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含3毫克屈螺酮和20微克炔雌醇的复方口服避孕药治疗经前烦躁障碍的疗效与安全性:一项随机、双盲、安慰剂对照研究

[Efficacy and safety of a combined oral contraceptive containing drospirenone 3 mg and ethinylestradiol 20 µg in the treatment of premenstrual dysphoric disorder: a randomized, double blind placebo-controlled study].

作者信息

Fu Yi, Mi Weifeng, Li Lingzhi, Zhang Hongyan, Wang Jia, Cheng Wenjun, Sun Lizhou, Li Lingjiang, Xie Shiping, Zhang Jinbei

机构信息

Peking University Institute of Mental Health, Beijing 100191, China.

Email:

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2014 Jul;49(7):506-9.

Abstract

OBJECTIVE

To compare the efficacy and safety of a new low-dose oral contraceptive pill (YAZ) containing drospirenone 3 mg and ethinylestradiol 20 µg with placebo in reducing symptoms of premenstrual dysphoric disorder (PMDD).

METHODS

This multicenter, double- blind, randomized clinical trial consisted of 2 run- in and 3 treatment cycles (84 days) with daily symptom charting; 187 women with symptoms of PMDD were randomized to either placebo group (n = 94) or YAZ group (n = 93), and assessed with daily record of severity of problems scale (DRSP) and clinical global impressions scale (CGI) before, during and after the treatments. Hormones were administered for 24 days, followed by 4 days of inactive pills.

RESULTS

Compared with baseline level of DRSP, both groups got improvement after treatment; the YAZ group (median -28.7, range: -82.5 to 2.3) had greater improvement than that in the placebo group (median -23.7, range: -86.0 to 11.8), while there was not significant difference (P > 0.05). The main adverse effects of YAZ included intermenstrual bleeding [13% (12/93) versus 3% (3/94)], menorrhagia [9% (8/93) versus 1% (1/94)], nausea [5% (5/93) versus 4% (4/94)] and skin rash [4% (4/93) versus 2% (2/94)].

CONCLUSIONS

YAZ could improve symptoms of PMDD better than placebo, while without statistic significance in this study. The most common adverse effects are intermenstrual bleeding, menorrhagia, nausea and rash.

摘要

目的

比较一种含3毫克屈螺酮和20微克炔雌醇的新型低剂量口服避孕药(优思悦)与安慰剂在减轻经前烦躁障碍(PMDD)症状方面的疗效和安全性。

方法

这项多中心、双盲、随机临床试验包括2个导入期和3个治疗周期(84天),每日记录症状;187名有PMDD症状的女性被随机分为安慰剂组(n = 94)或优思悦组(n = 93),在治疗前、治疗期间和治疗后用每日问题严重程度记录量表(DRSP)和临床总体印象量表(CGI)进行评估。激素服用24天,随后服用4天无活性药丸。

结果

与DRSP的基线水平相比,两组治疗后均有改善;优思悦组(中位数-28.7,范围:-82.5至2.3)的改善程度大于安慰剂组(中位数-23.7,范围:-86.0至11.8),但差异无统计学意义(P > 0.05)。优思悦的主要不良反应包括经间期出血[13%(12/93)对3%(3/94)]、月经过多[9%(8/93)对1%(1/94)]、恶心[5%(5/93)对4%(4/94)]和皮疹[4%(4/93)对2%(2/94)]。

结论

优思悦在改善PMDD症状方面优于安慰剂,但在本研究中无统计学意义。最常见的不良反应是经间期出血、月经过多、恶心和皮疹。

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