健康教育联合性激素补充治疗对130例功能性下丘脑性闭经患者的效果  

Effect of health education combined with sex hormone supplement in 130 patients with functional hypothalamic amenorrhea

作　　者：李筠[1] 毛乐乐 白文佩[2] LI Jun;MAO Lele;BAI Wenpei(Department of Obstetrics and Gynecology,Beijing Aerospace General Hospital,Beijing100076,China;Department of Obstetrics and Gynecology,Beijing Shijitan Hospital,Beijing100038,China)

机构地区：[1]北京航天总医院妇产科,北京100076 [2]北京世纪坛医院妇产科,北京100038

出　　处：《中国医药导报》2019年第23期94-97,共4页China Medical Herald

摘　　要：目的观察健康教育联合性激素补充治疗对功能性下丘脑性闭经(FHA)的效果。方法选择2016年1月~2017年8月北京世纪坛医院和北京航天总医院妇科门诊收治的130例FHA患者,其中70例有明确的减肥史、36例为精神刺激、24例为运动过度。排除性激素使用禁忌证后,针对病因进行健康教育的同时,均给予患者芬吗通(2/10)治疗,28 d为1个疗程,均服药6个疗程。用药前及用药6个月后,检测性激素五项[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、睾酮(T)、垂体泌乳素(PRL)],测量子宫大小及内膜厚度。随访6~12个月,观察月经周期恢复情况。结果130例患者中,99例患者月经恢复,总有效率为76.2%。用药前患者FSH、LH、E2均下降,LH下降更明显,用药6个月后检测FSH、LH、E2水平均有不同程度的升高(P<0.01),T、PRL水平变化不大(P>0.05)。与用药前比较,用药6个月后子宫体积增大、内膜增厚,差异有高度统计学意义(P<0.01)。结论健康教育同时给予性激素补充治疗可明显改善FHA患者的性激素水平、增大子宫体积及增厚内膜,尽快恢复月经。同时防止骨质疏松和生殖器官萎缩引发的一系列问题,改善雌激素低下引发的各种症状。Objective To observe the effect of health education combined with sex hormone supplement in the treatment of patients with functional hypothalamic amenorrhea(FHA).Methods From January 2016 to August 2017,130 cases with FHA in the Gynecological Outpatient Department of Beijing Shijitan Hospital and Beijing Aerospace General Hospital were selected,including 70 cases of clear history of weight loss,36 cases of mental stimulation and 24 cases of hyperactivity.After the exclusion of sex hormone contraindications,patients were treated with Fenmoxone(2/10)for 28 days,one course of treatment,all were treated for 6 courses of treatment.Five sex hormones,such as follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),testosterone(T),pituitary prolactin(PRL),and progesterone(P)were measured before and after 6 months of administration.The recovery of menstrual cycle and the improvement of symptoms were observed during the 6-12 months followe-up.Results There were 99 patients with menstruation recovery in 130 patients after treatment,and the total effective rate was 76.2%.The levels of FSH,LH and E2 decreased before administration,and LH decreased more significantly.The levels of FSH,LH,E2 and P increased to different degrees at 6 months after administration(P<0.01).The level change of T and PRL was not obvious(P>0.05).Compared with before administration,the uterine volume increased and endometrium thickened after 6 courses of administration,and the differences were highly statistically significant(P<0.01).Conclusion Sex hormone supplementation while the health education can significantly improve the hormone level,uterine volume,endometrium thickening and recover menstruation as soon as possible in patients with functional hypothalamic amenorrhea,and prevent a series of problems caused by osteoporosis and genital atrophy,improve the low estrogen caused symptoms such as menopause syndrome.

关 键 词：性激素补充治疗 健康教育 功能性下丘脑性闭经 

分 类 号：R711.5[医药卫生—妇产科学]