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一种首选的复方口服避孕药对健康女性的整体健康状况有影响:一项双盲、随机、安慰剂对照试验。

A first-choice combined oral contraceptive influences general well-being in healthy women: a double-blind, randomized, placebo-controlled trial.

机构信息

Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.

Department of Economics, Stockholm School of Economics, Stockholm, Sweden.

出版信息

Fertil Steril. 2017 May;107(5):1238-1245. doi: 10.1016/j.fertnstert.2017.02.120. Epub 2017 Apr 19.

Abstract

OBJECTIVE

To determine whether there is a causal effect of oral contraceptive (OC) treatment on general well-being and depressed mood in healthy women.

DESIGN

Double-blind, randomized, and placebo-controlled trial.

SETTING

University hospital.

PATIENT(S): Three hundred and forty healthy women aged 18-35 years randomized to treatment, of whom 332 completed the data collection at follow-up evaluation.

INTERVENTION(S): A combined OC (150 μg levonorgestrel and 30 μg ethinylestradiol) or placebo for 3 months of treatment.

MAIN OUTCOME MEASURE(S): Primary outcome measures: global score of Psychological General Well-Being Index (PGWBI) and the Beck Depression Inventory (BDI); secondary outcome measures: six separate dimensions of the PGWBI.

RESULT(S): The OC treatment statistically significantly decreased general well-being compared with placebo -4.12 (95% CI, -7.18 to -1.06). Furthermore, OC decreased the following PGWBI dimensions compared with placebo: positive well-being -3.90 (95% CI, -7.78 to -0.01), self-control -6.63 (95% CI, -11.20 to -2.06), and vitality -6.84 (95% CI, -10.80 to -2.88). The effect of OC on depressive symptoms and on the PGWBI dimension depressed mood were not statistically significant.

CONCLUSION(S): This study demonstrates a statistically significant reduction in general well-being by a first-choice OC in comparison with placebo in healthy women. We found no statistically significant effects on depressive symptoms. A reduction in general well-being should be of clinical importance.

摘要

目的

确定口服避孕药(OC)治疗对健康女性的整体幸福感和抑郁情绪是否有因果影响。

设计

双盲、随机、安慰剂对照试验。

地点

大学医院。

患者

340 名年龄在 18-35 岁的健康女性随机分组接受治疗,其中 332 名在随访评估时完成了数据收集。

干预措施

连续服用 3 个月的复方 OC(150μg 左炔诺孕酮和 30μg 炔雌醇)或安慰剂。

主要观察指标

主要观察指标:心理综合健康指数(PGWBI)和贝克抑郁量表(BDI)的总体评分;次要观察指标:PGWBI 的六个单独维度。

结果

OC 治疗与安慰剂相比,整体幸福感显著下降-4.12(95%置信区间,-7.18 至-1.06)。此外,OC 与安慰剂相比,以下 PGWBI 维度下降:积极幸福感-3.90(95%置信区间,-7.78 至-0.01)、自我控制-6.63(95%置信区间,-11.20 至-2.06)和活力-6.84(95%置信区间,-10.80 至-2.88)。OC 对抑郁症状和 PGWBI 维度抑郁情绪的影响没有统计学意义。

结论

与安慰剂相比,本研究表明首选 OC 可显著降低健康女性的整体幸福感。我们未发现 OC 对抑郁症状有统计学显著影响。幸福感下降应具有临床重要意义。

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