Sasaki Hiromi, Sakihama Mika, Karakida Noriko, Miyazaki Takasuke, Kobayashi Hiroaki, Taniguchi Noboru
Department of Orthopedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
Department of Obstetrics and Gynecology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
Womens Health (Lond). 2025 Jan-Dec;21:17455057251359384. doi: 10.1177/17455057251359384. Epub 2025 Jul 31.
Symptomatic hand osteoarthritis frequently affects perimenopausal women and is believed to be associated with estrogen deficiency. However, effective medical therapies for symptomatic relief remain limited.
To compare the effectiveness of menopausal hormone therapy and complementary and alternative medicine in treating symptomatic hand osteoarthritis in perimenopausal women.
Retrospective observational study.
We retrospectively reviewed the medical records of 73 perimenopausal Japanese women treated for symptomatic hand osteoarthritis at Kagoshima University Hospital between 2019 and 2022. Fifty-four patients received menopausal hormone therapy, and 19 received complementary and alternative medicine (Kampo formula and/or S-equol supplementation). No patients received additional orthopedic treatments for hand osteoarthritis, such as analgesics, splinting, rehabilitation, or injections. The outcomes included the disability of the arm, shoulder, and hand score and visual analog scale score for hand pain, which were assessed at baseline and 3 months. Two-factor repeated-measures analysis of variance was used to assess condition-by-time interactions, and effect sizes were calculated. For outcomes with significant interactions, post hoc Mann-Whitney tests were used to compare between-group changes.
Significant condition-by-time interactions were found for the disability of the arm, shoulder, and hand score ( = 12.85, p = 0.0007, partial η = 0.17) and visual analog scale score ( = 7.39, p = 0.008, partial η = 0.02), indicating that treatment effects differed between groups over time. Post hoc analyses revealed that the menopausal hormone therapy group showed significantly greater improvements than the complementary and alternative medicine group in both the disability of the arm, shoulder, and hand (10.85 versus -1.75 points, p = 0.003) and visual analog scale scores (27.9 versus 9.17 mm, p = 0.02). The mean improvement in disability of the arm, shoulder, and hand scores in the menopausal hormone therapy group exceeded the minimal clinically important differences, supporting both statistical and clinical significance.
Compared with complementary and alternative medicine, menopausal hormone therapy showed superior efficacy in improving hand pain and dysfunction associated with symptomatic hand osteoarthritis in perimenopausal Japanese women.
有症状的手部骨关节炎常影响围绝经期女性，被认为与雌激素缺乏有关。然而，用于缓解症状的有效药物治疗仍然有限。
比较绝经激素治疗与补充和替代医学在治疗围绝经期女性有症状的手部骨关节炎中的有效性。
回顾性观察研究。
我们回顾性分析了2019年至2022年期间在鹿儿岛大学医院接受有症状手部骨关节炎治疗的73名围绝经期日本女性的病历。54名患者接受了绝经激素治疗，19名患者接受了补充和替代医学治疗（汉方配方和/或补充S-雌马酚）。没有患者接受手部骨关节炎的额外骨科治疗，如镇痛药、夹板固定、康复治疗或注射治疗。观察指标包括手臂、肩部和手部功能障碍评分以及手部疼痛视觉模拟量表评分，在基线和3个月时进行评估。采用双因素重复测量方差分析评估病情随时间的交互作用，并计算效应量。对于有显著交互作用的观察指标，采用事后曼-惠特尼检验比较组间变化。
在手臂、肩部和手部功能障碍评分（F = 12.85，p = 0.0007，偏η² = 0.17）和视觉模拟量表评分（F = 7.39，p = 0.008，偏η² = 0.02）方面发现了显著的病情随时间交互作用，表明两组的治疗效果随时间不同。事后分析显示，绝经激素治疗组在手臂、肩部和手部功能障碍（10.85分对 -1.75分，p = 0.003）和视觉模拟量表评分（27.9毫米对9.17毫米，p = 0.02）方面均比补充和替代医学组有显著更大的改善。绝经激素治疗组手臂、肩部和手部功能障碍评分的平均改善超过了最小临床重要差异，支持了统计学和临床意义。
与补充和替代医学相比，绝经激素治疗在改善围绝经期日本女性有症状手部骨关节炎相关的手部疼痛和功能障碍方面显示出更高的疗效。
