| Abstract:Objectives:To arise awareness of climacteric syndrome through the clinical symptom comparisons of menopausal women by age groups.; Confirm the effect of hormone replacement therapy by the prognosis of the patients after exogenous hormone replacement therapy; Establish a profound method for determination of hormone through the monitoring on vivo hormone levels.; Search the best effect optimal dose by analysis the changes of hormone levels in the body before and after dose; Discover the correlation between hormone levels and the symptoms of menopause.Methods:Found out the average age of women in menopause and estrogen content from the literature; according to statistics collected in Obstetrics and Gynecology of Affiliated Hospital of Luzhou Medical College since January2012to February2014, there are altogether89diagnosed patients with climacteric syndrome at an average age of49.8, and the average duration of menopause is1.8±1.5years, without HRT contraindications. Simultaneously, set up the normal estrogen level by testing serum from15cases of non climacteric and normal women of childbearing age and used it as the sample for the reduction of estrogen in menopausal women. Then group all the research cases into three teams:Team A with the treatment of oral estrogen (Climen); Team B with the treatment of estrogen patch (Fem7); Team C with the treatment of topical estrogen (Chlorquinaldol). Ask the patients for a return visit after taking a course of medicine and carry on the relevant gynecology routine examination for all of them. At the same time, exsanguinate patients from three groups to test the post-treatment content of FSH, LH and E2by Radioimmunoassay. With optimal conditions, the patients should take type-B ultrasonic monitoring, in order to observe the size of uterus and endometrial thickness.Evaluate each team’s improvement of menopausal syndrome before and after treatment using the modified Kupperman scoring method. Use SPSS13.0software package for data analysis, testing of normality. If it meets the test of normality, using t tests, the data is represented by x±s; while it doesn’t meet the test of normality, using Mann-Whitney U tests, The median (range data) P<0.05is meaningful.Results:1. Changes of Kupperman score in three groups of climacteric syndrome:Group A:the patients’Kupperman score is25.3±4.5before, after a course of oral Climen, the score is14.2±4.3. The symptoms of menopause are apparently relieved. The difference is statistically significant (P<0.01).Group B:the patients’ Kupperman score is25.4±3.3before, after a course of patch (Fem7), the score is12.5±2.3. The symptoms of menopause are comparatively relieved. The difference is statistically significan(P<0.05);Group C:the patients’Kupperman score is25.5±2.6before, after a course of Chlorquinaldol Promestriene Vaginal Tablets, the score is8.9±2.3. The relief of symptoms of menopause reached good effect. The difference is statistically significant (P<0.01).2. Changes of serum with FSH, LH, E2before and after treatment in three groups:Group A:before taking oral Climen, FSH, LH, E2were45.3±3.2.31.4±6.5,42.6±3.6respectively. After a course of medicine, FSH, LH, E2were32.1±5.4.24.6±4.3.191.6±6.7respectively. Compared with before, E2increased significantly, while FSH and LH significantly decreased. The difference is statistically significant (P<0.05).Group B:before using patch, FSH, LH, E2were52.3±4.2.11.4±6.5.20.6±3.6respectively. After a course of medicine,FSH, LH, E2were34.1±6.3.22.6±7.3.60.6±4.7respectively. Compared with before, E2increased significantly, while FSH and LH significantly decreased. The difference is statistically significant (P<0.05).Group C:before taking Chlorquinaldol Promestriene Vaginal Tablets, FSH, LH, E2were44.6±25.7.36.4±17.4.35.7±11.3respectively. After a course of medicine, FSH, LH, E2were30.5±15.3.21.3±12.7.143.3±9.4respectively. Compared with before, E2increased significantly, while FSH and LH significantly decreased. The difference is statistically significant(P<0.05).3. Monitoring on the uterus by type-B ultrasonicThe size of uterus:the length of uterus was (32.1±2.1)mm before, after a course of medicine it was (29.1±6.4); The intimal thickness was (2.9±1.4)before, after a course of medicine it was (3.1±1.6). P>0.05, the difference is not statistically significant.Conclusion:1.Hormone replacement therapy can effectively decreased the level of FSH and LH, while improve the content of E2. It has obvious improvement effects on climacteric syndrome and greatly improved the life quality of climacteric women.2.Oral formulations significantly change hormone leverls,but its gastrointestinal reactions are obvious and patient compliance is poor3. Compared with oral hormone preparation, patch and pigmentum have less gastrointestinal adverse reaction and at a low incidence of adverse reaction rate. Also they were easier to take and have better compliance.4. Partial pigmentum have apparent effect on hormone disorder vaginal dryness etc, while not very effective on Neurological symptoms and cardiovascular symptoms.5. Patch is easy to use but hard to control the amount and there are damages to the skin.6. For those who need and fit the hormone replacement therapy, we have to make individual therapy according to the individual differences of each patient.7. The endometrial thickness does not increased obviously while using Estrogen and progesterone. With a proper administration time and small amount, there is little effect on endometrial. |
PDF Full Text Request