CAJ | 학술논문

目的：探讨戊酸雌二醇对围绝经期综合征及骨密度的影响。方法选择围绝经期综合征80例,随机分为对照组40例和观察组40例,对照组予碳酸钙D3片及地屈孕酮口服,观察组在对照组治疗基础上加服戊酸雌二醇,观察两组用药前、用药6个月及12个月后症状改善情况及骨密度的变化。结果治疗6个月后两组Greene评分均下降,与治疗前比较差异均有统计学意义(P均<0．05),组间评分比较差异均无统计学意义(P>0．05)；治疗12个月组间比较及与组内治疗6个月比较差异均有统计学意义( P均<0．05)。治疗6个月后两组脊柱、股骨颈骨密度与治疗前比较差异均有统计学意义(P均<0．05),组间比较差异无统计学意义(P>0．05)；治疗12个月后两组骨密度较治疗6个月及治疗前均增加,组内比较及组间比较差异均有统计学意义( P均<0．05)。治疗6个月后雌二醇(E2)、促卵泡生成素(FSH)水平组间比较及组内与治疗前比较差异均无统计学意义(P>0．05),孕酮组间比较及组内与治疗前比较差异均有统计学意义(P均<0．05)；两组治疗12个月后FSH、E2、孕酮水平与治疗6个月后比较差异均有统计学意义(P均<0．05),组间比较差异亦有统计学意义(P均<0．05)。相关性分析显示：FSH、E2、孕酮的表达均与骨密度存在相关性,其中FSH与骨密度呈负相关,E2、孕酮与骨密度呈正相关。结论围绝经期综合征存在激素水平紊乱及骨量丢失,戊酸雌二醇可明显改善围绝经期综合征症状及骨密度。
목적：탐토무산자이순대위절경기종합정급골밀도적영향。방법선택위절경기종합정80례,수궤분위대조조40례화관찰조40례,대조조여탄산개D3편급지굴잉동구복,관찰조재대조조치료기출상가복무산자이순,관찰량조용약전、용약6개월급12개월후증상개선정황급골밀도적변화。결과치료6개월후량조Greene평분균하강,여치료전비교차이균유통계학의의(P균<0．05),조간평분비교차이균무통계학의의(P>0．05)；치료12개월조간비교급여조내치료6개월비교차이균유통계학의의( P균<0．05)。치료6개월후량조척주、고골경골밀도여치료전비교차이균유통계학의의(P균<0．05),조간비교차이무통계학의의(P>0．05)；치료12개월후량조골밀도교치료6개월급치료전균증가,조내비교급조간비교차이균유통계학의의( P균<0．05)。치료6개월후자이순(E2)、촉란포생성소(FSH)수평조간비교급조내여치료전비교차이균무통계학의의(P>0．05),잉동조간비교급조내여치료전비교차이균유통계학의의(P균<0．05)；량조치료12개월후FSH、E2、잉동수평여치료6개월후비교차이균유통계학의의(P균<0．05),조간비교차이역유통계학의의(P균<0．05)。상관성분석현시：FSH、E2、잉동적표체균여골밀도존재상관성,기중FSH여골밀도정부상관,E2、잉동여골밀도정정상관。결론위절경기종합정존재격소수평문란급골량주실,무산자이순가명현개선위절경기종합정증상급골밀도。
Objective To study the effect of progynova on perimenopausal syndrome and bone mineral density. Methods 80 female patients with perimenopausal syndrome were included in the study, and randomly divided into control group (n=40) and observation group (n=40). The patients in the control group had oral calcium carbonate D3 tablets and dydrogesterone, while the observation group took Progynova based on treatment of the control group, and then the improve-ments of perimenopausal syndrome symptoms and the changes of bone mineral density before the treatment, 6 months and 12 months after the treatment were observed. Results 6 months after the treatment, the Greene scores of the two groups were both decreased, the differences when compared with that before the treatment in the two groups showed statistical significance (P<0. 05), but Greene scores of both groups showed no statistical differences (P>0. 05). 12 months and 6 months after treatment, the intra-group comparison and comparison among groups were of statistical significance (P<0. 05). 6 months af-ter the treatment, the spine and femoral neck bone mineral density of the two groups were of statistically significant differences compared to that before the treatment ( P <0. 05 ) , the comparison among groups was of no statistical significance ( P >0. 05 ) . 12 months after treatment, the bone mineral density concentration was higher than that after 6 months, the intra-group comparison and comparison among groups were of statistical significance differences ( P<0. 05 ) . 6 months after treatment, the comparison of E2 and FSH concentration between the two groups were of no significant differences ( P>0. 05 ) , only the changes of progesterone were of statistical differences compared to that before the treatment ( P<0. 05 ); the comparison of FSH, E2, oestrone levels in the two groups were of significant differences between 6 months and 12 months after treatment (P<0. 05), the comparison among the groups was also of statistically significant differences (P<0. 05). Correlation analysis revealed that the expressions of FSH, E2 and progesterone level were correlated with BMD, including negative correlation be-tween FSH and BMD, while E2, progesterone had positive correlation with BDM. Conclusion Hormone level disorder exists in perimenopausal syndrome and bone mass loss. Progynova can significant improve the symptoms of the perimenopausal syn-drome and bone mineral density.