目的 探究综合干预对绝经综合征(MPS)患者生存质量的影响。方法 纳入2019年9月至2021年6月间就诊于铜陵市妇幼保健院的147例绝经综合征患者为调查对象,按照随机数列表法分实验组和对照组,实验组73例患者接受绝经激素治疗(MHT)联合健康教育,对照组74例患者接受健康教育。经过6个月综合干预,观察改良Kupperman评分(KMI)、绝经期生存质量量表 (MENQOL)、焦虑自评量表(SAS)、抑郁自评量表 (SDS)及身体基本参数变化。结果 干预后实验组KMI(Z=3 348.500,P<0.001)、MENQOL(Z=4 698.500,P<0.001)、SAS(Z=4 474.000,P<0.001)、SDS(Z=4 398.000,P<0.001)评分显著低于对照组,实验组干预后MENQOL(Z=2 689.000,P<0.001)、SAS(Z=2 477.000,P<0.001)、SDS(Z=2 112.500,P<0.001)评分较干预前显著下降。实验组73人6个月综合干预后体质量指数(BMI)(t=-7.543,P<0.001)、腰臀比(WHR)(Z=2 178.000,P<0.001)、甘油三酯(TG)(Z=1 817.000,P=0.010)、血清总胆固醇(TC)(Z=2 190.000,P<0.001)、低密度脂蛋白(LDL)(t=-3.532,P=0.001)、血清卵泡雌激素(FSH)(Z=2 701.000,P<0.001)浓度较干预前均明显降低,血清雌二醇(E2)(Z=155.000,P<0.001)浓度明显升高。结论 MHT联合健康教育可有效缓解MPS,改善焦虑抑郁状态,明显提高MPS患者的心理健康水平和生存质量,早期启用MHT对心血管系统具有保护作用。
Abstract
Objective To explore the effect of comprehensive intervention measures on the quality of life of patients with menopausal syndrome (MPS). Methods A study was used to study the clinical data of 147 patients with menopausal syndrome who visited Tongling Maternity and Child Health Care Hospital between September 2019 and June 2021.These data were divided into experimental and control groups according to the random number list method.A total of 73 patients in the experimental group received menopausal hormone therapy (MHT) combined with health education,and 74 patients in the control group received health education only.During 6 months of comprehensive intervention,the patients' Kupperman menopausal index (KMI) score,menopause-specific quality of life (MENQOL) data,self rating anxiety scale (SAS) score,self-rating depression scale (SDS) data,and changes in basic physical parameters were observed and recorded during the intervention period. Results After intervention,the scores of KMI (Z=3 348.500,P<0.001),MENQOL (Z=4 698.500,P<0.001),SAS (Z=4 474.000,P<0.001) and SDS (Z=4 398.000,P<0.001) in the experimental group decreased significantly compared with the data of the control group.After intervention,the scores of MENQOL (Z=2 689.000,P<0.001),SAS (Z=2 477.000,P<0.001) and SDS (Z=2 112.500,P<0.001) in the experimental group were significantly decreased compared with those before intervention.The body mass index (BMI) (t=-7.543,P<0.001),waist hip ratio (WHR) (Z=2 178.000,P<0.001),triglyceride (TG) (Z=1 817.000,P=0.010),serum total cholesterol (TC) (Z=2 190.000,P<0.001),low-density lipoprotein (LDL) (t=-3.532,P=0.001),and serum follicle stimulating hormone (FSH) (Z=2 701.000,P<0.001) concentrations of 73 subjects in the experimental group after the 6-month comprehensive intervention were significantly reduced,while the concentration of serum estradiol (E2) (Z=155.000,P<0.001) significantly increased. Conclusion MHT combined with health education can effectively alleviate MPS,improve anxiety and depression,and significantly improve the mental health level and survival quality of MPS patients.Early initiation of MHT has a protective effect on the cardiovascular system.
关键词
绝经综合征 /
绝经激素治疗 /
健康教育 /
生存质量
Key words
Menopausal syndrome /
Menopausal hormone therapy /
Health education /
Quality of life
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参考文献
[1] Studd J.Ten reasons to be happy about hormone replacement therapy: a guide for patient[J].Menopause Int,2010,16(1):44-46.
[2] 谢梅青,陈蓉,任慕兰.绝经管理与绝经激素治疗中国指南(2018)[J].中华妇产科杂志,2018,53(11):729-739.
[3] 中国妇幼保健协会妇女保健专科能力建设专业委员会.更年期女性心理健康管理专家共识[J].中国妇幼健康研究,2021,32(8):1083-1089.
[4] 杨华,宋惠玲,刘雪婧.围绝经期激素补充治疗对常见老年疾病影响的多终点前瞻性研究[J].实用妇科内分泌电子杂志,2019,6(31):86-97.
[5] 徐素君,陈敏,陈立新,等.健康教育对绝经激素补充治疗围绝经期综合征效果的影响[J].实用预防医学,2018,25(7):841-843.
[6] 李玉英,马明福,姚勇利,等.青海地区100例围绝经期综合征的流行病学及激素补充治疗分析[J].中华保健医学杂志,2019,21(6):578-580.
[7] Lim HJ,Cho HJ,Lee MS.Pilot study of hormone replacement therapy and menopausal symptoms,depression,and quality of life in Korean climacteric women[J].Psychol Rep,2006,98(2):374-378.
[8] 黄慧卿,林元,陈小梅,等.短期绝经期激素治疗缓解妇女更年期症状的临床研究[J].海峡药学杂志,2015,27(10):211-213.
[9] Rossouw JE,PenticeRL,Manson JE,et al.Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause [J].JAMA,2007,297(13):1465-1477.
[10] 廖月园,牟建军.BMI的长期负担对远期心脏代谢表型的影响:30年的队列随访研究[J].中国妇幼健康研究,2021,32(6):787-792.
[11] 刘艳华,杨欣.绝经激素治疗与心血管疾病[J].中国实用妇科和产科杂志,2020,36(3):209-212.
[12] Stevenson JC,Crook D,Godsland IF.Influence of age and menopause on serum lipids and lipoproteins in healthy women[J].Atheroselerosis,1993,98:83-90.
[13] Stampfer MJ,Colditz GA,Willett WC,et al.Postmenopausal estrogen therapy and cardiovascular disease: ten-year follow-up from the Nurses' Health Study[J].N Engl J Med,1991,325:756-762.
[14] Tian QJ,Ge QS.Long-term low dose HRT protects the cardiovascular system in postmenopausal women[J].Gynecol Endocrinol,2006,22(1):104-105.
[15] 薛薇,孙爱军,郑婷萍,等.绝经早期妇女不同药物治疗的临床分析[J].中华医学杂志,2016,96(29):2327-2331.
[16] 朱连红,马麟娟,许正芬,等.对围绝经期妇女激素补充治疗的认知度调查[J].中华生殖与避孕杂志,2017,37(6):480-484.
基金
铜陵市重点研究与开发项目(20190203032)
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