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大豆(Glycine max (L.) Merr.)异黄酮阴道凝胶对绝经后女性上皮形态及雌激素受体表达的影响:一项为期12周的随机双盲安慰剂对照试验

Effects of Glycine max (L.) Merr. soy isoflavone vaginal gel on epithelium morphology and estrogen receptor expression in postmenopausal women: a 12-week, randomized, double-blind, placebo-controlled trial.

作者信息

Lima Sônia Maria Rolim Rosa, Bernardo Bianca Franco Augusto, Yamada Silvia Saito, Reis Benedito Fabiano, da Silva Gustavo Maximiliano Dutra, Galvão Maria Antonieta Longo

机构信息

Faculdade de Ciências Médicas da Santa Casa de São Paulo, R. Dr. Cesário Mota Júnior, 112, 01221-020 São Paulo, Brazil.

Faculdade de Ciências Médicas da Santa Casa de São Paulo, R. Dr. Cesário Mota Júnior, 112, 01221-020 São Paulo, Brazil.

出版信息

Maturitas. 2014 Jul;78(3):205-11. doi: 10.1016/j.maturitas.2014.04.007. Epub 2014 May 6.

Abstract

OBJECTIVE

Evaluate the effects of vaginal administration of isoflavones derived from Glycine max (L.) Merr. as a treatment option for vaginal atrophy, on the morphology and expression of estrogen receptors in vaginal epithelium of postmenopausal women.

METHODS

The double-blind, randomized, placebo-controlled, clinical trial. Sixty women were treated for 12 weeks with isoflavone vaginal gel 4% (1g/day) and a placebo gel. After 4 and 12 weeks, the vaginal atrophy symptoms were classified at none, mild, moderate and severe and the vaginal cytology were taken to determine the maturation value. Vaginal pH was measured at the beginning and end of therapy. Microbiopsies in vaginal fornix were performed before the treatment and after 12 weeks of treatment.

RESULTS

Isoflavone vaginal gel was effective for relief of vaginal dryness and dyspareunia symptons and an increase in the intermediate and superficial cells was noted. The vaginal pH in the isoflavone group was 7.1 at baseline and 5.4 after 12 weeks, whereas in the placebo group there was no significant change. A significant increase in thickness after treatment was detected in the Isoflavone Group. The percentage of estrogen receptor positive cells in vaginal epithelium for the Isoflavone Group ranged from 58.5% at the beginning of treatment to 82.6% after 12 weeks. These results were superior to placebo gel.

CONCLUSION

Glycine max (L.) Merr. at 4% vaginal gel on a daily basis in postmenopausal women led to improvements in vaginal atrophy symptoms, maturation values, vaginal pH, morphology and expression of estrogen receptors in vaginal epithelium. Isoflavones proved good treatment options for relief of vulvovaginal atrophy.

摘要

目的

评估经阴道给予源自大豆(Glycine max (L.) Merr.)的异黄酮作为治疗阴道萎缩的一种选择,对绝经后女性阴道上皮雌激素受体形态和表达的影响。

方法

采用双盲、随机、安慰剂对照的临床试验。60名女性分别接受4%异黄酮阴道凝胶(1克/天)和安慰剂凝胶治疗12周。在4周和12周后,对阴道萎缩症状进行无、轻度、中度和重度分级,并采集阴道细胞学样本以确定成熟值。在治疗开始和结束时测量阴道pH值。在治疗前和治疗12周后对阴道穹窿进行活检。

结果

异黄酮阴道凝胶可有效缓解阴道干燥和性交困难症状,且中间层和表层细胞数量增加。异黄酮组阴道pH值在基线时为7.1,12周后为5.4,而安慰剂组无显著变化。异黄酮组治疗后厚度显著增加。异黄酮组阴道上皮雌激素受体阳性细胞百分比从治疗开始时的58.5%升至12周后的82.6%。这些结果优于安慰剂凝胶。

结论

绝经后女性每日使用4%的大豆(Glycine max (L.) Merr.)阴道凝胶可改善阴道萎缩症状、成熟值、阴道pH值、阴道上皮形态及雌激素受体表达。异黄酮被证明是缓解外阴阴道萎缩的良好治疗选择。

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