围绝经期血管舒缩症状治疗方法的研究进展  

Research progress in treatment of perimenopausal vasomotor symptoms

作　　者：潘琦 任菁菁[1] PAN Qi;REN Jingjing(Department of General Practice,the First Afiliated Hospital,Zhejiang University,Hangzhou,Zhejiang 310003,China)

机构地区：[1]浙江大学医学院附属第一医院全科医学科,浙江杭州310003

出　　处：《中华全科医学》2023年第9期1566-1570,共5页Chinese Journal of General Practice

基　　金：国家自然科学基金项目(72274169)。

摘　　要：围绝经期是指女性绝经前后的一段时期,也是卵巢功能逐渐衰退的时期。此阶段因雌激素水平降低,可出现一系列绝经相关症状,短则持续1~2年,长则持续10~20年。其中潮热盗汗是血管舒缩症状的突出表现,也是围绝经期女性前来就诊的主要原因,严重影响女性的睡眠、工作及生活。因此,如何缓解围绝经期血管舒缩症状已成为医学研究人员关注的热点。目前绝经激素替代疗法仍是公认中重度潮热女性的首要治疗措施。激素替代治疗具有严格的适应证和禁忌证,长期使用需要定期全面体检,评估受益/风险比,以保证用药安全性。但因其在心血管疾病、静脉血栓及子宫内膜癌、乳腺癌等激素依赖肿瘤方面仍存在一定的风险,激素替代治疗的接受程度并不高。近年来,关于血管舒缩症状治疗的研究越来越多,一些非激素药物如选择性5-羟色胺再摄取抑制剂(SSRI)/选择性5-羟色胺和去甲肾上腺素双重再摄取抑制剂(SNRI)、黑升麻提取物、坤泰胶囊等,非药物治疗手段如身心疗法、针灸疗法等,也为深受血管舒缩症状困扰的女性提供更多治疗选择。本文通过查阅近年文献围绕围绝经期血管舒缩症状治疗措施包括激素药物治疗、非激素药物治疗及非药物治疗手段等方面进行归纳总结,为制定个体化临床治疗方案提供参考,以提高围绝经期女性的生活质量。Perimenopausal period refers to a period before and after menopause in women,and it's also a period of gradual decline of ovarian function.This stage due to estrogen levels decreased,may appear a series of menopausal symptoms,short lasting 1-2 years,long lasting 10-20 years.Among them,hot flashes and sweating are the prominent manifestation of vasomotor symptoms and the main reason for perimenopausal women to come to see a doctor,which seriously affects women's sleep,work and life.Therefore,how to alleviate perimenopausal vasomotor symptoms has become a hot topic for medical researchers.At present,postmenopausal hormone replacement therapy is still recognized as the primary treatment for women with moderate to severe tidal fever.Hormone replacement therapy has strict indications and contraindications.Long-term use requires regular and comprehensive physical examination to assess the benefit/risk ratio to ensure medication safety.But there are still some risks in cardiovascular disease,venous thrombosis,endometrial cancer,breast cancer and other hormone-dependent tumors,the acceptance of hormone replacement therapy is not high.In recent years,more and more research has been conducted on the treatment of vasodilatory symptoms.Non-hormonal medications such as selective 5-hydroxytryptamine reuptake inhibitors(SSRI)/selective 5-hydroxytryptamine and norepinephrine dual reuptake inhibitors(SNRI),black cohosh extract,and kuntai capsules,as well as non-pharmacological treatments such as mind-body therapies,and acupuncture treatments,have also provided more treatment choices for women who are deeply afflicted by vasodilatory symptoms.This paper summarizes the treatment measures of vasomotor symptoms in perimenopausal women,including hormone drug therapy,non-hormone drug therapy and non-drug therapy,and provides theoretical guidance for formulating individualized clinical treatment programs to improve the quality of life of perimenopausal women.

关 键 词：围绝经期 血管舒缩症状 药物治疗 非药物治疗 

分 类 号：R173.4[医药卫生—妇幼卫生保健]