Akrivis C, Vezyraki P, Kiortsis D N, Fotopoulos A, Evangelou A
Obstetrics and Gynaecology Clinic, General Hospital of Ioannina, Greece.
Eur J Clin Pharmacol. 2000 Dec;56(9-10):621-3. doi: 10.1007/s002280000228.
Thiols (sulfydryl compounds) have a prolactin-lowering effect in animals. The purpose of our study was to evaluate the effects of orally administered N-2-mercaptopropionyl-glycine (tiopronin) on suppression of lactation and plasma prolactin (PRL) levels in a group of women in the puerperium.
One hundred women aged 17-37 years were studied. We divided our population in four groups (25 patients in each group). In group I, no medication was administered but only conservative measures were taken (restriction of fluid intake, ice-bags applied on the breasts, tight breast binders). Subjects in group II received tiopronin (200 mg/day) for 14 days. In group III, tiopronin (500 mg/day) was administered for 14 days. Subjects in group IV, took bromocriptine (5 mg/day) for 14 days. Assessment of suppression of lactation was performed clinically and laboratory determinations were obtained before and after 1, 2, 3, 4, and 14 days of treatment. Furthermore, in seven healthy women plasma PRL responses to thyrotropin-releasing hormone (TRH) before and after one week of tiopronin therapy (500 mg/day) were studied.
Statistically significant higher percentages of success of lactation suppression were obtained with tiopronin (84% and 88%) and bromocriptine (96%) compared to conservative treatment (60%). In the four groups a significant decrease of PRL was observed. However, in women who received tiopronin and bromocriptine, the levels of PRL after 14 days of therapy were lower compared to the conservative treatment group. Moreover, in the tiopronin groups and the bromocriptine group, lactation was stopped earlier. In the first group (conservative measures) the lactation was suppressed after 13.3+/-5.4 days of treatment. In the groups who received tiopronin (200 mg/day and 500 mg/ day) lactation was suppressed after 4.4+/-1.7 and 4.3+/-1.6 days of treatment. In the bromocriptine group the lactation was stopped after 1.2+/-0.4 days. Bromocriptine treatment was associated with more frequent side effects than the tiopronin.
Administration of tiopronin in low to moderate doses is effective in suppression of puerperal lactation.
硫醇（巯基化合物）对动物有降低催乳素的作用。我们研究的目的是评估口服N-2-巯基丙酰甘氨酸（硫普罗宁）对一组产褥期妇女泌乳抑制及血浆催乳素（PRL）水平的影响。
研究了100名年龄在17 - 37岁的妇女。我们将研究对象分为四组（每组25名患者）。第一组未用药，仅采取保守措施（限制液体摄入、乳房冰敷、紧身胸罩）。第二组患者接受硫普罗宁（200毫克/天）治疗14天。第三组患者接受硫普罗宁（500毫克/天）治疗14天。第四组患者服用溴隐亭（5毫克/天）治疗14天。临床评估泌乳抑制情况，并在治疗1、2、3、4和14天前后进行实验室检测。此外，研究了7名健康女性在硫普罗宁治疗（500毫克/天）一周前后促甲状腺激素释放激素（TRH）刺激后的血浆PRL反应。
与保守治疗（60%）相比，硫普罗宁（84%和88%）和溴隐亭（96%）在泌乳抑制成功率上有统计学显著更高的百分比。四组中均观察到PRL显著下降。然而，接受硫普罗宁和溴隐亭治疗的妇女在治疗14天后的PRL水平低于保守治疗组。此外，在硫普罗宁组和溴隐亭组中，泌乳停止得更早。第一组（保守措施组）在治疗13.3±5.4天后泌乳得到抑制。接受硫普罗宁（200毫克/天和500毫克/天）治疗的组在治疗4.4±1.7天和4.3±1.6天后泌乳得到抑制。溴隐亭组在1.2±0.4天后泌乳停止。溴隐亭治疗比硫普罗宁有更频繁的副作用。
低至中等剂量的硫普罗宁给药对抑制产褥期泌乳有效。
