余颖华

【摘要】 目的：探讨绝经前和绝经后患者应用激素替代治疗（HRT）和植物雌激素（PE）治疗对围绝经期综合征的疗效，以期提高围绝经期患者生活质量. 方法：采用前瞻性研究，绝经前患者102例，绝经后患者76例. 其中HRT组106例、PE组72例. 观察患者在用药前、用药3 mo后的围绝经期症状及血脂变化，并观察两种治疗方法的副作用. 结果：两组患者的围绝经期症状均有明显减轻，但PE的作用明显次于HRT (P<0.05)；HRT组中患者血脂中低密度脂蛋白较用药前明显下降(P<0.05)，高密度脂蛋白较用药前明显升高(P<0.05)；而PE组中患者血脂波谱无明显改变；治疗过程中所引起的副作用HRT组明显高于PE组(P<0.05). 结论：HRT和PE均能明显减轻患者的围绝经期症状，HRT能改善血脂波谱状态，而PE能减少患者因服药带来的副作用.

【关键词】 激素替代疗法；植物;雌激素类；围绝经期综合征；血脂； 副作用

【Abstract】AIM: To compare the treatment effects of hormone replacement therapy (HRT) and phytoestrogen (PE) for perimenopausal women. METHODS: Totally 178 patients (102 premenopausal and 76 postmenopausal women) were randomely divided into 2 groups: 106 were given HRT and 76 were given PE for 3 months. The side effects were compared between the 2 therapies. RESULTS: After 3 months of treatment， perimenopausal symptoms of all patients in the 2 groups were improved， but the improvement in PE group was less obvious than that in HRT group (P<0.05). Lowdensity lipoprotein decreased and highdensity lipoprotein increased in HRT group after treatment (P<0.05 vs PE group); www.zhlzw.comthere was no any significant changes in lipoproteins in PE group. Side effect in HRT was more significantly serious than that of PE therapy (P<0.05). CONCLUSION: HRT and PE can all significantly improve perimenopausal symptoms， but HRT is better in lipoprotein improvement， and PE caused side effect is less.

【key words 】hormone replacement therapy; plants; estrogens; perimenopause syndrome; serum lipid; adverse effect

【中图分类号】R722.12 【文献标识码】B【文章编号】1004-4949(2014)07-0017-01

传统的激素替代治疗(hormone replacement therapy， HRT)可治疗或缓解由自然绝经和人工绝经导致的雌激素缺乏综合征. HRT治疗围绝经期综合症，对纠正植物神经系统功能紊乱的症状、动脈粥样硬化和以高血脂、骨质疏松为症状的代谢障碍发挥积极的作用［1］. 然而，长期使用HRT可以引起不少副作用，如肝功损害，静脉栓塞、血管疾病和乳腺癌的危险性增加等. 植物雌激素(phytoestrogen，PE)是存在于植物、水果和蔬菜中的一类天然的结构及生物活性均类似于雌激素的非甾体类化合物，具有弱雌激素活性，为杂环多酚类化合物. PE可与雌激素受体结合，对内源性雌激素起双向调节作用，其在改善围绝经期症状、降低血脂水平、防止骨质疏松、预防尿失禁等方面有着有益作用［2］. 我们对围绝经期妇女应用HRT和PE对围绝经期综合征进行治疗，比较两种方法的临床疗效.

1对象和方法

1.1对象收集我中心门诊就诊的处于围绝经期患者178例的资料. 其中，102例处于绝经前，年龄（49.2±1.5）岁；……