Mendoza N, Pisón J A, Fernández M, Sánchez M C, Malde J, Miranda J A
Department of Obstetrics and Gynecology, Hospital Virgen de las Nievas, Avda. Fuerzas Armadas s/n, 18014 Granada, Spain.
Maturitas. 2002 Apr 25;41(4):289-98. doi: 10.1016/s0378-5122(01)00298-5.
To compare compliance, symptom control, bleeding patterns, lipid and biochemical changes in postmenopausal women treated with three regimens of HRT.
In a prospective, randomised, group comparative study, with 165 patients, the effects on the aforementioned parameters, as well as treatment compliance and side effects were studied with oral tibolone 2.5 mg per day, with cyclic combined regimen of transdermal oestrogen and progestogen (transdermal patch of 17beta-oestradiol 50 microg/day during 14 days and transdermal patch of 17beta-oestradiol 50 microg/day plus 0.25 mg/day NETA during the following 14 days), and with intermittent progesterone regimen (transdermal 17beta-oestradiol 50 microg/day and oral micronised natural progesterone 200 mg twice a week). Statistical analysis was carried out using the Fisher-test, analysis of the variance (ANOVA) and the Bouferoni test.
Ten women dropped out of the tibolone group, 11 dropped out of the intermittent dosing group and 21 dropped out of the cyclid combined group. Irregular bleeding occurred at more rates in the cyclid combined group. Similar reductions in climacteric symptoms were found in the three groups. No differences were observed with respect to biochemical analysis.
Efficacy and safety of the three treatment regimens being comparable, but the patients in our study preferred those that did not produce bleeding episodes.
比较三种激素替代疗法(HRT)方案治疗绝经后女性的依从性、症状控制情况、出血模式、血脂及生化指标变化。
在一项前瞻性、随机、组间比较研究中,纳入165例患者,研究每日口服2.5 mg替勃龙、经皮雌激素与孕激素的周期联合方案(17β-雌二醇50 μg/天的经皮贴片使用14天,随后14天使用17β-雌二醇50 μg/天加0.25 mg/天NETA的经皮贴片)以及间歇孕激素方案(17β-雌二醇50 μg/天经皮给药,口服微粉化天然孕激素200 mg,每周两次)对上述参数的影响,以及治疗依从性和副作用。采用Fisher检验、方差分析(ANOVA)和Bouferoni检验进行统计分析。
替勃龙组有10名女性退出,间歇给药组有11名退出,周期联合组有21名退出。周期联合组不规则出血发生率更高。三组更年期症状的减轻程度相似。生化分析未观察到差异。
三种治疗方案的疗效和安全性相当,但本研究中的患者更喜欢不引起出血事件的方案。