristics and SWD.     

补肾调周法合二藤汤灌肠治疗慢性盆腔炎性不孕症的临床疗效观察

目的观察补肾调周法口服中药合二藤汤保留灌肠法治疗慢性盆腔炎性不孕症疗效,评价其有效性和安全性。方法选取2016年2月—2017年1月期间山东省济宁市中医院妇产科门诊收治的60例慢性盆腔炎性不孕症患者,按随机数字表法分为治疗组和对照组,每组30例。对照组给予二藤汤,1剂/d,水煎400 ml,200 ml口服、200 ml保留灌肠。治疗组给予补肾调周方药口服1剂/d结合二藤汤灌肠2日1剂。两组均在每个月经周期的非经期期间治疗15 d,连续治疗3个月经周期为1个疗程。治疗结束后观察这两组患者妊娠情况、临床症状、体征评分、月经改善情况。结果治疗后治疗组患者受孕率66.67%(20/30),对照组受孕率46.33%(13/30),两组比较差异有统计学意义(P<0.05)。两组患者治疗后临床症状、体征积分均降低与治疗前比较差异有统计学意义(P<0.05),且治疗组临床症状、体征积分均优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后治疗组总有效率90.00%(27/30),对照组总有效率73.33%(22/30),两组比较差异有统计学意义(P<0.05)。治疗后治疗组治疗盆腔炎症总有效率93.33%(28/30),对照组治疗盆腔炎症总有效率86.67%(26/30),两组比较差异有统计学意义(P<0.05)。结论补肾调周法口服中药合二藤汤灌肠治疗慢性盆腔炎性不孕症不但能提高妊娠率,而且还明显改善患者临床症状、体征、月经情况,疗效确切有效,在临床上值得推广应用。     

补肾活血组方对人流术后月经过少的临床观察

目的探究补肾活血组方对人流术后月经过少的临床疗效。方法将90例人流术后月经过少患者随机分为两组,观察组给予补肾活血组方治疗,对照组给予常规治疗,对比两组疗效。结果观察组有效率显著高于对照组(P0.05);治疗后,观察组行经时间显著高于对照组(P0.05);观察组子宫内膜厚度显著高于对照组(P0.05)。结论人流术后月经过少患者经补肾活血法治疗,可有效促进月经恢复,疗效显著。     

补肾活血散瘀汤联合高强度聚焦超声对子宫腺肌病的疗效及病人免疫功能的影响

目的探究补肾活血散瘀汤联合高强度聚焦超声对子宫腺肌病的疗效及病人免疫功能的影响。方法选取 2020年 7—12月石家庄市人民医院收治的 110例子宫腺肌病病人,按随机数字表法分为超声组( 55例)和联合组( 55例)。其中超声组给予高强度聚焦超声治疗,联合组给予补肾活血散瘀汤联合高强度聚焦超声治疗子宫腺肌病病人。比较两组病人免疫功能［补体 C3、C4、免疫球蛋白 A(IgA)、免疫球蛋白 G(IgG)、免疫球蛋白 M(IgM)］,月经改善情况(月经量、疼痛程度)中医症候积分,血清糖类抗原 CA125水平、子宫体积及不良反应发生情况。结果与治疗前比较,两组治疗后补体 C3［联合,组( 95.32±2.12)比( 102.74±3.42)mg/dL、超声组( 98.12±2.58)比( 101.89±3.36)mg/dL］、 IgA水平［联合组( 2.42±0.26)比( 3.47±0.46)mg/dL、超声组( 3.01±0.34)比( 3.54±0.51)g/L］、月经量评分、疼痛视觉模拟评分法( VAS评分)、中医症候积分、血清糖类抗原 CA125水平、子宫体积明显降低( P<0.05)且与超声组比较,联合组明显降低( P<0.05);两组血清 IgG［联合组( 15.78±1.67)比( 12.12±1.14)g/L、超声组( 13.78±1.42)比.35±1.21)g/L］明显升高( P<0.05),且与超声组比较,联合组明显升高( P<0.05)两组不良反应发生率比较差异无统计学意义( P>0.05)。结论补肾活血散瘀汤联合高强度聚焦超声治疗子宫腺肌病病人可有效改善临(12,床症状,提高免疫功能,安全有效。     

近代燕京妇科名家诊治不孕症的经验浅析

燕京中医流派源远流长,是著名的中医流派之一,其妇科名家在中医妇科诊疗方面具有较高的学术造诣及独到的学术见解。不孕症是影响人类生殖健康最主要的疾病,困扰众多渴求生育的妇女。通过收集燕京妇科名家治疗不孕症的理论资料及临床验案,浅析燕京妇科名家治疗不孕症的临床经验及用药特色,以飱同道。     

中药对阳虚血瘀型子宫憩室患者经期延长的临床疗效观察

目的:观察中药对阳虚血瘀型子宫憩室患者经期延长的临床效果.方法:选择阳虚血瘀型子宫憩室导致的经期延长患者84例.随机分为对照组(42例)和观察组(42例).对照组给予口服达因35治疗,观察组给予中药治疗.比较两组疗效情况;观察治疗前后两组中医证候积分变化情况,比较治疗前后血清E2、FSH、T及LH水平变化情况;观察两组...     

一贯煎在妇科临床上的应用

目的：探讨一贯煎在妇科临床上的应用。方法：辨证分析妇科不同证型,一贯煎各方适量加减进行治疗。结果：对于不同证型的妇科疾病,应用一贯煎治疗,效果较好。结论：一贯煎治疗妇科疾病疗效较好。     

Documentation of Sexual and Menstrual Histories for Adolescent Patients in the Inpatient Setting

Study ObjectiveIn this study, we aimed to determine the frequency of menstrual history and sexual history documentation in the inpatient setting.Design, Setting, and ParticipantsA retrospective chart review was conducted for 307 female patients ages 11-18 years admitted from the emergency department at a single institution within a 7-month period. These charts were reviewed for documentation of menstrual and sexual history.Interventions and Main Outcome MeasuresRates of menstrual and sexual history documentation were compared according to patient age, chief complaint, admitting specialty, and medical complexity.ResultsSexual history documentation was noted in 158 (45.9%) of the 344 reviewed charts. Sexual history documentation rates were higher for patients with mental health symptoms (62.9%; 61 of 98 charts; P = .02) and lower for patients admitted to surgical services (30.6%; 19 of 62 charts; P = .04). At least 1 aspect of menses was documented in 113 (32.8%) of the 344 reviewed charts. Last menstrual period was the most commonly documented aspect of menstrual history, appearing in 100 (29.1%) of the 344 reviewed charts. Menarche (4.4%; 15/344), menses frequency (7.0%; 24/344), menses duration (2.6%; 9/344), flow quantity (4.9%; 17/344), and dysmenorrhea (4.4%; 15/344) were rarely documented, regardless of chief complaint or admitting service. Menstrual history documentation rates were significantly higher for patients requiring a gynecology consultation (73.3%; 11 of 15 charts; P < .01).ConclusionMenstrual and sexual history documentation rates for adolescent patients requiring inpatient admission were low, with fewer than half of patients having a documented menstrual or sexual history.