目的 探讨更年舒片联合戊酸雌二醇治疗更年期综合征的临床效果。方法 选取2012年6月-2017年12月南阳医学高等专科学校第二附属医院收治的78例更年期综合征，随机分为对照组和治疗组，每组各39例。对照组口服戊酸雌二醇片，1片/次，1次/d。治疗组在对照组基础上口服更年舒片，5片/次，3次/d。两组均连续治疗3个月。观察两组的临床疗效，比较两组治疗前后绝经期生存质量量表（MENQOL）评分、改良Kupperman绝经指数（KMI）、内分泌激素水平、血脂水平、血流变学参数的变化情况。结果 治疗后，对照组和治疗组的总有效率分别是79.5%、94.9%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者MENQOL评分、改良KMI评分均较治疗前显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后，治疗组MENQOL评分、改良KMI评分均显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者血清雌二醇（E₂）水平均显著高于治疗前，而卵泡刺激素（FSH）、促黄体生成素（LH）水平则均显著下降，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后，治疗组E₂水平高于对照组，而FSH、LH水平低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）水平均较治疗前显著降低，而高密度脂蛋白胆固醇（HDL-C）水平则均显著增高，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后，治疗组TC、LDL-C水平低于对照组，而HDL-C高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血浆黏度（PV）、红细胞聚集指数（RCAI）及红细胞比容（HCT）均显著低于治疗前，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后，治疗组患者这些血流变学参数值低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 更年舒片联合戊酸雌二醇治疗更年期综合征的整体疗效确切，可明显减轻患者更年期相关症状，改善生殖内分泌紊乱，纠正血脂及血流变学异常，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Gengnianshu Tablets combined with estradiol valerate in treatment of climacteric syndrome. Methods Patients (78 cases) with climacteric syndrome in the Second Affiliated Hospital of Nanyang Medical College from June 2012 to December 2017 were randomly divided into control (39 cases) and treatment (39 cases) groups. Patients in the control group were po administered with Estradiol Valerate Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Gengnianshu Tablets, 5 tablets/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy was evaluated, and the changes of MENQOL score, modified KMI scores, endocrine hormone level, blood lipid level and hemorheological parameters in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 79.5% and 94.9%, respectively, and there were differences between two groups (P<0.05). After treatment, MENQOL score and modified KMI score in two groups were significantly decreased, and there were differences in the same group (P<0.05). After treatment, MENQOL score and modified KMI score in the treatment group were lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, E₂ in two groups were significantly increased, but FSH and LH were significantly decreased, and there were differences in the same group (P<0.05). After treatment, E₂ in the treatment group were higher than those in the control group, but FSH and LH were lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, TC and LDL-C in two groups were significantly decreased, but HDL-C was significantly increased, and there were differences in the same group (P<0.05). After treatment, TC and LDL-C in the treatment group were lower than those in the control group, but HDL-C were higher than those in the control group, and there were differences between two groups (P<0.05). After treatment, PV, RCAI, and HCT in two groups were significantly decreased, and there were differences in the same group (P<0.05). After treatment, the hemorheological parameters were lower than those in the control group, and there were differences between two groups (P<0.05). Conclusion Gengnianshu Tablets combined with estradiol valerate has overall efficacy in treatment of climacteric syndrome, and can significantly reduce symptoms related to menopause, and improve reproductive endocrine disorders, and correct abnormal blood lipids and hemorheology, which has a certain clinical application value.

R984