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Effects of menopausal hormone treatment on patients with uterine fibroids during peri-menopausal period |
CHEN Minghua CHEN Daozhen GONG Jian |
Department of Health Care, Wuxi Maternal and Child Health-Care Hospital Affiliated to Nanjing Medical University, Jiangsu Province, Wuxi 214002, China |
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Abstract Objective To investigate the effect of menopausal hormone treatment on patients with uterine fibroids during peri-menopausal period. Methods 193 patients with uterine fibroids during peri-menopausal period treated in Wuxi Maternal and Child Health-Care Hospital Affiliated to Nanjing Medical University from January 2010 to September 2014 were selected. All patients received estrogen progesterone cycle sequential therapy. The Kupperman score was used to evaluate the symptoms of perimenopausal syndrome before medication and 3, 6, 9, 12, 24 months after medication. Uterine volume, fibroid volume and endometrial thickness were monitored by vaginal ultrasound. The levels of serum follicle stimulating hormone, luteinizing hormone and estradiol were measured by chemiluminescent immunoassay. Results After medication the total score and item scores of Kupperman were significantly lower than before medication (P < 0.05). 9, 12, 24 months after medication the uterine volumes were significantly smaller than before medication (P < 0.05), however, there were no significant differences in endometrial thickness and fibroid volume among before and after medication (P > 0.05). After medication the levels of follicle-stimulating hormone were significantly lower than before medication (P < 0.05), however, there were no significant differences in luteinizing hormone and estradiol levels among before and after medication (P > 0.05). Conclusion Menopausal hormone treatment for patients with uterine fibroids during peri-menopausal period can effectively improve peri-menopausal symptoms, but has no obvious effect on the uterine fibroids.
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[1] 章诗琪,胡运涛,曹袁媛.激素替代治疗围绝经期综合征与乳腺癌关系的meta分析[J].安徽医科大学学报,2009, 44(3):399-402.
[2] 洪利生,张冬梅.六味地黄丸合加味逍遥丸治疗肾阴虚型围绝经期综合征临床观察[J].临床军医杂志,2012,40(5):1139-1141.
[3] Zayas-Jaime FJ,Ornelas-Aguirre JM,Pérez-Nápoles DE. Reasons for abandonmentof hormone replacement therapy with tibolone in menopausal women [J]. Ginecol Obstet Mex,2013,81(10):593-601.
[4] 中华医学会妇产科学分会绝经学组.绝经期管理与激素补充治疗临床应用指南(2012版)[J].中华妇产科杂志,2013,48(10):795-799.
[5] 笪红英,李冬华,吴洁.围绝经期患者相关问题的调查与分析[J].现代医学,2014,43(5):543-545.
[6] 中华医学会妇产科学分会绝经学组.绝经相关激素补充治疗的规范诊疗流程[J].中华妇产科杂志,2013,48(2):155-158.
[7] 肖枝兰.激素替代治疗对围绝经期综合征的症状改善程度及不良反应分析[J].中国妇幼保健,2014,29(29):4852-4853.
[8] Fichera M,Rinaldi N,Tarascio M,et al. Indications and controindicationsof hormone replacement therapy in menopause [J]. Minerva Ginecol,2013,65(3):331-344.
[9] 姜鸿雁,邱爽.激素替代治疗对围绝经期妇女体质指数的影响[J].中国妇幼保健,2012,27(14):2159-2160.
[10] 李喜芳.性激素替代治疗对围绝经期子宫肌瘤的影响[J].实用妇科内分泌杂志,2015,2(9):6-7.
[11] 陈梦珠,彭丹红.绝经激素治疗对围绝经期及绝经后子宫肌瘤影响的研究进展[J].现代医学,2016,44(6):882-887.
[12] 高芳,施德丽,张丽娟.深度认识子宫肌瘤的诊治[J].中医临床研究,2012,4(21):109-111.
[13] 田玉玲.B超和CT在诊断子宫肌瘤中的作用对比[J].中外医学研究,2012,10(31):48-49.
[14] Lindsay R,Gallagher JC,Kleerokoper M,et al. Effect of lower doses of conjugated equine estrogens with and without medroxyprogesterone acetate on bone in early postmenopausal women [J]. JAMA,2002,287(20):2668-2676.
[15] Archer DF,Philput CB,Levine AS,et al. Effects of ethinyl estradiol and ibuprofen compared to placebo on endometrial bleeding,cervical mucus and the postcoital test in levonorgestrel subcutaneous implant users [J]. Contraception,2008,78(2):106-112.
[16] Lobo RA,Bush T,Carr BR,et al. Effects of lower doses of conjugated equine estrogens and medroxyprogesterone acetate on plasma lipids and lipoproteins,coagulation factors,and carbohydrate metabolism [J]. Fertil Steril,2001,76(3):13-24.
[17] 王启盛,王芳,王红珍.激素替代疗法的临床应用[J].现代预防医学,2007,34(17):3297.
[18] 张焕晓,郁琦.绝经激素治疗慎用情况[J].实用妇产科杂志,2015,31(5):328-330.
[19] 张巧利,孙爱军.围绝经期子宫肌瘤的研究进展[J].中国妇幼健康研究,2013,24(2):271-275.
[20] 朱晓兰,李洁明.米非司酮联合宫瘤消胶囊对子宫肌瘤患者细胞因子和性激素水平影响研究[J].中国性科学,2016,25(4):56-59.DOI:10.3969/j.issn.1672-1993.2016. 04.018.
[21] 吴志军,许园姣,古岳东,等.宫腔镜电切术治疗黏膜下子宫肌瘤的临床价值研究[J].中国医药科学,2016,6(22):83-85.DOI:10.3969/j.issn.2095-0616.2016.22.026.
[22] 孙亚晶,张宜群.腹腔镜下与开腹子宫肌瘤剔除术的临床效果与并发症对比分析[J].中国性科学,2016,25(4):50-52.DOI:10.3969/j.issn.1672-1993.2016.04.016.
[23] 龚宇,艾战秀,黎锐勤,等.子宫肌瘤患者IGF-Ⅰ和IGF-Ⅱ水平的变化与ER、PR的关系研究[J].中国医药科学,2016,6(16):95-97,165.
[24] 卢惠珍,龚健,邹菊华,等.性激素替代治疗围绝经患者子宫肌瘤45例的临床观察[J].中国妇幼保健,2010,25(31):4530-4531. |
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