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目的: 探讨经皮肤吸收雌激素对更年期症状的治疗作用和调脂作用。方法: 100例有更年期症状的围绝经期和绝经后妇女接受 25μg/d的经皮肤吸收雌激素, 按连续序贯方案配伍安宫黄体酮 4mg/d, 治疗 16周。治疗 8周时, 若症状缓解不满意, 则改为 50μg/d。治疗前后行Kupperman和潮热评分, 并测定肝肾功能、血脂、子宫内膜厚度、E2、FSH, 判断其疗效和安全性, 计算由低剂量改为高剂量的比例。结果: Kupperman和潮热评分治疗 4周时有显著下降, 16周时有极显著下降, TG、TC、FSH显著下降, E2 显著上升, 达早卵泡期水平; 其余指标无显著改变。改为 50μg/d的比例为 5%, 皮贴脱落率 <1%。结论: 经皮肤吸收的 17β雌二醇能有效缓解围绝经期症状, 并有良好的可接受性。
Objective: To explore the therapeutic effect of transdermal absorption of estrogen on menopausal symptoms and lipid-lowering effect. METHODS: Perimenopausal and postmenopausal women with menopause symptoms were treated with 25 μg / day of transdermal estrogen and 100 mg of escitalopram 4 mg / d for 16 weeks. Treatment of 8 weeks, if the symptoms are not satisfied, then changed to 50μg / d. Before and after treatment Kupperman and hot flashes score, and determination of liver and kidney function, blood lipids, endometrial thickness, E2, FSH, to determine the efficacy and safety, calculated from low dose to high dose ratio. Results: The scores of Kupperman and hot flashes decreased significantly at 4 weeks after treatment, with a significant decrease at 16 weeks. The levels of TG, TC and FSH decreased significantly. E2 increased significantly and reached the level of early follicular stage. Other indexes did not change significantly. Change to 50μg / d ratio of 5%, peeling rate <1%. CONCLUSIONS: 17β estradiol, which is absorbed through the skin, can effectively relieve the symptoms of perimenopause and has good acceptability.