Erenus M, Yücelten D, Gürbüz O, Durmuşoğlu F, Pekin S
Marmara University School of Medicine, Istanbul, Turkey.
Fertil Steril. 1996 Aug;66(2):216-9. doi: 10.1016/s0015-0282(16)58441-6.
To compare the efficacy of two antiandrogens, cyproterone acetate (CPA) and spironolactone, in the treatment of hirsutism.
Prospective randomized single-blinded study.
A tertiary hirsutism clinic.
Forty-two premenopausal patients with hirsutism were selected.
Subjects were randomized to receive either 100 mg spironolactone and an oral contraceptive (OC) containing 150 microg desogestrel and 30 microg ethinyl E2 or 50 mg CPA daily on days 1 to 10 of the menstrual cycle, which was administered with 35 microg ethinyl E2 daily on days 1 to 21.
Hirsutism scores were measured according to Ferriman-Gallwey scoring system and side effects were monitored for 9 months of treatment. Blood samples were taken at each visit for assessment of endocrine, biochemical, and hematologic parameters.
Hirsutism scores were decreaded significantly in both groups at the end of 9 months. The percent of change in hirsutism scores in CPA and spironolactone group were as follows: 19.23% +/- 14.77% and 24.48% +/- 14.27% at 3 months; 39.01% +/- 19.77% and 37.46% +/- 16.90% at 6 months; and 51.89% +/- 20.87% and 46.39% +/- 16.10% at 9 months, respectively. There was a trend toward a better response with CPA treatment, which did not achieve significance. None of the patients stopped treatment because of side effects.
The present data suggest that both spironolactone and CPA were similarly effective in treatment of hirsutism.
比较两种抗雄激素药物醋酸环丙孕酮（CPA）和螺内酯治疗多毛症的疗效。
前瞻性随机单盲研究。
一家三级多毛症诊所。
选取42例绝经前多毛症患者。
将受试者随机分为两组，一组在月经周期第1至10天每日服用100 mg螺内酯和含150 μg去氧孕烯及30 μg炔雌醇的口服避孕药（OC），在月经周期第1至21天每日服用35 μg炔雌醇；另一组在月经周期第1至10天每日服用50 mg CPA，在月经周期第1至21天每日服用35 μg炔雌醇。
根据费里曼-盖尔维评分系统测量多毛症评分，并在9个月的治疗期间监测副作用。每次就诊时采集血样以评估内分泌、生化和血液学参数。
9个月末两组多毛症评分均显著降低。CPA组和螺内酯组多毛症评分的变化百分比分别为：3个月时19.23%±14.77%和24.48%±14.27%；6个月时39.01%±19.77%和37.46%±16.90%；9个月时51.89%±20.87%和46.39%±16.10%。CPA治疗有反应更好的趋势，但未达到显著差异。没有患者因副作用而停止治疗。
目前的数据表明，螺内酯和CPA在治疗多毛症方面同样有效。
