雌三醇膏剂与结合雌激素膏剂治疗绝经后泌尿生殖道萎缩的比较研究

目的 旨在比较雌二醇膏剂及结合雌激素膏剂连续使用治疗绝经后泌尿生殖道萎缩的疗效和安全性。方法 选择68例有泌尿生殖道萎缩症状的患者按1:1随机入组使用雌三醇阴道膏剂及结合雌激素膏剂共计21d,观察泌尿生殖道症状和体征的改善情况,阴道健康评分、阴道细胞成熟值的变化,及用药前后阴道内膜变化及其他副作用。结果 用药后两组患者的症状、体征明显改善,阴道健康评分及阴道MV值明显提高。有6例(两组各3例)患者子宫内膜厚度>5mm,结合雌激素组有1例刮宫内膜病理为增殖期子宫内膜,部分腺体呈囊性扩张。结论 雌二醇膏剂及结合雌激素膏剂,连续使用治疗绝经后泌尿、生殖道萎缩疗效显著,但使用时间较长,或剂量较大应加用孕激素防止内膜增厚及内膜增生。

Comparative study of safety and efficacy of estriol cream and conjugated equine estrogen vaginal cream in the treatment of postmenopausal urogenital atrophy

Objective To compare the safety and efficacy of continuous estriol cream with conjugated equine estrogen vaginal cream for the treatment of postmenopausal urogenital atrophy.Methods 68 postmenopausal women with symptoms and signs of urogenital atrophy were randomised on a 1:1 basis to divide into two groups: continuous treatment with estriol cream (group A) verse conjugated equine estrogen vaginal cream (group B) for 21 days. The symptoms, signs, vaginal healthy valuations, vaginal MV, endometrial thickness and other side effects were studied during treatment.Results Equal effectiveness were shown between the two groups for relief of the symptoms and signs, improvement of vaginal healthy valuations and vaginal MV. There were 6 cases with endometrial thickness over 5mm (3 in each group) . One in group B her endometrial assessments revealed proliferative endometrium, with partial cystic hyperplasia. Conclusions Both vaginal creams are highly effective for the treatment of postmenopausal urogenital atrophy. For long term user, progestogen should be added to prevent the increasing endometrial thickness and endometrial hyperplasia.