孕激素对围绝经期综合征的治疗作用

目的探讨应用孕激素治疗围绝经期妇女月经紊乱及围绝经期综合征的作用。方法选择有围绝经症状伴子宫异常出血或月经周期改变的122例围绝经期妇女作为研究对象。分为2组:A组(54例):月经过多、异常出血,经诊刮术病理证实为子宫内膜异常增生的功能性子宫出血患者。给予炔诺酮6~8 mg/d×22 d×2个周期,之后于月经第16天服用安宫黄体酮6~8mg/d×10 d×1个周期。B组(68例):月经周期改变,稀发或不规律,月经量正常、轻度增加或减少者。月经周期第16天给予安宫黄体酮6~8 mg/d×10 d×3个周期。用药前后2组计有85例进行了促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)的测定,有围绝经综合征的94例进行G reene评分。2组用药前后均用B超测量子宫内膜厚度。结果2组用药前及用药后比较,FSH值明显下降(P<0.01),E2值明显上升(P<0.05),差异均有统计学意义。而LH值虽有下降,但差异无统计学意义(P>0.05)。122例患者中有围绝经期症状的计有94例(77%)。用孕激素治疗3月后G reene评分明显降低,用药前后比较差异有统计学意义(P<0.01)。2组之间FSH、LH、E2、G reene评分值比较差异均无统计学意义(P>0.05)。2组用药后子宫内膜厚度均明显变薄(P<0.01)。结论围绝经期妇女应用孕激素治疗能够有效缓解围绝经症状,调整月经周期,并对子宫内膜产生保护作用。

The Therapeutic Effects of Progestin on Perimenopuasal Syndrome

Objective To study the therapeutic effects of progesterone on menstrual cycle disorder and perimenopuasal syndrome in perimenopausal women.Methods 122 subjects with menstrual cycle disorder and perimenopuasal syndrome were divided into two groups: Group A(54 cases) with menorrhagia and endometrial proliferation,who was diagnosised with D &; C.They took norethisterone 6～8 mg/d for 22 d per month for 2 cycles,and then changed into medroxyprogestone 6～8 mg for 10 d for 1 cycles during day of cycle 16 d.Group B(68 cases)with irregular cycle or oligomenorrhea,menstrual flow was normal or slight increased or decreased.They received medroxyprogestone 6⁸ mg for 10 d for 3 cycles during day of cycle 16 d.The serum concentration of FSH,LH,E₂ were compared before and after treatment(85 cases).The greene score were performed in two groups(94 cases) who had primenopuasal syndrome before and after treatment. Results FSH was significantly lower(P<0.01),and E₂ was significant higher(P<0.05),LH was decreased,but no significant defference(P>0.05) before and after treatment.In both groups,the symptoms of 94 subjects with perimenopuasal syndrome(77%)were alleviated after treatment,the Greene score were significantly decreased(P<0.01),no significant difference was observed between two groups.Extended menstrual flow was decreased,and disorder of menstrual cycles kept regular for several months after taking progesterone.Conclusion Taking progesterone can alleviate symptoms of perimenopuasal syndrome,regulate menstrual cycles,and protect uterine endomitrium in perimenopausal women.