益癸方聯合芬嗎通治療圍絕經期綜合征的療效研究

吳紅艷 黃飛翔 賈涔琳

摘要 目的：探討益癸方聯合芬嗎通治療圍絕經期綜合征的療效。方法：選取2015年1月至2017年12月南京醫科醫科大學附屬杭州醫院收治的圍絕經期婦女266例作為研究對象，按照治療不同的治療方法分為西藥組（芬嗎通）（n=85）、中藥組（益癸方）（n=61）、中西藥組（同時服用芬嗎通和益癸方）（n=80）。比較分析治療前后3組患者的Kupperman評分及FSH、LH、E2、TC、TG、HDL、LDL、ALT、AST水平。結果：初診時3組患者Kupperman評分，FSH、LH、E2、血脂水平、肝酶水平比較，差異均無統計學意義（均P>0.05）。治療3個月后，與治療前比較，3組患者FSH、LH、LDL水平及Kupperman評分顯著下降，E2水平顯著升高，差異均有統計學意義（均P<0.05）;3組患者肝酶水平無顯著變化，差異均無統計學意義（均P>0.05）。中西藥組與西藥組、中藥組比較，Kupperman評分及FSH水平下降更為顯著，且西藥組療效優于中藥組，差異均有統計學意義（均P<0.05）。結論：中藥益癸方、西藥芬嗎通及兩者的聯合治療均可改善圍絕經期癥狀，降低FSH、LDL水平，且對肝功能無顯著影響，而益癸方聯合芬嗎通的治療方案療效更為顯著。

關鍵詞 益癸方;芬嗎通;圍絕經期綜合征;肝酶;Kupperman評分

Abstract Objective：To explore the effect of Yigui Decoction combined with Femoston on perimenopausal syndrome.Methods：The 266 cases of perimenopausal women were recruited from the gynecology outpatient in the Hangzhou Women′s Hospital from January 2015 to December 2017.They were divided into a western medicine group（Femoston）of 85 cases，a Chinese medicine group（Yigui Decoction）of 61 cases，and a Chinese medicine and western medicine group（taking both Femoston and Yigui Decoction）of 80 cases according to different treatment methods.Kupperman Mnopause Index（KMI），follicle stimulating hormone（FSH），luteinizing hormone（LH），estradiol（E2），TC，TG，HDL，LDL，ALT，AST were measured before and after 3 months treatment，respectively.Results：There were no significant differences in the FSH，LH，E2，blood lipid levels，liver enzyme levels and Kupperman scores in the 3 groups before treatment（all P>0.05）.The FSH，LH，LDL levels and Kupperman scores were significantly decreased while E2 level was increased obviously after 3 months treatment compared with those before treatment in the 3 groups（all P<0.05）.And there were no significant change in liver enzyme levels in the 3 groups（all P>0.05）.Compared with the western medicine group and the Chinese medicine group，Kupperman score and FSH level in the Chinese medicine and western medicine group were significantly decreased.The effects of western medicine group were better than those of Chinese medicine group，and the difference was statistically significant（all P<0.05）.Conclusion：Chinese medicine Yigui Decoction，western medicine Femoston and combination of both all can improve perimenopausal syndrome，decrease FSH，LDL levels，and has no significant effects on liver function.The treatment of Yigui Decoction combined with Femoston is more effective.

Key Words Yigui Decoction; Femoston; Perimenopausal syndrome; Liver enzyme; Kupperman score

中圖分類號：R271.11 文獻標識碼：A doi：10.3969/j.issn.1673-7202.2019.10.023

圍絕經期是女性一生中的重要轉折點，該時期女性的卵巢功能逐漸衰退，雌激素水平波動性下降易導致各種圍絕經期癥狀的出現及相關疾病的發生，如：潮熱出汗、失眠、抑郁焦慮、泌尿生殖道問題等近期癥狀及骨質疏松、心血管疾病、老年癡呆等遠期并發癥，嚴重影響中老年女性生命質量及生理心理健康[1-2]。目前已證實絕經激素治療（Menopausal Hormone Therapy，MHT）療效顯著，能緩解圍絕經期相關癥狀，降低心血管疾病、結直腸癌、骨質疏松等的發生風險[3]。但我國許多婦女對激素補充治療存在排斥及恐懼心理;而部分圍絕經期婦女存在MHT的慎用情況及禁忌證或是MHT后癥狀控制不理想。近年……