雷公藤多甙伍用雌孕激素对卵巢功能保护作用观察

目的通过雌、孕激素序贯性干预治疗,探讨雌孕激素对雷公藤多甙(TW)所致卵巢功能减退的保护及卵巢早衰(POF)的防治方法。方法选择因停用雷公藤多甙片(TWP)后肾小球肾炎复发的继发性月经紊乱或POF患者16例,给予TWP伍用雌、孕激素序贯性替代治疗(HPT),观察治疗前及停药后的临床症状、性激素变化和月经恢复情况。结果16例均为TWP治疗有良好疗效,因继发性月经紊乱或闭经停用TWP后免疫性肾小球肾炎再发的患者。经过TWP伍用雌、孕激素序贯性干预治疗,肾小球疾病稳定且围绝经期征候群改善。HPT治疗停止3个月后卵巢分泌雌激素(E2)明显增高,垂体分泌的卵泡刺激素(FSH)和黄体生成素(LH)则明显下降(P<0.001),87.5%(14/16)病人有规律性的阴道流血。结论在对TWP有较好疗效的肾炎患者中,规律地伍用雌、孕激素干预治疗,可避免或减少TWP所致的POF,对卵巢功能有较好的保护作用。

The protective effect to ovary by the usage combined with hormone replacement therapy in the patients with Triptergium wifordii

Objective To investigate The protective effect of estrogen combined with progestogen replacement therapy in the patients with secondary premature ovary failure induced by Triptergium wifordii.Methods The 16 patients who had suffered from nephritis and secondary premature ovary failure by TW had were treated by TWP and estrogen combined with progestogen replacement therapy periodically.The levels of E2,LH and FSH in their blood were estimated and changes of menses and clinical situation before the treatment and 3 months after stopping treatment were observed respectively.Results All of them had suffered from POF and a relapse of nephritis during a pause of TWP,which had been confirmed by the levels of sexual hormone in their blood and their clinical situations.The E2 secreted by ovary was higher and LH,FSH secreted by pituitary were lower after treating than those before treating (P<0.001).Their clinical symptoms had been improved after treating.Their situations were stable after the treatment had been stopped for 3 months.The rate of efficiency for this treatment was 87.5%Conclusion It was an effective method that TWP combined with hormone replacement therapy periodically treated the patients suffered from POF and a relapse of nephritis during a pause of TWP to protect ovary function and keep effect of TWP.