McBane Sarah E
Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA.
JAAPA. 2008 Apr;21(4):26-31. doi: 10.1097/01720610-200804000-00012.
Prescription HRT is the most effective therapy for vasomotor symptoms, but some patients may find the risks unacceptable. Treatment with lower doses or alternative dosage forms for short periods may reduce risk. Soy isoflavones and black cohosh have a proven ability to reduce hot flashes, but they should not be used when estrogen is contraindicated. Bioidentical HRT may offer no benefits over conventional HRT. Neuroendocrine agents may reduce hot flashes effectively and can be used when estrogen is contraindicated, but these agents may cause significant CNS side effects. Lifestyle modifications are the foundation of vasomotor symptom therapy and are safe to recommend for all women. Clinicians and patients should carefully discuss the expectations for therapy, and the clinician should be prepared to customize the treatment regimen.
处方激素替代疗法（HRT）是治疗血管舒缩症状最有效的疗法，但有些患者可能觉得其风险难以接受。短期使用较低剂量或其他剂型进行治疗可能会降低风险。大豆异黄酮和黑升麻已被证实有减轻潮热的能力，但当雌激素禁忌时不应使用。天然同源激素替代疗法可能并不比传统激素替代疗法更具优势。神经内分泌药物可有效减轻潮热，且在雌激素禁忌时也可使用，但这些药物可能会引起严重的中枢神经系统副作用。生活方式的改变是血管舒缩症状治疗的基础，对所有女性来说推荐使用都是安全的。临床医生和患者应仔细讨论对治疗的期望，临床医生应准备好定制治疗方案。
