目的 探究黃體酮與地屈孕酮分別聯(lián)合低劑量結(jié)合雌激素治療圍絕經(jīng)期綜合征的療效。方法 選取2015年10月—2017年10月在昆山市第四人民醫(yī)院接受治療的80例圍絕期綜合征患者作為研究對象，根據(jù)治療方法將患者分為對照組和觀察組，每組各40例。對照組患者給予低劑量結(jié)合雌激素片0.3 mg/d；用藥12 d后口服地屈孕酮片，10 mg/d，持續(xù)用藥18 d。觀察組患者給予低劑量結(jié)合雌激素片0.3 mg/d；用藥12 d后，口服黃體酮軟膠囊100 mg/d，連續(xù)用藥18 d。30 d為一個用藥周期，周期之間無停藥間隔，兩組均治療3個周期。觀察兩組患者的臨床療效，同時比較兩組治療前后的Kupperman評分和血清激素水平。結(jié)果 治療后，觀察組臨床總有效率為85.00%，與對照組的77.50%差異無統(tǒng)計學(xué)意義。治療后，對照組和觀察組的Kupperman評分均顯著降低，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.01）；但兩組間的Kupperman評分比較無顯著差異。兩組治療后血清卵泡刺激素（FSH）、促黃體生成激素（LH）水平明顯下降；血清雌二醇（E₂）和抗苗勒管激素（AMH）水平顯著上升（P<0.05），且觀察組血清E₂和AMH水平顯著高于對照組（P<0.05）。結(jié)論 黃體酮與地屈孕酮聯(lián)合低劑量結(jié)合雌激素均可顯著地緩解圍絕經(jīng)期綜合征患者的癥狀，但黃體酮相比于地屈孕酮更能有效延緩患者卵巢功能衰退，改善患者體內(nèi)激素及卵巢功能相關(guān)因子水平。

Objective To explore the efficacy of progesterone and dydrogesterone combined with low dose conjugated estrogens in treatment of perimenopausal syndrome. Methods A total of 80 patients with perimenopausal syndrome who were treated in the Kunshan Fourth People's Hospital from October 2015 to October 2017 were selected as the research objects. According to the treatment methods, the patients were divided into control group and observation group, with 40 patients in each group. Patients in the control group were given low-dose Conjugated Estrogens Tablets at 0.3 mg/d. After 12 days of medication, patients were po administered with Dydrogesterone Tablets at 10 mg/d and continued for 18 days. Patients in the observation group were given a lowdose Conjugated Estrogens Tablets of 0.3 mg/d. After 12 days of administration, Patients were po administered with Progesterone Soft Capsules, 100 mg/d continuously for 18 days. 30 d was a medication cycle, with no stopping interval between cycles, and both groups were treated for 3 cycles. After treatment, the clinical effect in two groups were observed, and the Kupperman score, and serum hormone levels before and after treatment were compared. Results After treatment, the total clinical effective rate of the observation group was 85.00%, and the difference was not statistically significant compared with 77.50% of the control group. After treatment, Kupperman scores of the control group and the observation group were significantly decreased, and the difference in Kupperman scores in the same group was statistically significant (P<0.01). However, there was no significant difference in Kupperman score between two groups. After treatment, the serum levels of FSH and LH in two groups were decreased significantly, serum E 2 and AMH levels were significantly increased (P<0.05), and serum E₂ and AMH levels in the observation group were significantly higher than those in the control group (P<0.05). Conclusion Both progesterone and dydrogesterone combined with low dose conjugated estrogens can significantly alleviate the symptoms of patients with perimenopausal syndrome, but compared with dydrogesterone, progesterone can effectively delay the ovarian function decline, and improve the levels of hormones and factors related to ovarian function in patients.

R984