文拉法辛、激素及激素合并文拉法辛治疗围绝经期综合征的临床对照分析

目的探讨围绝经期综合征的有效治疗方法。方法将148例围绝经期综合征女性患者分为三组：就诊于妇科门诊但有激素治疗禁忌征者及首次就诊于心理咨询门诊者接受文拉法辛75mg～150mg/d治疗,共42例作为A组,将其它106例随机分为B与C两组,每组各53人,B组接受尼尔雌醇,两周2mg治疗;C组接受尼尔雌醇两周2mg加文拉法辛75mg～150mg/d治疗,三组在不同药物治疗的同时,均给予支持性心理治疗。对三组临床疗效、性激素水平等多方面进行对照。结果三组在治疗起效时间与症状改善时间上比较差异有显著性,以A组最快,C组次之,B组最慢;三组改良的Kupperman总分及各因子分、HAMA、HAMD分值比较差异有显著性,但以A组减分率最高,其次为C组,B组减分率最低。三组治疗后性激素测定FSH浓度均下降,治疗前后差异有显著性（P〈0.05）,而E2浓度均轻度上升,但治疗前后差异无显著性（P〉0.05）。结论提示文拉法辛可以作为围绝经期综合征的有效治疗方法之一。

Clinical comparison and analysis for treatment of perimenopause syndrome by taking hormone with venlafaxine

Objective To evaluate the effective treatment of perimenopause syndrome.Methods A total of 148 females with perimenopause syndrome were divided into 3 groups,42 female outpatients who had the contraindication of hormone in gynecology and had the first psychological consulting were assigned as group A with venlafaxine.The other 106 cases were randomly divided in group B and group C,nylestriol 2 mg/twice week was given in group B and both nylestriol 2 mg/twice week and venlafaxine 75-150 mg/day were given in group C.All of the groups were cured with the medicine and the psychological consulting.Compared the clinical efficient,the sex hormone level,etc.Result After treatment,significant differences among the time of medicine becoming effect and symptoms improvement for the 3 Groups,group A fastest,group C fair,group B slowest.The improved-Kupperman scores,the scores of HAMA,the scores of HAMD and hormone level were significantly different,group A with the highest reduce ratio,group C lower,group B lowest.The reduction of FSH in blood for the test of sex hormone before and after hormone treatment were observed(P<0.05)for the 3 Groups.But The content of E2 decreased slightly,and there was no significant difference(P>0.05).Conclusion Venlafaxine could be one of the more effective treatment for perimenopause syndrome.