雌、孕激素补充疗法对绝经后妇女膝骨关节炎症状的作用

目的观察雌、孕激素连续联合用药对绝经后膝骨关节炎(OA)患者的疗效.方法将64例有放射学证据并有关节疼痛的绝经后膝关节OA患者(45～75岁)随机分为治疗组和对照组,分别给予每日口服戊酸雌二醇(E2V)1.0mg 安宫黄体酮(MPA)2 mg和安慰剂治疗,共6个月,所有患者均同时给予乳酸钙8片/d(相当于400mg元素钙).采用0～100mm目测模拟标尺线(VAS)方法,于用药前,用药1、3、6个月末对关节疼痛等症状程度进行评价.结果用药1个月时,治疗组患者和对照组患者在夜间睡眠痛和步行时疼痛方面的变化差异有显著性(P分别为0.036和0.035).用药6个月时,两组在夜间睡眠痛、步行时疼痛及晨僵持续时间改善程度方面相比,差异均有显著性(P分别为0.026、0.027和0.011).结论雌、孕激素连续联合补充治疗对绝经后膝OA患者的临床症状有一定缓解作用.

Effect of combined continued hormone replacement therapy on knee osteoarthritis symptom of postmenopausal women

Objective To study the effect of combined continued estrogen and progestin replacement therapy on knee osteoarthritis?(OA?)symptoms of postmenopausal women. Methods Sixty-four postmenopausal women with radiological knee OA and symptoms aged 45 - 75 were divided into treatment group and control group. They were given estradiol velerate?(E2V?)1.0 mg/d and medroxyprogestetone acetate?(MPA?)2 mg/d?(treat ment group?)or placebo?(control group?)for 6 months. Calcium 400 mg/d were given to all cases. Then 0 - 100 mm visual analon scale?(VAS?)was used to evaluate the severity of knee pain at baseline and after 1? 3? 6 month of treatment. Results Significant differences on pain at night and tenderness around knee were seen in the treatment group compared with the control group after 1 months of treatment(P = 0.036 and 0.035? respectively). The improvement of pain at night? during walk and morning stiffness between the two groups showed significant difference after 6 months(P = 0.026? 0.027? and 0.011? respectively). Conclusion Combined estrogen and progestin replacement therapy can relieve the knee OA symptoms of postmenopausal women.