低剂量激素替代治疗糖尿病围绝经期综合征的疗效观察  

An observation on efficacy of low dose hormone in treatment of diabetes mellitus complicated with perimenopausal syndrome

作　　者：李祥芬 高文芳 李相宜 张玲 张海燕 

机构地区：[1]成都市双流区东升社区服务中心,成都610200 [2]成都市双流区第一人民医院

出　　处：《西南国防医药》2018年第2期135-137,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的比较低剂量结合雌激素(CEE)与常规剂量CEE联合孕酮治疗2型糖尿病围绝经期综合征的疗效。方法将65例2型糖尿病围绝经期综合征患者随机分为A组(32例)与B组(33例),两组均予以常规降血糖治疗,A组予低剂量CEE与孕酮,B组给予常规剂量CEE与孕酮,采用序贯治疗方案治疗6个周期后,对比观察两组改良Kupperman评分、临床疗效、雌二醇(E)、促卵泡素(FSH)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAcl)、稳态胰岛素抵抗指数(HOMA-IR)、血清脂抵抗素、肿瘤坏死因子(TNF-α)及不良反应发生率。结果治疗后,两组改良Kupperman评分均显著下降(P<0.01),但两组间疗效无统计学差异(P>0.05)。与治疗前比较,治疗后两组FSH、FPG、2 hPG、HbAcl、HOMA-IR、脂抵抗素、TNF-α均显著性下降(P<0.01),E显著升高(P<0.05),而两组间FSH、FPG、2hPG、HbAcl、HOMA-IR、脂抵抗素、TNF-α比较无统计学差异(P>0.05),但B组E水平显著高于A组(P<0.01)。A、B两组阴道不规则流血发生率分别为18.75%、39.39%,B组显著高于A组(P<0.05);A、B两组乳房胀痛发生率分别为31.25%、33.33%,无统计学差异(P>0.05)。结论 CEE联合孕酮治疗2型糖尿病围绝经期综合征,能显著降低患者的血糖水平,改善更年期症状,减小不良反应,值得临床推广应用。Objective To compare the efficacy of low dose conjugated estrogens （CEE） combined with progesterone versus standard dose CEE combined with progesterone in the treatment of type-2 diabetes mellitus complicated with perimenopausal syndrome A total of 65 patients with type-2 diabetes mellitus complicated with perimenopausal syndrome were randomlydivided into a group A（n=32） and a group B（n=33）; routine hypoglycemic treatment was performed on both groups, with low dose CEE and progesterone for group A and routine dose CEE and progesterone for group B. After 6-week sequential therapy, the score of modified Kupperman Index, clinical efficacy and the levels of estradiol （E）, follicle stimulating hormone （FSH）, fasting plasma glucose （FPG）, 2h postprandial plasma glucose （2 hPG）, glycosylated hemoglobin HbAlc, homeostatic model assessment for insulin resistance （HOMA-IR）, serum resistin and tumor necrosis factor （TNF-α ）and incidence of adverse reactions were compared between the two groups. Results After the treatment, the scores of modified Kupperman Index in both groups decreased significantly （P 〈 0.01）, but there was no statistical difference between two groups in efficacy （P 〈 0.05）. Compared with those before the treatment, the levels of FSH, FPG, 2 hPG, HbAlc, HOMA-IR, resistin and TNF-琢 in both groups decreased significantly after the treatment^5 〈 0.01）, and the level of E increased significantly （P 〈 0.05）; there was no statistical difference in the levels of FSH, FPG, 2hPG, HbAlc, HOMA-IR, resistin, TNF-α between two groups （i5〉0.05）, but the level of B in group B was significantly higher than that in group A （P〈 0.01）. The incidence of irregular virginal bleeding in groups A and B was 18.75% and 39.39% respectively, and that in group B was significantly higher than that in group A （P 〈 0.05）; the incidence of distending pain in breast in groups A and B was 31.25% and 33.33% respectively and

关 键 词：围绝经期综合征 雌激素 低剂量 替代治疗 糖尿病 

分 类 号：R587.1[医药卫生—内分泌]