目的揭示萎缩性阴道炎患者阴道群落特征,并探讨阴道菌群结构与萎缩性阴道炎发病之间的潜在关联。方法共纳入30名萎缩性阴道炎患者参与本研究(萎缩性阴道炎组),另有30名进行体检的绝经后健康妇女作为对照组。以16S r RNA基因为研究靶点,...目的揭示萎缩性阴道炎患者阴道群落特征,并探讨阴道菌群结构与萎缩性阴道炎发病之间的潜在关联。方法共纳入30名萎缩性阴道炎患者参与本研究(萎缩性阴道炎组),另有30名进行体检的绝经后健康妇女作为对照组。以16S r RNA基因为研究靶点,采用Illumina第二代高通量测序技术结合生物信息学分析,得阴道菌群结构数据。采用正则变量的逐步判别分析,对两组间群落组成的关联和差异进行比较。采用Spearman等级回归分析,探讨单个物种数量与疾病严重程度间的关系。结果在所有60例中,总共测得288个属的细菌。萎缩性阴道炎组和对照组间阴道菌群总体结构差异有统计学意义(P<0.05)。其中12个属的主要细菌相对丰度差异显著。在绝经后正常妇女的阴道内,乳酸杆菌占据整个阴道微生物群落主导地位。萎缩性阴道炎组阴道加德纳菌相对丰度(41.7%)显著高于对照组(16.7%,P<0.000 1),并取代乳酸杆菌成为阴道群落中生物优势最大的种群。萎缩性阴道炎组的乳酸杆菌失去了其生物优势地位,相对丰度(11.2%)显著低于对照组(53.2%,P<0.000 1)。相关性分析显示,萎缩性阴道炎组患者生殖道症状的严重程度与乳酸杆菌的相对丰度呈显著负相关(r=-0.301,P<0.001),而与加德纳菌(r=0.278,P<0.001)及奇异菌属(r=0.166,P<0.05)的数量呈显著正相关。结论阴道微生物群落失衡与萎缩性阴道炎发病存在关联。对于绝经后女性而言,处于生物优势地位的乳酸杆菌在维持阴道健康方面起到更为重要的作用。而阴道加德纳菌属和奇异菌属与绝经后妇女生殖道萎缩症状的严重程度有关,且这2种微生物的过度生长可能增加了罹患萎缩性阴道炎的风险。展开更多
Objective： To evaluate the efficacy and safety of Heyan Kuntai Capsule（和颜坤泰胶囊, HYKT） and hormone therapy（HT） on perimenopausal syndromes（PMSs）. Methods： From 2005 to 2008, 390 women with PMSs were recrui...Objective： To evaluate the efficacy and safety of Heyan Kuntai Capsule（和颜坤泰胶囊, HYKT） and hormone therapy（HT） on perimenopausal syndromes（PMSs）. Methods： From 2005 to 2008, 390 women with PMSs were recruited from 4 clinic centers. The inclusion criteria included ages 40 to 60 years, estradiol（E2） below 30 ng/L, and follicle stimulating hormone（FSH） above 40 IU/L, etc. The patients were randomly assigned to HYKT group or HT group by random number table method, administrated HYKT or conjugated estrogen with/without medroxyprogesterone acetate tablets for 12 months. During treatment, the patients were interviewed quarterly, Kupperman Menopausal Index（KMI） scores, hot flush scores, insomnia scores, Menopause-Specific Quality of Life（MENQOL） scores and adverse effects were used for evaluating drug efficacy and safety respectively. The last interview was made at the end of 12-month treatment. Results： After treatment, KMI scores of HYKT group and HT group were both significantly decreased compared with baseline（P〈0.01） and there was no significant difference between groups（P〉0.05）, except that KMI of HYKT group was higher after 3-month treatment（P〈0.05）. After treatment, hot flush and insomnia scores were both improved significantly in two groups（P〈0.01）; and HT had a better performance than HYKT in improving hot flush（P〈0.05）. MENQOL were significantly improved in both groups after treatment（P〈0.01）; but there was no significant difference between two groups（P〉0.05）. The incidence of adverse event in the HYKT group was much lower than that in the HT group（P〈0.01）. Conclusions： HYKT could effectively relieve PMSs and improve patient quality of life without severe adverse reactions. Although HYKT exerted curative effects more slowly than hormone, it possessed better safety profile than hormone.展开更多
Background： Menopausal hormone therapy （MHT） has been proven to have beneficial effects on several components of metabolic syndrome. However, the effects vary according to different regimens, dosages, and duration ...Background： Menopausal hormone therapy （MHT） has been proven to have beneficial effects on several components of metabolic syndrome. However, the effects vary according to different regimens, dosages, and duration of MHT. The aim of the study was to evaluate the effect of standard-dose 0.625 mg conjugated equine estrogen （CEE） and half-dose 0.3 mg CEE daily with different progestogens in a continuous sequential regimen on postmenopausal metabolic parameters in generally healthy postmenopausal women. Methods： A prospective, open-label, randomized controlled clinical trial was conducted between February 2014 and December 2015. Totally 123 Chinese postmenopausal women with climacteric symptoms were included in this study and were randomly assigned to three groups： Group A received CEE 0.3 mg/micronized progesterone （MP） 100 mg daily; Group B received CEE 0.625 mg/MP 100 mg daily; and Group C received CEE 0.625 mg/dydrogesterone 10 mg daily. Drugs were given in a continuous sequential pattern. The duration of treatment was 12 months. Clinical, anthropometrical, and metabolic variables were measured. Data were analyzed according to intention-to-treat analysis, using Student＇s t-test and analysis of variance. Results： A total of 107 participants completed the 12-month follow-up and were included in the data analysis. At 12 months of treatment, high-density lipoprotein cholesterol and apolipoprotein A significantly increased, and low-density lipoprotein cholesterol, fasting glucose, and glycosylated hemoglobin significantly decreased in Groups B and C, compared with baseline （all P 〈 0.05）. Among the three groups, only Group C showed significantly increased triglycerides compared with baseline （ 1.61 ± 0.80 mmol/L vs. 1.21 ± 0.52 mmol/L, P 0.026）. Each group showed a neutral effect on total cholesterol, lipoprotein A, apolipoprotein B, and fasting insulin levels. No cardiovascular and venous thromboembolic events occurred in the three groups. Conclusions： Among Chinese postmenopausal 展开更多
2002年美国妇女健康干预(Women’s Health Initiative,WHI)的发表使绝经激素治疗进入了一个低谷。近10年来该领域取得了重大进展,目前的观点已经有很大的不同。该文在具体介绍WHI研究后,着重介绍了该领域10年来的最重要研究,包括WHI再...2002年美国妇女健康干预(Women’s Health Initiative,WHI)的发表使绝经激素治疗进入了一个低谷。近10年来该领域取得了重大进展,目前的观点已经有很大的不同。该文在具体介绍WHI研究后,着重介绍了该领域10年来的最重要研究,包括WHI再分析、丹麦的DOPS研究、欧洲的EURAS-HRT研究等,突出了这10年来最重要的进展为"窗口期"理论和孕激素选择。最后介绍了2013年关于绝经激素治疗(menopausal hormone therapy,MHT)的国际共识要点。展开更多
OBJECTIVE: To determine the therapeutic effect of Ziyin Jianghuo Ningxin Decoction(ZYJHNXD) plus dehydroepiandrosterone(DHEA) and menopausalhormone therapy(MHT) in patients suffering from menopausal symptoms identifie...OBJECTIVE: To determine the therapeutic effect of Ziyin Jianghuo Ningxin Decoction(ZYJHNXD) plus dehydroepiandrosterone(DHEA) and menopausalhormone therapy(MHT) in patients suffering from menopausal symptoms identified as, in terms of Traditional Chinese Medicine, symptom pattern of Yin deficiency with hyperactive fire.METHODS: Totally 180 postmenopausal women aged 40 to 60 years were assigned into four groups and accepted femoston, femoston with ZYJHNXD,femoston with DHEA, femoston with ZYJHNXD and DHEA therapies, respectively, for three months.Common questionnaire-based measure instruments included modified Kupperman index(MKI),Hamilton Rating Scale for Anxiety(HAMA), and Hamilton Rating Scale for Depression(HAMD). Follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E2), 5-hydroxyindole-3-acetic acid(5-HIAA), norepinephrine(NE), dopamine(DA),bone mineral density(BMD), and sleep quality were evaluated before and three months after the treatments.RESULTS: In all four groups, the scores of MKI, HAMA, HAMD and the levels of FSH, LH decreased significantly(P < 0.05) after the treatment, while the levels of E2, 5-HIAA, NE, and DA showed obvious elevation(P < 0.05). The group receiving ZYJHNXD and DHEA combined with femoston had superiority in the preservation of bone mineral density and improvement of total sleep time and nighttime sleep time over the other three groups.CONCLUSION: ZYJHNXD and DHEA combined with MHT therapy have a favorable outcome in managing menopausal symptoms, restoring hormone levels, preventing skeletal rarefaction or osteoporosis,and improving sleep quality for postmenopausal women.展开更多
文摘目的揭示萎缩性阴道炎患者阴道群落特征,并探讨阴道菌群结构与萎缩性阴道炎发病之间的潜在关联。方法共纳入30名萎缩性阴道炎患者参与本研究(萎缩性阴道炎组),另有30名进行体检的绝经后健康妇女作为对照组。以16S r RNA基因为研究靶点,采用Illumina第二代高通量测序技术结合生物信息学分析,得阴道菌群结构数据。采用正则变量的逐步判别分析,对两组间群落组成的关联和差异进行比较。采用Spearman等级回归分析,探讨单个物种数量与疾病严重程度间的关系。结果在所有60例中,总共测得288个属的细菌。萎缩性阴道炎组和对照组间阴道菌群总体结构差异有统计学意义(P<0.05)。其中12个属的主要细菌相对丰度差异显著。在绝经后正常妇女的阴道内,乳酸杆菌占据整个阴道微生物群落主导地位。萎缩性阴道炎组阴道加德纳菌相对丰度(41.7%)显著高于对照组(16.7%,P<0.000 1),并取代乳酸杆菌成为阴道群落中生物优势最大的种群。萎缩性阴道炎组的乳酸杆菌失去了其生物优势地位,相对丰度(11.2%)显著低于对照组(53.2%,P<0.000 1)。相关性分析显示,萎缩性阴道炎组患者生殖道症状的严重程度与乳酸杆菌的相对丰度呈显著负相关(r=-0.301,P<0.001),而与加德纳菌(r=0.278,P<0.001)及奇异菌属(r=0.166,P<0.05)的数量呈显著正相关。结论阴道微生物群落失衡与萎缩性阴道炎发病存在关联。对于绝经后女性而言,处于生物优势地位的乳酸杆菌在维持阴道健康方面起到更为重要的作用。而阴道加德纳菌属和奇异菌属与绝经后妇女生殖道萎缩症状的严重程度有关,且这2种微生物的过度生长可能增加了罹患萎缩性阴道炎的风险。
基金Supported by the"Tenth-Five"National Medical Science and Technique Foundation,China(No.2004BA720A08)
文摘Objective： To evaluate the efficacy and safety of Heyan Kuntai Capsule（和颜坤泰胶囊, HYKT） and hormone therapy（HT） on perimenopausal syndromes（PMSs）. Methods： From 2005 to 2008, 390 women with PMSs were recruited from 4 clinic centers. The inclusion criteria included ages 40 to 60 years, estradiol（E2） below 30 ng/L, and follicle stimulating hormone（FSH） above 40 IU/L, etc. The patients were randomly assigned to HYKT group or HT group by random number table method, administrated HYKT or conjugated estrogen with/without medroxyprogesterone acetate tablets for 12 months. During treatment, the patients were interviewed quarterly, Kupperman Menopausal Index（KMI） scores, hot flush scores, insomnia scores, Menopause-Specific Quality of Life（MENQOL） scores and adverse effects were used for evaluating drug efficacy and safety respectively. The last interview was made at the end of 12-month treatment. Results： After treatment, KMI scores of HYKT group and HT group were both significantly decreased compared with baseline（P〈0.01） and there was no significant difference between groups（P〉0.05）, except that KMI of HYKT group was higher after 3-month treatment（P〈0.05）. After treatment, hot flush and insomnia scores were both improved significantly in two groups（P〈0.01）; and HT had a better performance than HYKT in improving hot flush（P〈0.05）. MENQOL were significantly improved in both groups after treatment（P〈0.01）; but there was no significant difference between two groups（P〉0.05）. The incidence of adverse event in the HYKT group was much lower than that in the HT group（P〈0.01）. Conclusions： HYKT could effectively relieve PMSs and improve patient quality of life without severe adverse reactions. Although HYKT exerted curative effects more slowly than hormone, it possessed better safety profile than hormone.
文摘Background： Menopausal hormone therapy （MHT） has been proven to have beneficial effects on several components of metabolic syndrome. However, the effects vary according to different regimens, dosages, and duration of MHT. The aim of the study was to evaluate the effect of standard-dose 0.625 mg conjugated equine estrogen （CEE） and half-dose 0.3 mg CEE daily with different progestogens in a continuous sequential regimen on postmenopausal metabolic parameters in generally healthy postmenopausal women. Methods： A prospective, open-label, randomized controlled clinical trial was conducted between February 2014 and December 2015. Totally 123 Chinese postmenopausal women with climacteric symptoms were included in this study and were randomly assigned to three groups： Group A received CEE 0.3 mg/micronized progesterone （MP） 100 mg daily; Group B received CEE 0.625 mg/MP 100 mg daily; and Group C received CEE 0.625 mg/dydrogesterone 10 mg daily. Drugs were given in a continuous sequential pattern. The duration of treatment was 12 months. Clinical, anthropometrical, and metabolic variables were measured. Data were analyzed according to intention-to-treat analysis, using Student＇s t-test and analysis of variance. Results： A total of 107 participants completed the 12-month follow-up and were included in the data analysis. At 12 months of treatment, high-density lipoprotein cholesterol and apolipoprotein A significantly increased, and low-density lipoprotein cholesterol, fasting glucose, and glycosylated hemoglobin significantly decreased in Groups B and C, compared with baseline （all P 〈 0.05）. Among the three groups, only Group C showed significantly increased triglycerides compared with baseline （ 1.61 ± 0.80 mmol/L vs. 1.21 ± 0.52 mmol/L, P 0.026）. Each group showed a neutral effect on total cholesterol, lipoprotein A, apolipoprotein B, and fasting insulin levels. No cardiovascular and venous thromboembolic events occurred in the three groups. Conclusions： Among Chinese postmenopausal
文摘2002年美国妇女健康干预(Women’s Health Initiative,WHI)的发表使绝经激素治疗进入了一个低谷。近10年来该领域取得了重大进展,目前的观点已经有很大的不同。该文在具体介绍WHI研究后,着重介绍了该领域10年来的最重要研究,包括WHI再分析、丹麦的DOPS研究、欧洲的EURAS-HRT研究等,突出了这10年来最重要的进展为"窗口期"理论和孕激素选择。最后介绍了2013年关于绝经激素治疗(menopausal hormone therapy,MHT)的国际共识要点。
基金Supported by the National Natural Science Foundation of China(No.31571196)the Science and Technology Commission of Shanghai Municipality 2015 YIXUEYINGDAO project(No.15401932200)+3 种基金the FY2008 JSPS Postdoctoral Fellowship for Foreign Researchers P08471the National Natural Science Foundation of China(No.30801502)the Shanghai Pujiang Program(No.11PJ1401900)Development Project of Shanghai Peak Disciplines-Integrative Medicine(No.20150407)
文摘OBJECTIVE: To determine the therapeutic effect of Ziyin Jianghuo Ningxin Decoction(ZYJHNXD) plus dehydroepiandrosterone(DHEA) and menopausalhormone therapy(MHT) in patients suffering from menopausal symptoms identified as, in terms of Traditional Chinese Medicine, symptom pattern of Yin deficiency with hyperactive fire.METHODS: Totally 180 postmenopausal women aged 40 to 60 years were assigned into four groups and accepted femoston, femoston with ZYJHNXD,femoston with DHEA, femoston with ZYJHNXD and DHEA therapies, respectively, for three months.Common questionnaire-based measure instruments included modified Kupperman index(MKI),Hamilton Rating Scale for Anxiety(HAMA), and Hamilton Rating Scale for Depression(HAMD). Follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E2), 5-hydroxyindole-3-acetic acid(5-HIAA), norepinephrine(NE), dopamine(DA),bone mineral density(BMD), and sleep quality were evaluated before and three months after the treatments.RESULTS: In all four groups, the scores of MKI, HAMA, HAMD and the levels of FSH, LH decreased significantly(P < 0.05) after the treatment, while the levels of E2, 5-HIAA, NE, and DA showed obvious elevation(P < 0.05). The group receiving ZYJHNXD and DHEA combined with femoston had superiority in the preservation of bone mineral density and improvement of total sleep time and nighttime sleep time over the other three groups.CONCLUSION: ZYJHNXD and DHEA combined with MHT therapy have a favorable outcome in managing menopausal symptoms, restoring hormone levels, preventing skeletal rarefaction or osteoporosis,and improving sleep quality for postmenopausal women.
