消炎痛治疗宫内放环后出血

积极治疗节育手术并发症是搞好计划生育的一个重要环节。月经异常是宫内放置节育环的主要并发症，也是节育环停止使用的主要原因。近几年来本人采用消炎痛治疗官内放环后月经异常，取得了良好的效果。     

妇女月经周期睡眠行为变化

目的 观察在月经周期中,妇女睡眠活动的变化。方法 本工作以问卷填表方式调查在月经周期中妇女睡眠行为的变化,应用多道睡眠脑电图观察在卵泡期和黄体期睡眠脑电波形的变化。结果 与黄体期比较,在卵泡期妇女多梦、记忆清楚,易醒、再入睡困难,白天精力体力差,自 感觉没睡好,总睡眠时间无显著差异,总睡眠分值低;与黄体期比较,卵泡期快波睡眠时间延长,慢波2期和4期睡眠时间缩短。结论 在月经周期中,妇女睡眠行为的变化系由体内雌激素浓度变化所致。     

Menstrual patterns in Danish elite swimmers

Summary Questionnaires were given to 140 female elite swimmers from the highest ranking division in the Danish Swimming Association inquiring about their menstrual history. Eighty-nine percent completed the questionnaires. We found a very low incidence of menstrual dysfunction (16%) compared to other groups of endurance trained females. Hard physical endurance training did not seem to delay the onset of menarche among swimmers. Furthermore, no difference in adjusted body mass between a group with oligomenorrhoea and a normal menstruating group could be demonstrated. The study indicated that the influence of body mass or body fat content was a more important factor in menstrual function than the amount of training or psychological stress.     

安神调经针法治疗月经后期探析

心身疾病是当今医学亟待解决的课题.临床上大量月经后期的患者其发病与心理社会因素密切相关,属心身疾病的范畴.据此,笔者提出了月经调节的中医"心脑-肾气-天癸-冲任-胞宫轴"的新模式,并认为它与现代医学"大脑皮层-下丘脑-垂体-卵巢-子宫生殖轴"的神经内分泌调节系统极为相似.在此基础上创立了一套安神调经疗法.通过调整心脑功能,从而调节下丘脑-垂体-性腺轴,促进卵泡发育,治疗月经后期.并以此为突破点,为心身疾病引起的各种妇科病的针灸治疗提供了一种新方法、新思路.     

Ovulation disturbances and mood across the menstrual cycles of healthy women

We examined the cyclicity of negative mood relative to ovulation and ovulation disturbances in Menstrual Cycle Diary© data collected daily during a 1-year study of ovulation, exercise, and bone change. A validated quantitative basal temperature-based methodology was used to determine the onset of the luteal phase. ‘Feeling depressed’, ‘feeling anxious’, and ‘feeling angry/frustrated’ were scored on a scale of 0 (absent) to 4 (very intense). Mood scores were examined over two 15-day intervals centered on either ovulation/midpoint, or on the onset of flow. Data were available from 765 cycles of 62 healthy and initially ovulatory women with a mean age of 33.9?±?5.4 years. Of 739 cycles that could be classified, 532 (72%) were normally ovulatory, 185 (25%) were ovulatory with a short (<10 day) luteal phase, and 22 (3%) were anovulatory. Minor cyclic mood changes were present in both ovulatory and anovulatory menstrual cycles. In anovulatory cycles, mood tended to be more variable but less negative, with a time course that differed from that in ovulatory cycles. Mood scores did not differ based on luteal phase length or with hormone levels. Patterns and mechanisms of mood change in very symptomatic women appear to be essentially amplifications of normal experiences.     

补肾活血法在治疗月经不调中临床应用

目的：观察补肾活血法在治疗月经不调中的疗效作用。方法：按随机原则将90名月经不调患者平均分为两组，中医组采用补肾活血法治疗，西医组采用口服乙烯雌酚方法治疗。结果：与西医组相比，中医组的整体治疗效果明显提高，其治愈率高于西医组，治疗后典型性双相率也明显增高，且两组的差异具有统计学意义，P〈0.05。结论：补肾活血法治疗女性月经不调疗效显著。     

探讨铅暴露对女性FSH、PRL、LH等激素水平的影响

目的初步探讨低水平铅暴露对女性血清性激素及月经周期的影响。方法对铅暴露女性269人及对照组女性348人的一般情况、生殖结局进行回顾性队列研究,并测血铅及用放射免疫法测定孕酮（P）、雌二醇（E2）、催乳素（PRL）、卵泡刺激素（FSH）、黄体生成素（LH）性激素水平。结果暴露组女性月经紊乱明显高于对照组（P〈0．01）,且早产率、自然流产率亦高于对照组,差异有统计学意义（P〈0．01）;暴露组血清性激素水平孕酮（P）、雌二醇（E2）降低,促卵泡素、促黄体生成素升高。结论说明长期低浓度铅暴露干扰下丘脑一垂体～卵巢轴正常的内分泌调节功能,可引起女性月经失调、影响内分泌激素水平。     

女性尘肺病及观察对象胸膜病变患者月经情况调查

目的了解女性尘肺病及观察对象胸膜病变患者月经的情况,为保护该人群的健康提供依据。方法对53例女性尘肺病及观察对象胸膜病变患者(简称接尘组)的月经情况进行回顾性调查。结果接尘组月经总异常率较高,为62.26%,且以月经失调、经前紧张综合征为主要表现,月经失调、经前期综合征检出率分别为9.43%、13.21%,均高于对照组。两组比较,以上3项差异均有统计学意义(P0.05)。结论女性接尘组的月经异常发生情况较对照组明显,有关部门应予以重视。     

孕激素治疗月经期癫痫的临床证据评价

目的 采用循证医学方法评价孕激素治疗月经期癫痫的疗效和药物不良反应,为月经期癫痫提供有循证依据的最佳治疗方案。方法 以月经期癫痫痫（catamenial epilepsy）、药物治疗（drugtherapy）、孕激素（progesterone）、四氢孕酮（allopregnanolone）、系统评价（systematic review）、随机对照试验（randomized controlled trials）等中英文词汇为检索词,分别检索万方数据库、维普期刊资源整合服务平台、中国知网中国知识基础设施工程、英国Cochrane图书馆、美国国立医学图书馆、Google学术搜索等国内外数据库,获得系统评价、随机对照试验、开放性试验、前瞻性或回顾性病例分析研究、病例观察研究和综述等文献,采用Jadad量表质量标准评价文献质量。结果 经筛选共纳入孕激素治疗月经期癫痫相关英文文献18篇,包括系统评价1篇、随机对照试验3篇、开放性试验1篇、前瞻性病例研究2篇、病例随访研究1篇、综述10篇。其中10篇为高质量文献（评分≥4分）,8篇为低质量文献（评分〈4分）。对各项临床试验治疗原则以及疗效和安全性评价显示：（1）孕激素作为抗癫痫药物的添加方案治疗月经期癫痫,可显著减少月经期癫痫发作频率,且安全性和耐受性良好。（2）天然孕激素和人工合成孕激素均可用于月经期癫痫的治疗。（3）孕激素治疗月经期癫痫的方式包括周期性孕激素治疗和抑制治疗,以前者更常用。结论 借助循证医学评价方法可为孕激素治疗月经期癫痫提供最佳临床证据。     

The accuracy of using last menstrual period to determine gestational age for first trimester medication abortion: a systematic review

Objective

We sought to evaluate the accuracy of assessing gestational age (GA) prior to first trimester medication abortion using last menstrual period (LMP) compared to ultrasound (U/S).

Study Design

We searched Medline, Embase and Cochrane databases through October 2013 for peer-reviewed articles comparing LMP to U/S for GA dating in abortion care. Two teams of investigators independently evaluated data using standard abstraction forms. The US Preventive Services Task Force and Quality Assessment of Diagnostic Accuracy Studies guidelines were used to assess quality.

Results

Of 318 articles identified, 5 met inclusion criteria. Three studies reported that 2.5–11.8% of women were eligible for medication abortion by LMP and ineligible by U/S. The number of women who underestimated GA using LMP compared to U/S ranged from 1.8 to 14.8%, with lower rates found when the sample was limited to a GA < 63 days. Most women (90.5–99.1%) knew their LMP, 70.8–90.5% with certainty.

Conclusion

Our results support that LMP can be used to assess GA prior to medication abortion at GA < 63 days. Further research looking at patient outcomes and identifying women eligible for medication abortion by LMP but ineligible by U/S is needed to confirm the safety and effectiveness of providing medication abortion using LMP alone to determine GA.