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绝经后骨质疏松症的性激素补充疗法
绝经后骨质疏松症,亦称退行性Ⅰ型骨质疏松症.其发病机理主要是由于绝经后雌激素水平骤然下降,促使骨吸收增加,骨矿含量快速丢失,骨折发生率升高.
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According to the TCM theory that the kidney is in charge of the bone, the authors carried out a study on the effect of acupuncture on bone mineral density in 40 postmenopausal women with osteoporosis treated by the method of reinforcing the kidney to strengthen the bone, with satisfactory therapeutic results reported as follows.
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According to the TCM theory that the kidney is in charge of the bone, the authors carried out a study on the effect of acupuncture on bone mineral density in 40 postmenopausal women with osteoporosis treated by the method of reinforcing the kidney to strengthen the bone, with satisfactory therapeutic results reported as follows.
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Primary osteoporosis, a commonly encountered metabolic bone disease in the postmenopausal women and the aged people, can be classified by modern medicine into postmenopausal osteoporosis (Type I) and senile osteoporosis (Type II). The disease seriously affects health and quality of life of the people as it often cause ostealgia, fracture and the secondary symptoms or diseases. Presently, the pharmacotherapy (including both Chinese herbal drugs and western drugs) remains the first among all other therapeutic methods which are mainly adopted in treatment of the disease at home and abroad. Studies related have been curried out quite early and systematically, and considerable progress has been made, but limit of the pharmacotherapy has also been found. Certain non-drug treatments (such as dietetic therapy, physical exercise, acupuncture and moxibustion, and qigong, especially acupuncture and moxibustion therapy, although with a late start, have been proved effective with satisfactory results. The following is a summary of all the contributions concerned.
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关键词: postmenopausal women
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雌激素和孕激素在绝经后妇女中的应用:北美绝经协会2008年7月的立场声明(第二部分)
医疗实践问题药物作用的共性与个性雌激素和孕激素具有某些共同的特点和作用,但是二者特性明显不同.而对任何一种给定药物(单用或合用),决定其纯净临床结果的金标准都要通过RCTs.在缺乏关于各种雌孕激素严格的,头对头的,且不太可能开展RCTs的情况下,临床医生需要将一种药物的临床试验结果外推到该家族的所有药物.
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绝经后妇女雌激素受体(ER)基因XbaⅠ限制性片断长度多态性(RFLP)与骨密度的关系
目的研究绝经后妇女ER基因XbaⅠ限制性片断长度多态性(RFLP)与骨密度、骨生化指标和停经年限的关系.方法用PCR-RFLP方法检测绝经后妇女的ER基因型;DEXA检测腰椎和股骨各处骨密度,同时测定血骨钙素、尿吡啶并酚等骨转换指标.结果在205例绝经后妇女中发现XX、Xx和xx基因型频率分别为6.8%、25.9%和67.3%,XX基因型的妇女虽然停经时间更长,但腰椎骨密度仍高于Xx和xx型.结论 ER基因XX型可能对腰椎骨量的维持有一定作用.
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重新认识绝经妇女长期性激素补充治疗的利弊
绝经妇女应用性激素补充治疗(HRT)已有半个世纪的历史了,它的发展及人们对其受益与风险的认识,经历了曲折的道路.早年应用雌激素,仅限于治疗绝经期综合征.20世纪70年代,开始应用单一雌激素治疗围绝经期症状,但因子宫内膜癌发病数的增加,而使雌激素的临床应用陷入低潮.20世纪80年代,有关研究规定,有完整子宫的妇女在应用单一雌激素时必须加用孕激素,以及雌、孕激素的剂量、日程(每日方案)及配伍方案, 并规定了补充雌激素的目标浓度.
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医学职称英语考试模拟试题(9)
Ⅰ.阅读理解:阅读下列短文,然后回答文章后面的问题,从四个供选择的答案中挑出正确的一个.FDA Approves New Osteoporosis DrugThe Food and Drug Administration (FDA) has approved new drug, raloxifene, for the prevention of osteoporosis in postmenopausal women. Osteoporosis is a condition of progressive degeneration of bone mass and reduced bone strength that most commonly affects postmenopausal women and often leads to hip, wrist or spine fractures.
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Objective To evaluate the effect and feasibility of using estrogen cream for the prevention and treatment of recurrent urinary tract infection (UTI) in postmenopausal women.Methods Forty-five postmenopausal women with a history of recurrent UTI were divided into two groups (group premarin and group antibiotic). Participants were assigned to apply intravaginal premarin cream (group premarin, n=30) or oral antibiotic (group antibiotic, n=15) for 3 months respectively. Urine routine test, midstream urine and vaginal cultures, vaginal health score (VHS), vaginal cell maturation value (MV), endometrial thickness and blood estrogen level were obtained before and after the study.Results The incidence of UTI in the group premarin was significantly reduced as compared with that in the group antibiotic (2/27 vs 12/15, P<0.001). In the group premarin Lactobacilli reappeared (from 0 to 59.3%) and MV (from 9.2±6.8 to 74.6±14.1) and VHS (from 5.2±0.4 to 13.4±2.5) were improved after 3 months. There was no significant change in the group antibiotic.Conclusion It seems that intravaginal use of estrogen cream would effectively prevent and reduce the UTI in postmenopausal women.
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正确应用性激素补充疗法促进绝经后妇女的健康
美国妇女健康研究(Women′s Health Initiative, WHI)是一个大规模、复杂的临床研究[1],目的是针对在绝经后妇女中疾病和死亡多见病因的预防和控制,包括:癌症、心血管病和骨质疏松性骨折.WHI开始于1992年,计划于2007年结束,在美国国内设40个临床中心,研究对象为50~79岁的绝经后妇女.研究分两类:临床随机对照研究和观察性研究,前者纳入研究对象约64 500名,后者约100 000名.临床随机对照研究评价3种干预:低脂饮食、性激素补充疗法(HRT)和钙及维生素D的补充.
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雌激素对绝经后妇女血管内皮功能的作用
1998年3月~1998年7月对20例绝经后妇女服用17-B-雌二醇后测定血管内皮因子的变化,报告如下.
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阿仑膦酸钠对绝经后骨质疏松性骨痛的疗效分析
Background: Osteoporosis is a metabolic bone disease characterized by low bone component and regeneration of the microstructure of bone tissues, osteoporosis occurs in postmenopausal women for decreased estrogen level. Those women with osteoporosis often suffer from bone ache, such as pain at low back, back, knees and heels. In severe cases, there may be crookback or non- violent fracture. Objective: To discuss treatment effect of the Alendronate on 56 postmenopausal women with bone ache caused by osteoporosis. Unit: 210 Hospital of PLA.
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全面认识绝经妇女激素替代治疗的益处与风险
绝经妇女激素替代治疗(HRT)专指性激素补充治疗,其核心是补充雌激素(ERT),要求达到育龄妇女早卵泡期水平.为保护子宫内膜,在有完整子宫的妇女需配伍孕激素.在少数情况下可同时补充雄激素.HRT的临床应用已有30余年的历史,对其受益与风险比的认识一直经历着不断深入、更新的过程.近"妇女健康初始行动"(Women health initiative,WHI)研究中期报告的发表[1]又一次引起了轰动及疑惑,究竟还应不应该选用HRT?正在用HRT的妇女有多大风险?应该如何对待?为此有必要介绍一下WHI研究及有关的背景情况,讨论今后对HRT的态度.
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结合马雌激素对子宫切除后的绝经后妇女认知和情绪的影响
既往研究表明在绝经后妇女中,激素治疗仅对认知功能的某些方面,如词语和图像记忆以及快速注意力有作用.妇女健康计划记忆研究(WHIMS)的结果显示,与安慰剂组相比,65岁以上绝经后妇女接受结合马雌激素(CEE)和甲羟孕酮(MPA)联合治疗或CEE单药治疗后痴呆风险升高,总体认知功能减退[用Modified Mini-Mental State Exam(3MS)衡量].妇女健康计划认知老化研究(WHISCA)从WHIMS中选择无痴呆者作为研究对象,每年测试1次认知功能,共4次;评估激素治疗对特定领域认知功能的影响.与安慰剂相比,CEE+MPA对词语记忆有负面影响,对图像记忆有较正面影响,而对其他认知领域和情绪则无显著影响.
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绝经后妇女内源性性激素、肥胖和胰岛素抵抗与糖尿病发生的关系
横断面研究发现,在未使用激素替代的绝经后妇女中,血清生物可利用睾酮(T)、雌二醇(E2)增高、性激素结合球蛋白(SHBG)降低与空腹血糖受损(IFC)及2型糖尿病相关.
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绝经妇女激素替代治疗观点的历史演变
随着妇女平均寿命的延长,绝经后的问题日益受到全社会的广泛关注,旨在改善妇女生活质量的激素替代治疗(HRT)所引发的问题也不断涌现,HRT对绝经后妇女的生活质量究竟是否有总体益处已成为目前关注的焦点.2002年7月9日,美国国立卫生研究院(NIH)心脏、肺和血液研究所(NHLBI)宣布妇女健康初始行动(WHI)中雌激素加孕激素预防健康绝经后妇女的临床试验由于乳腺癌发病相对风险增加26%,且并无总体益处予以提前终止,这是一项按循证医学进行的重要研究结果,将对今后绝经后妇女HRT产生重大影响.自从1963年Wilson倡导HRT以来,HRT的发展走过了一段曲折之路,本文就其过去、现状和未来作一介绍.
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重视绝经后妇女的健康保健(二)绝经后阴道出血的病因和诊断
随着人类寿命延长,老年人疾病相对增多,绝经后妇女疾病的患病率也随之增加.我国妇女平均绝经年龄约为50岁左右,根据1994年世界卫生组织人类生殖特别规划委员会推荐,绝经的定义为妇女一生中的后1次月经,绝经的时间应在绝经后1年回顾性确定[1].因此,绝经后阴道出血(postmenopausal bleeding,PMB)系指绝经后1年以上的生殖道出血,是老年妇女常见的临床症状之一.引起绝经后阴道出血的疾病如下.
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前言——重视绝经后妇女的健康保健(一)
随着人民生活水平的提高,平均寿命明显延长,绝大多数妇女绝经后还要经历平均25年甚至更长的生命时间,因此应当重视绝经后妇女的健康与保健.
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绝经后女性骨密度与中心脉压关系的探讨
骨质疏校症是一种全身性的骨骼疾病,随着年龄的增大而日渐严重,特别在约经后女性人群中,这种骨代谢异常表现得尤为显著.