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目的:观察小剂量雌激素和孕激素替代治疗对子宫肌瘤绝经后妇女的影响。方法:选择子宫肌瘤绝经后妇女56例。采用小剂量戊酸雌二醇联合地屈孕酮周期序贯方案治疗,结合个体或同一个体不同阶段对药物的不同反应调整雌激素剂量,治疗12个月后改用连续序贯方案。分别于治疗前及治疗后3个月、6个月、12个月和24个月,采用改良Kupperman评分法对绝经综合征症状进行评分,超声检测子宫和子宫肌瘤大小、子宫内膜厚度,并行乳腺检查。结果:本组46例完成整个疗程及随访观察。治疗后3个月、6个月、12个月和24个月,Kupperman总分分值均较治疗前非常显著降低(P<0.01);治疗前后子宫大小、子宫肌瘤大小和子宫内膜厚度比较,均差异不显著(P>0.05)。治疗后血清卵泡生成激素(FSH)水平均较治疗前显著降低(P<0.05),雌二醇(E2)水平与治疗前比较差异不显著(P>0.05)。治疗前后乳腺未见改变。结论:小剂量雌激素和孕激素周期序贯方案个体化治疗,能够改善子宫肌瘤绝经后妇女的绝经期症状,但对子宫肌瘤的发生和发展影响不显著。
Objective: To observe the effects of low-dose estrogen and progesterone replacement therapy on postmenopausal women with uterine fibroids. Methods: 56 cases of uterine fibroids postmenopausal women were selected. A small dose of estradiol valerate combined with dydrogesterone cycle sequential regimen treatment, combined with different individual or same individual in different stages of the drug response to adjust the estrogen dose, 12 months after the switch to continuous sequential program. The symptoms of menopausal syndrome were scored by improved Kupperman’s score before treatment, 3 months, 6 months, 12 months and 24 months after treatment. The size of uterus and uterine fibroids, the thickness of endometrium, Parallel breast examination. Results: The group of 46 patients completed the entire course of treatment and follow-up observation. Kupperman’s total scores at 3 months, 6 months, 12 months and 24 months after treatment were significantly lower than those before treatment (P <0.01); Uterine size, uterine fibroids size and endometrial thickness Comparison, no significant difference (P> 0.05). Serum follicle stimulating hormone (FSH) levels were significantly lower (P <0.05) and estradiol (E2) levels were not significantly different after treatment (P> 0.05). No change in the breast before and after treatment. Conclusion: The individualized treatment of low-dose estrogen and progesterone sequential sequential regimen can improve the menopausal women’s symptoms of uterine fibroids, but have no significant effect on the occurrence and development of uterine fibroids.