[摘要]目的：探讨基于肾虚冲任失养理论指导下补肾调冲汤治疗围绝经期综合征的临床疗效。方法：选取2023年1月至2026年1月期间在本院接受治疗的114例围绝经期综合征（PMS）患者为研究对象，根据入院顺序编号后随机分为对照组（常规西医治疗）、观察组（常规西医+肾虚冲任失养理论指导下补肾调冲汤治疗）各57例。对比两组临床疗效及治疗前后雌激素水平、中医证候积分、改良Kupperman评分及生活质量水平。结果：与对照组治疗后临床疗效总有效率78.95%对比，观察组94.74%显著升高（P＜0.05）。治疗后观察组雌二醇（E2）水平比对照组高，卵泡刺激素（FSH）、黄体生成素（LH）水平均比对照组低（P＜0.05）。治疗后观察组烘热汗出、心烦不宁、腰膝酸软、手足心热、口干便坚症状的中医证候积分均比对照组低（P＜0.05）。治疗后观察组改良Kupperman评分、围绝经期综合征生存质量量表（MENQOL）评分均比对照组低（P＜0.05）。结论：基于肾虚冲任失养理论指导的补肾调冲汤治疗围绝经期综合征，能够显著提升疗效，调节性激素水平，降低中医证候积分，改善临床症状与生活质量，值得临床推广。

目的 分析围绝经期女性糖脂代谢水平与卵巢储备功能减退（DOR）的相关性，并探讨绝经激素治疗的应用价值。方法 回顾性选取2024年2月至2026年2月就诊于本院的194例围绝经期女性为研究对象，根据其卵巢储备功能将其分为DOR组（n=103）与卵巢储备功能正常组（NOR，n=91）。比较2组临床资料，采用Logistic回归分析围绝经期女性DOR的危险因素，绘制ROC曲线分析其预测效能，并利用Spearman相关系数分析指标相关性。同时予以所有患者绝经激素治疗（MHT），比较治疗前后的性激素指标、糖代谢指标、超声指标及安全性指标。结果 Logistic多因素结果显示：年龄、FSH、HbA1c、TG是围绝经期女性DOR的重要影响因素（P＜0.05）。ROC结果显示：联合预测的AUC=0.982，95%CI为0.964~1.000，灵敏度为0.990，特异度为0.923，校准曲线拟合性好。卵巢储备功能与年龄、FSH、HbA1c、TG均呈显著正相关（P均<0.05）。与治疗前相比，FSH、LH、HbA1c、TG、LDL-C水平有明显下降（P＜0.05），子宫内膜厚度略有增加（P＜0.05）；AMH、卵巢体积无显著变化（P＞0.05）。MHT治疗后不良反应发生率为4.64%。结论 糖脂代谢异常与围绝经期女性DOR密切相关，是其重要危险因素。规范MHT干预可有效改善内分泌代谢紊乱，且安全性可靠。

Objective To analyze the correlation between glycolipid metabolism levels and diminished ovarian reserve (DOR) in perimenopausal women, and to explore the application value of menopausal hormone therapy.Methods A total of 194 perimenopausal women admitted to our hospital from February 2024 to February 2026 were retrospectively enrolled. They were divided into the DOR group (n=103) and the normal ovarian reserve (NOR) group (n=91) according to ovarian reserve function. Clinical data were compared between the two groups. Logistic regression analysis was used to identify risk factors for DOR. Receiver operating characteristic (ROC) curves were plotted to evaluate predictive efficacy, and Spearman correlation analysis was performed to assess indicator correlations. All patients received menopausal hormone therapy (MHT). Sex hormone indicators, glycolipid metabolic indicators, ultrasonographic indicators and safety indicators were compared before and after treatment.Results Multivariate Logistic regression showed that age, folliclestimulating hormone (FSH), glycated hemoglobin A1c (HbA1c) and triglyceride (TG) were independent risk factors for DOR in perimenopausal women (P＜0.05). ROC analysis revealed that the combined prediction yielded an AUC of 0.982 (95%CI: 0.964–1.000), with a sensitivity of 0.990 and a specificity of 0.923, and good calibration curve fitting. Ovarian reserve was significantly positively correlated with age, FSH, HbA1c and TG (all P＜0.05). After treatment, levels of FSH, luteinizing hormone (LH), HbA1c, TG and lowdensity lipoproteincholesterol (LDLC) decreased significantly (P＜0.05), and endometrial thickness increased slightly (P＜0.05). No significant changes were observed in antiMüllerian hormone (AMH) and ovarian volume (P＞0.05). The incidence of adverse reactions after MHT was 4.64%.Conclusion Abnormal glycolipid metabolism is closely associated with DOR and serves as a critical risk factor in perimenopausal women. Standardized MHT can effectively improve endocrinemetabolic disorders with satisfactory safety.

目的：探析更年安片配合芬吗通对于围绝经期综合征的治疗效果。方法：对我院诊治的82例围绝经期综合征患者进行随机分组，对照组、试验组各41例。对照组以芬吗通治疗，试验组以更年安片配合芬吗通治疗。对治疗后两组的症状严重度，生活质量，总体疗效及不良反应展开比较。结果：治疗后，相较于对照组，试验组Greene更年期症状量表（GCS）、改良Kupperman评估量表（KMI）评分更低（P＜0.05）；治疗后，相较于对照组，试验组更年期特异性生活质量量表（MENQOL）评分更低，简明健康调查量表（SF-36）评分更高（P＜0.05）；相较于对照组的75.61%，试验组92.68%的总有效率更高（P＜0.05）；试验组14.63%的不良反应发生率与对照组的9.76%无明显差异（P＞0.05）。结论：围绝经期综合征患者接受更年安片配合芬吗通治疗，能促进症状改善，起到增效作用，并能提升生活质量，且未明显增加不良反应。

目的 探讨围绝经期功能失调性子宫出血患者应用宫腔镜电切术联合炔诺酮治疗对临床效果的影响。方法 选取2017年1月—2020年9月在我院治疗的87例围绝经期功能失调性子宫出血患者,按照随机数字表法分成观察组(n=44)与对照组(n=43),观察组采用宫腔镜电切术联合炔诺酮治疗,对照组仅采用宫腔镜电切术治疗,比较2组临床疗效、手术情况、住院时间、不良反应发生率,分析治疗前后子宫形态、血红蛋白含量变化。结果 观察组治疗总有效率为100.00%,对照组为86.05%,观察组高于对照组(P<0.05);2组手术时间、术中出血量、膨宫液用量、住院时间比较无差异(P>0.05);2组治疗后子宫内膜厚度增加(P<0.05),血红蛋白水平下降(P<0.05),观察组子宫内膜厚度大于对照组(P<0.05),血红蛋白水平较对照组更低(P<0.05);观察组不良反应发生率为9.09%,对照组为27.91%,观察组低于对照组(P<0.05)。结论 宫腔镜电切术联合炔诺酮应用于围绝经期功能失调性子宫出血患者治疗中能够促进子宫状况改善,提高临床疗效,且安全性较高,值得临床推广。

目的 了解城市围绝经期妇女绝经综合征的发生现状及分析相关影响因素,为进一步加强围绝经期妇女的保健工作提供理论依据。方法 纳入2019年2月—2020年2月就诊于广州市妇女儿童医疗中心中西医妇科门诊、天河及越秀区某社区的40～60岁女性共1 013名,采用问卷调查及Kupperman评分表收集出生日期,月经情况(初潮、绝经年龄等),孕产史,既往疾病史,身高、体质量,工作性质、家庭收入及个性等特征。结果 1 013例妇女的平均年龄是(47.70±4.95)岁,已绝经267例,未绝经女性中月经规律458例、月经紊乱288例,平均绝经年龄(49.49±3.26)岁。Kupperman评分超过15分(即诊断为绝经综合征)392 例(38.7%),其中轻度(15～20分) 222例(56.63%),中度(21～35分)162例(41.33%),重度(>35分)8例(2.04%)。多因素Logistic 回归分析表明,有慢性疾病较无慢性疾病史,月经紊乱、绝经较月经规律,家庭情况一般较和睦女性出现围绝经期症状风险升高,未观察到婚姻状况、个性特征、上班时长、社会适应、负性事件经历与围绝经期症状的出现相关。结论 广州城市存在绝经综合征的女性以轻中度为主,有慢性疾病、月经紊乱、绝经、家庭关系一般女性的绝经综合征发生风险较高,故应重视对全社会进行围绝经相关知识的宣教,重视家庭关系的和谐维护,当围绝经期妇女出现相关症状须及时寻求帮助,以保障广大围绝经期妇女顺利度过围绝经期阶段。

Objective To investigate the menopause symptoms and factors of the premenopausal women in urban areas, and thereby provide theoretical basis for their health care. Methods The research data was collected from 1 013 patients (age between 40-60) in the gynecology clinic and adult traditional Chinese medicine clinic in Guangzhou Women and Children's Medical Center, and the communities in Tian'he and Yue'xiu during February 2019—February 2020. By applying the questionnaire and Kupperman score table, the survey was conducted on the dates of birth, menstruations, times of menarche and menopause, records on pregnancy and childbirth, previously diagnosed diseases, heights, weights, classifications of work, family incomes, and personalities, etc. Results The average age of the 1 013 women was 47.70±4.95. Among them, 267 were with menopause (happening in 49.49±3.26 years old), 458 had regular menstruation, while 288 were with menstrual disorder. In the Kupperman scale, the scores of 392 cases (38.7%) were above 15, which can be diagnosed with menopause symptoms. Among them, the majority (222 cases, 56.63%) were with slight symptoms (15-20 scores), followed by 162 cases (41.33%) with moderate symptoms (21-35 scores), and 8 cases (2.04%) with severe symptoms (above 35 scores) respectively. Logistic regression analysis demonstrated that compared with women having satisfactory family relationship, participants suffering from chronic diseases, menstrual disorder, and poor family relationships, had higher risks of perimenopause. However, it had no relations with the marital status, personalities, working hours, social adaptabilities, and negative life events. Conclusion Guangzhou urban women with menopause symptoms are mainly slight and moderate. Participants with chronic diseases, menstrual disorders and poor family relationships are at a higher risk of having menopause symptoms. Therefore, it is recommended to popularize the knowledge of menopause in the society and attach importance to the maintenance of satisfactory family relationship. When perimenopausal women have relevant symptoms, they should seek medical help in time thus they can smoothly pass the peri-menopausal stage.

目的 探讨妈富隆用于治疗围绝经期功血的临床效果。方法 选择年龄40~53岁的出现围绝经期功血的育龄妇女100例。采用盲选法随机分为观察组和对照组,每组各50例。观察组诊刮后第5天开始口服妈富隆,开始每次服1片,每8 h服1次,血止后每3天递减1/3剂量,至维持量1片/天,共计21天,停药后撤退性出血的第5天开始服下周期的药;对照组诊刮后第15天开始口服醋酸甲羟孕酮片,10 mg/天,连服10 天停药后撤退性出血的第15天开始服下周期的药;两组各连服3个周期。结果 观察组服药后阴道流血控制时间和完全止血时间明显短于对照组,在治疗效果方面,观察组总有效率90%,对照组48%,观察组疗效优于对照组。结论 妈富隆治疗围绝经期功血的效果优于孕激素后半周期治疗围绝经期功血的效果,临床上值得推广。

Objective To investigate the clinical effect of Marvelonon perimenopausal dysfunctional uterine bleeding. Methods Select the age 40-53 year old appearance ofperimenopausal dysfunctional uterine bleeding of 100 women of childbearing age. The blind were randomly divided into the observation group and the control groupmethod, 50 cases in each group. The observation group and curettage fifth days after the start of Marvelon, begin to take 1 tablets eachtime, every 8 h 1 times, after the cessation of blood every 3 days and decreasing 1/3 dose,to maintain the volume of 1 pieces of/d, a total of 21 days, fifth days after stopping drug withdrawal bleedingbegan to take periodic drug; control group and curettagefifteenth days after the start of oral medroxyprogesterone acetate tablets, 10 mg/d, and even served fifteenth daysafter withdrawal of 10d. withdrawal bleeding began to takeperiodic drug; two of each suit 3 cycle group. Results The observation group after taking the vaginal bleedingcontrol time and complete hemostasis time significantly shorter than the control group, in treatment effect, total effective rate of observation group 90%, contrast group48%, observation group was significantly better than the control group. Conclusion Conclusion Marvelon on perimenopausal dysfunctional uterine bleeding effect is better than the second half cycleof progesterone treatment of perimenopausal dysfunctional uterine bleeding effect, is worth popularizingin clinic.