Kopciuch Dorota, Paczkowska Anna, Zaprutko Tomasz, Michalak Michał, Nowakowska Elżbieta
Altern Ther Health Med. 2017 Mar;23(2):12-19.
Context • Psychoneurological symptoms are present in nearly all women in the perimenopausal period. Key elements of care in the period may include hormone replacement therapy (HRT). Alternatively, phytoestrogens, antidepressant pharmacotherapy, or a combination of hormonal and antidepressant therapies may be recommended. Objective • The study intended to verify whether women who are menopausal believe that a reduction in their symptoms of anxiety and depression depends on the type of pharmacotherapy used. Design • The study was designed as a multicenter study, conducted in public and private, gynecological, outpatient clinics. Setting • The study took place in public and private, gynecological, outpatient clinics in 3 regions of Poland: northwestern, central, and northern. Participants • Potential participants were 1239 women of menopausal age who visited gynecologists at the clinics. Outcome Measures • Participants were divided into 3 subgroups using the divisions of menopause defined by the World Health Organization, either premenopausal, perimenopausal, or postmenopausal. The study evaluated the severity of participants' menopausal symptoms using the Kupperman Index and the severity of their depression and anxiety disorders using the Hospital Anxiety and Depression Scale. A general mental health assessment was performed using a visual analogue scale, whereas the drugs used were evaluated using a Likert scale. Results • The study found statistically significant differences between the menopausal period and the severity of the menopausal symptoms. The highest efficacy in terms of relief from menopausal symptoms, such as shortness of breath, flushing, or sweating, was observed for a combined HRT and selective serotonin reuptake inhibitor/serotonin and norepinephrine reuptake inhibitor antidepressant therapy. Nevertheless, phytoestrogen therapy was also highly effective. Conclusions • The best method of treatment with the smallest risk of adverse effects together with a high level of patient satisfaction was found to be the phytoestrogen therapy. The women themselves believed that the therapies were effective and largely helped them to stay mentally fit.
背景 • 几乎所有围绝经期女性都会出现精神神经症状。该时期护理的关键要素可能包括激素替代疗法（HRT）。此外，也可能推荐使用植物雌激素、抗抑郁药物治疗或激素与抗抑郁药物联合治疗。
目的 • 本研究旨在验证处于更年期的女性是否认为焦虑和抑郁症状的减轻取决于所使用的药物治疗类型。
设计 • 本研究设计为多中心研究，在公立和私立妇科门诊进行。
地点 • 研究在波兰3个地区的公立和私立妇科门诊进行：西北部、中部和北部。
参与者 • 潜在参与者为1239名更年期年龄的女性，她们在诊所就诊于妇科医生。
结局指标 • 根据世界卫生组织定义的更年期分类，将参与者分为3个亚组，即绝经前、围绝经期或绝经后。本研究使用库珀曼指数评估参与者更年期症状的严重程度，使用医院焦虑抑郁量表评估其抑郁和焦虑障碍的严重程度。使用视觉模拟量表进行总体心理健康评估，而使用李克特量表评估所使用的药物。
结果 • 研究发现更年期与更年期症状严重程度之间存在统计学显著差异。对于缓解更年期症状，如呼吸急促、潮热或出汗，观察到激素替代疗法与选择性5-羟色胺再摄取抑制剂/5-羟色胺和去甲肾上腺素再摄取抑制剂联合抗抑郁治疗的疗效最高。然而，植物雌激素疗法也非常有效。
结论 • 发现风险最小且患者满意度高的最佳治疗方法是植物雌激素疗法。女性自身认为这些疗法有效，并且在很大程度上帮助她们保持心理健康。
