低剂量结合雌激素与标准剂量ＣＥＥ 联合天然黄体酮 或地屈孕酮对围绝经期综合征患者骨密度的影响研究

Objective To study the effects of low-dosage and standard-dosage CEE (Conjugated Equine Estrogens) plus natural progesterone or dydrogesterone on bone mineral density ( BMD) in perimenopausal syndrome patients. Methods 83 perimenopausal syndrome patients treated from January 2015 to June 2017 in our hospital were selected and randomly assigned to group I (n = 28)，group II (n = 27)，group III (n = 26) and group IV (n = 26). Patients took low-dosage ECC plus natural progesterone, low-dosage ECC plus dydrogesterone, standard-dosage ECC plus natural progesterone or standard-dosage ECC plus dydrogesterone, respectively. Comparisons between groups were made for hormone levels before and after treatment, Kupperman scores at menopausal period and adverse reactions. Results Before treatment, the clinical symptom scores and the related index including FSH (follicle-stimulating hormone), E2 (estradiol) and LH (luteinizing hormone) for each group were not significantly different (尸 > 0. 05). After one to three treatment courses, the Greene scores for each group were reduced, with statistically significant differences among groups (P<0. 05) ； the values of FSH, E2 and LH for each group were improved, but the FSH values in group I and group III were higher than the other groups and the values of E2 and LH were lower (P<0. 05). Before treatment, the BMD of LI~4 and femoral neck for each group was not significantly different (P> 0.05). After treatment, the BMD of LI~4 and femoral neck for each group was improved, especially in group I and group III (P<0. 05). Conclusion The standard-dosage CEE plus natural progesterone could remarkably relieve the clinical symptoms. However, the low-dosage CEE plus natural progesterone could not only relieve the clinical symptoms, but also improve the hormone levels and produce no negative effect on BMD. The proper dosage of CEE should be taken according to the patient’s actual conditions. [ABSTRACT FROM AUTHOR]