目的 探讨定坤丹联合替勃龙治疗围绝经期综合征的临床疗效。方法 选取2018年8月—2019年8月至新郑市人民医院就诊的围绝经期综合征患者82例，随机分为对照组和治疗组，每组各41例。对照组口服替勃龙片，2.5 mg/次，1次/d。治疗组在对照组基础上口服定坤丹，6 g/次，2次/d。所有患者均治疗3个月。比较两组的临床疗效，观察两组治疗前后汉密尔顿焦虑量表（HAMA）评分、汉密尔顿抑郁量表（HAMD）评分、Kupperman绝经指数（KMI）评分及血清雌二醇（E₂）、卵泡刺激素（FSH）、促黄体生成激素（LH）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C），γ-干扰素（IFN-γ）、白细胞介素-2（IL-2）、IL-4、IL-10，外周血CD3⁺、CD4⁺、CD8⁺水平。结果 治疗后，治疗组总有效率是95.12%，显著高于对照组的80.49%（P<0.05）。治疗后，两组HAMA评分、HAMD评分、KMI评分均显著低于同组治疗前（P<0.05）；且治疗后治疗组相关评分均显著低于对照组（P<0.05）。治疗后，两组E₂显著升高，而FSH、LH均显著低于同组治疗前（P<0.05）；且治疗后治疗组激素水平显著优于对照组（P<0.05）。治疗后，两组患者血清TG、TC、LDL-C水平均低于治疗前，但血清HDL-C水平均高于治疗前（P<0.05）；治疗后，治疗组血脂水平优于对照组（P<0.05）。治疗后，两组血清INF-g、IL-2水平均低于治疗前，但血清IL-4、IL-10水平均高于治疗前（P<0.05）；治疗后，治疗组患者这些血清炎性因子水平优于对照组（P<0.05）。治疗后，两组CD3⁺、CD4⁺水平均高于治疗前，但CD8⁺水平均低于治疗前（P<0.05）；且治疗后，治疗组淋巴细胞水平优于对照组（P<0.05）。结论 定坤丹联合替勃龙治疗围绝经期综合征具有较好的临床疗效，可有效减轻患者负面情绪，调节雌激素水平，改善血脂代谢，提高免疫应答能力，具有一定的临床推广应用价值。

Objective To investigate the effect of Dingkun Pills combined with tibolone in the treatment of perimenopausal syndrome and its effects on sex hormones, lipid metabolism and immune function. Methods 82 Cases of postmenopausal osteoporosis patients diagnosed and treated in Xinzheng People's Hospital from August 2018 to August 2019 were randomly divided into control group and treatment group, with 41 patients in each group. The control group was po administered with Tibolone Tablets, 2.5 mg/time, once daily. The treatment group was po administered with Dingkun Pills, 6 g/time, twice daily. All patients were treated for 3 months. The clinical efficacy of the two groups was compared, and hamilton anxiety scale (HAMA) scores, Hamilton depression scale (HAMD) scores, Kupperman postmenopausal index (KMI) score and serum estradiol (E₂), follicle-stimulating hormone (FSH), luteinizing hormone (LH), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), gamma interferon (IFN-g), interleukin-2 (IL-2), IL-4, IL-10, levels of CD3⁺, CD4⁺ and CD8⁺ in two groups before and after treatment were observed. Results After treatment, the total effective rate in the treatment group was 95.12%, significantly higher than 80.49% in the control group (P<0.05). After treatment, HAMA score, HAMD score and KMI score in both groups were significantly lower than those in the same group before treatment (P<0.05). After treatment, these correlation scores of the treatment group were significantly lower than those of the control group (P<0.05). After treatment, E₂ was significantly increased in both groups, while FSH and LH were significantly lower than those before treatment (P<0.05). After treatment, the hormone level of the treatment group was significantly better than that of the control group (P<0.05). After treatment, serum TG, TC and LDL-C levels in both groups were lower than those before treatment, but serum HDL-C levels were higher than those before treatment (P<0.05). After treatment, the blood lipid levels of the treatment group were better than those of the control group (P<0.05). After treatment, the levels of serum INF-g and IL-2 in both groups were lower than those before treatment, but the levels of serum IL-4 and IL-10 were higher than those before treatment (P<0.05). After treatment, the serum levels of these inflammatory factors in the treatment group were better than those in the control group (P<0.05). After treatment, CD3⁺ and CD4⁺ levels in both groups were higher than before treatment, but CD8⁺ levels were lower than before treatment (P<0.05). After treatment, the lymphocyte levels in the treatment group were better than those in the control group (P<0.05). Conclusion Dingkun Pills combined with tibolone has good clinical effect in the treatment of perimenopausal syndrome, and can effectively reduce patients' negative emotions, and also can regulate estrogen levels, improve blood lipid metabolism and immune response ability, which has certain clinical application value.

R984