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含屈螺酮的复方口服避孕药对梅尼埃病经前加重的影响:初步研究

Effects of combined oral contraception containing drospirenone on premenstrual exacerbation of Meniere's disease: Preliminary study.

作者信息

Caruso Salvatore, Mauro Diletta, Maiolino Luigi, Grillo Caterina, Rapisarda Agnese Maria Chiara, Cianci Stefano

机构信息

Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, Research Group for Sexology, University of Catania, Via Santa Sofia 78, PC 95124, Catania, Italy.

Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, Research Group for Sexology, University of Catania, Via Santa Sofia 78, PC 95124, Catania, Italy.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2018 May;224:102-107. doi: 10.1016/j.ejogrb.2018.03.015. Epub 2018 Mar 10.

Abstract

OBJECTIVES

Meniere's disease is caused by an augmented endolymph pressure in the inner ear; symptoms are vertigo, fluctuating hearing loss and tinnitus. Exacerbations has been noted during premenstrual phase. The study aims to evaluate the effects of a 20 μm Ethinylestradiol (EE) and 3 mg Drospirenone (DRSP) oral contraceptive (20 μmEE/3mgDRSP) in continuous regimen, associated with rehabilitation therapy on Meniere's disease.

STUDY DESIGN

This non-randomized controlled study was performed from October 2015 to October 2017. Forty-two premenopausal women affected by MD with severe distress in the premenstrual phase were enrolled. Sixteen women constituted the study group (Group A), and twenty women constituted the control group (Group B). Group A underwent EE/DRSP therapy and rehabilitation and Group B underwent rehabilitation therapy alone. Stabilometry and the Dizziness Handicap Inventory questionnaire were used to measure vestibular function and distress related to the disease, respectively, at baseline (T0), 3 months (T1) and 6 months (T2).

RESULTS

At T0, both groups had large, similar areas of stabilometric ellipses (p = NS) that reduced more in Group A than in Group B, at T1 and T2 (p < 0.001). High scores of the DHI (cut-off ≤54) were observed at T0 in both groups (A 66.8 ± 2.8 vs B 65.5 ± 3.6; p = NS). At T1, a gradual improvement in both groups was observed, manly in Group A (A 45.1 ± 3.6 vs B 62.4 ± 4.1; p < 0.001). At T2, the DHI scores were significantly lower in Group A (39.2 ± 3.8) compared to Group B (68.8 ± 3.6) (p < 0.001).

CONCLUSIONS

DRSP could be effective in reducing the fluid overload typical of the premenstrual phase, improving symptoms of MD. The results support the efficacy of EE/DRSP usage associated with rehabilitation therapy on premenstrual exacerbation of MD.

摘要

目的

梅尼埃病由内耳内淋巴压力升高引起;症状包括眩晕、波动性听力损失和耳鸣。已注意到在经前期病情会加重。本研究旨在评估连续服用含20 μg炔雌醇(EE)和3 mg屈螺酮(DRSP)的口服避孕药(20 μg EE/3mg DRSP)联合康复治疗对梅尼埃病的影响。

研究设计

本非随机对照研究于2015年10月至2017年10月进行。纳入42名在经前期受梅尼埃病影响且有严重不适的绝经前女性。16名女性组成研究组(A组),20名女性组成对照组(B组)。A组接受EE/DRSP治疗及康复治疗,B组仅接受康复治疗。分别在基线(T0)、3个月(T1)和6个月(T2)时,使用姿势稳定仪和头晕残障量表问卷来测量前庭功能和与疾病相关的不适。

结果

在T0时,两组姿势稳定椭圆面积大且相似(p = 无统计学意义),在T1和T2时,A组的椭圆面积减小幅度大于B组(p < 0.001)。两组在T0时DHI(临界值≤54)得分均较高(A组66.8 ± 2.8 vs B组65.5 ± 3.6;p = 无统计学意义)。在T1时,两组均有逐渐改善,主要是A组(A组45.1 ± 3.6 vs B组62.4 ± 4.1;p < 0.001)。在T2时,A组的DHI得分(39.2 ± 3.8)显著低于B组(68.8 ± 3.6)(p < 0.001)。

结论

屈螺螺螺螺酮可能有效减少经前期典型的液体过载,改善梅尼埃病症状。结果支持EE/DRSP联合康复治疗对梅尼埃病经前期病情加重的疗效。

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