探索戊酸雌二醇并用醋甲羟孕酮疗法的最佳方案

目的 :探索戊酸雌二醇 (E2 V )并用醋甲羟孕酮 (MPA)疗法的最佳方案。方法 :91名绝经后妇女分 5组。组 1(18人 )用碳酸钙 0 .5g ,tid ;组 2 (17人 )用E2 V 1mg ,qd ;组 3(17人 )用E2 V 1mg与MPA 1mg ,qd ;组 4 (2 0人 )用E2 V 1mg与MPA2mg ,qd和组 5 (19人 )用E2 V 1.5mg与MPA 2mg ,qd。均 po ,3mo。每日记录症状 ,用药前后测血雌二醇、子宫内膜厚度、子宫内膜细胞及病理学检查。结果 :E2 V 1mg ,qd与 1.5mg ,qd缓解绝经症状相似 ;治疗 3mo时组 2和组 3子宫内膜增厚 ,分别为(3.2±s 1.2 )mm和 (1.8± 0 .9)mm ,(P <0 .0 1) ;组 3,4 ,5阴道出血率分别为 2 9% ,5 0 % ,5 8% ;用药前后子宫内膜细胞病理学检查均无病变。结论 :有子宫绝经后妇女使用E2 V 1mg和MPA 2mg ,qd ,为最佳方案。

Search of optimal regimen of a combination of estrodiol valerate and medroxyprogesterone acetate

AIM: To search an optimal regimen of a combination of estrodiol valerate (E 2V) and medroxyprogesterone acetate (MPA). METHODS: Ninety one postmenopausal women were divided into five groups for 3 mo study. Group 1 ( n =18) was treated with CaCO 3 0.5 g, po , tid, for 3 mo; Group 2 ( n =17) was treated with E 2V 1 mg, po , qd for 3 mo; Group 3 ( n =17) was treated with E 2V 1 mg and MPA 1 mg, po qd for 3 mo; Group 4 ( n =20) was treated with E 2V 1 mg and MPA 2 mg, po qd, for 3 mo; Group 5 ( n =19) was treated with E 2V 1.5 mg and MPA 2 mg, po qd, for 3 mo. The menopausal symptoms and vaginal bleeding were recorded in diary. Endometrial thickness was measured by vaginal ultrasonography, endometrial cytology and serum estrogen level were determined before and after treatment. RESULTS: Symptoms were released similarly in dose of E 2V 1 mg, qd and E 2V 1.5 mg, qd. Endometrial thickness were increased significantly in group 2 and 3 (3.2± s 1.2) mm, (1.8±0.9) mm( P <0.01). Bleeding rates were 29 %, 50 %, and 58 % in group 3, 4, and 5, respectively. No endometrial abnormality were detected at the beginning and end of the study. CONCLUSION: E 2V 1 mg, qd and MPA 2 mg, qd is an optimal regimen for postmenopausal women with intact uterus.