宫腔镜诊治围绝经期子宫出血(附138例报告)

目的 :探讨宫腔镜在诊治围绝经期异常子宫出血 (perimenopausaluterinebleeding ,PMUB)的价值。方法 :回顾分析PMUB 138例用宫腔镜诊治的临床资料。结果 :138例中子宫内膜息肉 5 5例 ,子宫颈息肉 2 9例 ,粘膜下子宫肌瘤 4 0例 ,子宫内膜增生过长 6例 ,子宫内膜不典型增生 3例 ,子宫内膜癌 1例 ,正常子宫内膜 4例。总体检查阳性率为 97 10 %。术中 1例发生子宫穿孔并发症。术后随访 2 ～12个月 ,随访率为82 6 1% ,患者症状明显改善 10 6例 ,满意率为 92 98%。结论 :用宫腔镜诊断PMUB有相当高的特异性和准确性。可同时治疗良性病变 ,减少不必要的开腹手术 ,是治疗PMUB的首选方法。     

中医药治疗围绝经期综合征的临床研究进展

围绝经期综合征影响女性的工作及生活.本文通过查阅近年来临床治疗围绝经期的相关文献,从病因病机、中药治疗、针灸治疗等方面对调理冲任、平衡阴阳、有效控制病情等中医药的治疗优势进行了归纳.     

浅析围绝经期睡眠障碍的中医发病机制

目的：探讨围绝经期睡眠障碍的中医发病机制。方法：分析肾、心、肝三脏与围绝经期睡眠障碍的关系。结论：心肾不交、肝阳上亢是围绝经期睡眠障碍的主要病理机制。     

莉芙敏治疗妇女围绝经期综合征的疗效研究

目的探讨莉芙敏治疗妇女围绝经期综合征的疗效及安全性。方法选取我科门诊就诊的符合围绝经期综合征诊断标准的150例患者随机分配入两组:莉芙敏组(治疗组)100例,给予莉芙敏口服治疗,1片/次,2次/d,连续服用3个月;维生素B6组(对照组)50例,给予维生素B6口服治疗,1片/次,1次/d,连续服用3个月。经检查无子宫、卵巢的恶性病变,子宫内膜<5mm,乳腺检查无异常。治疗前后填写Kupperman Index(KMI)和Men-opause Rating Scale(MRS)量表并评分,对比治疗前后围绝经期综合征妇女的临床症状、性激素水平〔促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E2)〕、肝肾功能〔丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、肌酐(Cr)〕、脂代谢〔三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)〕及空腹血糖(FBG)的变化,同时行妇科B超、乳腺B超、宫颈细胞学涂片及乳房触诊等检查及观察药物不良反应。结果应用莉芙敏治疗3个月后,围绝经期综合征患者的症状明显缓解,部分患者潮热、多汗、睡眠障碍消失,总有效率为92.3%;用药前后KMI及MRS量表评分差异显著,与对照组比较及治疗前后比较差异有统计学意义(P<0.001);治疗组用药前后血FSH、LH、E2水平无明显变化,差异无统计学意义(P>0.05);用药后FBG与用药前相比无明显变化,差异无统计学意义(P>0.05);脂代谢中TG、TC含量较用药前降低,差异有统计学意义(P<0.05),HDL较用药前升高,LDL较用药前降低,差异有统计学意义(P<0.05);用药前后患者的肝肾功能无明显变化(P>0.05);用药前后的宫颈涂片均未发现有不典型增生细胞及癌细胞;用药过程中6例患者在治疗1月后出现胃部不适,4例在治疗2个月后出现乳房胀痛,继续服药后症状消失,仅1例在治疗1个月后头痛,未出现异常阴道流血、腹痛、水肿、乳房包块等严重不良反应。结论莉芙敏治疗围绝经期综合征有较好的临床疗效,能有效改善围绝经期综合征妇女的临床症状,安全性高且不良反应少,患者易于接受,值得临床进一步研究。     

柏子养心汤加味治疗围绝经期心脾两虚型失眠症临床观察

目的观察柏子养心汤加味治疗围绝经期心脾两虚型失眠症的临床疗效。方法将100例围绝经期心脾两虚型失眠症患者随机分为2组,治疗组50例予柏子养心汤加味治疗,对照组50例予常规治疗,2组均10 d为1个疗程,治疗2个疗程。比较2组疗效,观察2组治疗前后匹兹堡睡眠质量指数量表(PSQI)评分变化。结果治疗组总有效率88.0%,对照组62.0%,2组总有效率比较差异有统计学意义(P0.05),治疗组疗效优于对照组。治疗组治疗前后睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能评分及PSQI总分比较差异均有统计学意义(P0.05),治疗后均低于治疗前。2组治疗后睡眠质量、入睡时间、睡眠时间、睡眠效率、催眠药物、日间功能评分及PSQI总分比较差异均有统计学意义(P0.05),治疗组低于对照组,而睡眠障碍评分比较差异无统计学意义(P0.05)。结论柏子养心汤加味治疗围绝经期心脾两虚型失眠症疗效显著,对患者睡眠质量的改善作用明确,副作用较少。     

A longitudinal study of cognition change during early menopausal transition in a rural community

OBJECTIVE: To characterize changes in cognition that occur during the hormonal transitions of menopause. METHOD: We conducted a longitudinal population-based study in Kinmen, Taiwan, recruiting all women age 40-54 years who were premenopausal and without a history of hormone replacement therapy (HRT) or hysterectomy. The cognitive measures used to assess function included the Auditory-Verbal Learning Test, visual memory, verbal fluency, Trail Making Test and digit span. RESULTS: A total of 694 eligible women participated in the baseline study, and 573 women (83%) completed follow-up 18 months later. After excluding 78 women who received hysterectomy or HRT, the final sample was composed of 495 subjects, of whom 114 (23%) progressed to perimenopause during follow-up. Women who remained premenopausal were younger than those who became perimenopausal (44.7 +/- 2.3 years versus 47.1 +/- 3.0 years, p < 0.01). All follow-up cognitive scores in women who entered perimenopause were slightly better than baseline measures except for Rey Auditory-Verbal Learning Test, which decreased by 0.23 (S.D. = 2.9, p = 0.3). At follow-up, cognitive function except for verbal fluency did not differ significantly between women who stayed premenopausal and those became perimenopausal after controlling for age, education, and baseline cognitive scores. Women who entered perimenopause have an average of 1.3 items (S.D. = 0.4) less in verbal fluency measures as compared with their premenopausal peers at the follow-up period. CONCLUSIONS: The menopausal transition might not accompany significant cognitive decline except for verbal fluency.     

Body composition and resting metabolic rate of perimenopausal women using continuous progestogen contraception

Objective The effect on body composition and in particular on fat mass (FM) of 12 months’ use of a desogestrel (DSG)-only contraceptive pill or the levonorgestrel-releasing intrauterine system (LNG-IUS) was evaluated in women in the perimenopause.

Methods An observational study comprised 102 perimenopausal women: 42 received a 75 μg DSG pill, 34 received the 52 mg LNG-IUS, and 26 received no treatment. Body composition, body weight and resting metabolic rate (RMR) were evaluated at baseline and again after 12 months.

Results FM did not change in the control group (? 0.5 ± 1.6%) but significantly increased in the LNG-IUS group (+ 1.1 ± 2.9%; p = 0.02 vs. controls) and in the DSG group (+ 2.8 ± 3.5%; p = 0.0001 vs. controls; p = 0.02 vs. LNG-IUS). Women treated with DSG or the LNG-IUS showed a non-significant increase in body weight, body mass index and waist circumference. RMR did not significantly vary in the control group (? 3.8 ± 292.9 kJ/ 24 h) and tended to decrease but not significantly in the LNG-IUS (115.5 ± 531.8 kJ/ 24 h) and DSG groups (305.9 ± 556.9 kJ/24 h).

Conclusions The results of this preliminary study seem to indicate that in perimenopausal women continuous use of the DSG-only pill and to a lesser extent the LNG-IUS may favour FM accumulation.     

戊酸雌二醇片/雌二醇环丙孕酮片复合包装治疗围绝经期功能失调性子宫出血的临床效果观察

目的：探讨戊酸雌二醇片/雌二醇环丙孕酮片复合包装治疗围绝经期功能失调性子宫出血的临床效果。方法选取本院2013年3月～2014年2月收治的96例围绝经期功能失调性子宫出血患者,随机分为治疗组与对照组各48例。治疗组口服戊酸雌二醇片/雌二醇环丙孕酮片复合包装进行治疗,对照组应用炔诺酮片进行治疗。比较两组的临床疗效及治疗前后月经周期、经期、经量的变化情况。结果治疗组痊愈率为75.0%,总有效率为93.75%;对照组痊愈率为41.67%,总有效率为56.25%;治疗组痊愈率及总有效率明显高于对照组（P＜0.05）。两组治疗后月经周期、经期、经量与治疗前比较,差异有统计学意义（P＜0.05）;治疗后治疗组月经周期、经期、经量与对照组比较,差异有统计学意义（P＜0.05）。结论戊酸雌二醇片/雌二醇环丙孕酮片复合包装治疗围绝经期功能失调性子宫出血效果显著,值得临床进一步推广应用。     

更欣汤治疗心肾不交型围绝经期失眠症的临床疗效研究

目的：观察更欣汤治疗心肾不交型围绝经期失眠症的临床疗效。方法：选取2019年6月至2021年1月就诊于北京中医药大学东直门医院妇科门诊的心肾不交型围绝经期失眠患者40例作为研究对象,随机分为观察组和对照组,每组20例。其中观察组给予更欣汤中药颗粒剂治疗,对照组给予西药佐匹克隆治疗,2组疗程均为4周。收集患者一般资料及临床基本情况,以匹兹堡睡眠质量指数(PSQI)评分变化为主要疗效指标,以改良Kupperman量表、中医证候量表评分变化以及睡眠监测项目中的睡眠潜伏期和睡眠时间变化为次要疗效指标,以血常规、尿常规、生化检验结果中的指标变化及有无不良反应的发生作为安全性指标,分别于治疗前后进行临床治疗效果及安全性指标的评价,采用SPSS 20.0统计软件进行数据分析。结果：更欣汤与第3代环吡咯酮类催眠药佐匹克隆都能有效改善妇女围绝经期失眠症状,延长患者睡眠时间,提高睡眠效率,2组疗效比较,差异无统计学意义(P>0.05);同时更欣汤还能安全有效地改善患者其他围绝经期综合征相关症状,疗效显著优于佐匹克隆,2组疗效比较,差异有统计学意义(P<0.05)。结论：更欣汤能有效改善妇女围绝...     

激素替代治疗围绝经期抑郁症疗效观察

目的 探讨激素替代治疗围绝经期抑郁症患者的临床疗效.方法 将201 8年12月～2019年12月本院接收的104例围绝经期抑郁症患者通过电脑随机分为两组,每组52例患者.常规组予以单纯抗抑郁药物治疗,研究组予以抗抑郁药物治疗+激素替代治疗.比较两组的效果.结果 研究组临床疗效高于常规组(P＜0.05);研究组用药之后第...