Maddox P R, Harrison B J, Horobin J M, Walker K, Mansel R E, Preece P E, Nicholson R I
University of Wales College of Medicine, Cardiff.
Ann R Coll Surg Engl. 1990 Mar;72(2):71-6.
A double-blind crossover study giving 20 mg/day of medroxyprogesterone acetate during the luteal phase was carried out in 26 women with cyclical mastalgia. Symptomatic response to this progestogen supplementation or placebo was assessed objectively by clinical examination and subjectively by linear analogue scales and breast pain charts. No significant relief of pain or tenderness was found on placebo or active treatment, irrespective of treatment order, and breast nodularity was similarly unaltered. No evidence of progesterone deficiency or prolactin abnormality was found. Side-effects were incurred in 11 patients (five on placebo, five on active treatment and one while on both) and were mostly vague premenstrual symptoms. We conclude that the therapeutic response of medroxyprogesterone acetate in cyclical mastalgia is no better than placebo and that progestogen supplementation can no longer be recommended for routine use in the management of breast pain.
一项双盲交叉研究对26名患有周期性乳房疼痛的女性在黄体期给予每日20毫克醋酸甲羟孕酮。通过临床检查客观评估对这种孕激素补充剂或安慰剂的症状反应，并通过线性模拟量表和乳房疼痛图表主观评估。无论治疗顺序如何，在安慰剂或积极治疗中均未发现疼痛或压痛有明显缓解，乳房结节性也同样未改变。未发现孕酮缺乏或催乳素异常的证据。11名患者出现了副作用（5名服用安慰剂，5名接受积极治疗，1名在两种治疗期间均出现），且大多是模糊的经前症状。我们得出结论，醋酸甲羟孕酮在周期性乳房疼痛中的治疗反应并不比安慰剂好，并且不再推荐常规使用孕激素补充剂来治疗乳房疼痛。
