目的 探討定坤丹聯(lián)合替勃龍治療圍絕經(jīng)期綜合征的臨床療效。方法 選取2018年8月—2019年8月至新鄭市人民醫(yī)院就診的圍絕經(jīng)期綜合征患者82例，隨機(jī)分為對(duì)照組和治療組，每組各41例。對(duì)照組口服替勃龍片，2.5 mg/次，1次/d。治療組在對(duì)照組基礎(chǔ)上口服定坤丹，6 g/次，2次/d。所有患者均治療3個(gè)月。比較兩組的臨床療效，觀察兩組治療前后漢密爾頓焦慮量表（HAMA）評(píng)分、漢密爾頓抑郁量表（HAMD）評(píng)分、Kupperman絕經(jīng)指數(shù)（KMI）評(píng)分及血清雌二醇（E₂）、卵泡刺激素（FSH）、促黃體生成激素（LH）、三酰甘油（TG）、總膽固醇（TC）、低密度脂蛋白膽固醇（LDL-C）、高密度脂蛋白膽固醇（HDL-C），γ-干擾素（IFN-γ）、白細(xì)胞介素-2（IL-2）、IL-4、IL-10，外周血CD3⁺、CD4⁺、CD8⁺水平。結(jié)果 治療后，治療組總有效率是95.12%，顯著高于對(duì)照組的80.49%（P<0.05）。治療后，兩組HAMA評(píng)分、HAMD評(píng)分、KMI評(píng)分均顯著低于同組治療前（P<0.05）；且治療后治療組相關(guān)評(píng)分均顯著低于對(duì)照組（P<0.05）。治療后，兩組E₂顯著升高，而FSH、LH均顯著低于同組治療前（P<0.05）；且治療后治療組激素水平顯著優(yōu)于對(duì)照組（P<0.05）。治療后，兩組患者血清TG、TC、LDL-C水平均低于治療前，但血清HDL-C水平均高于治療前（P<0.05）；治療后，治療組血脂水平優(yōu)于對(duì)照組（P<0.05）。治療后，兩組血清INF-g、IL-2水平均低于治療前，但血清IL-4、IL-10水平均高于治療前（P<0.05）；治療后，治療組患者這些血清炎性因子水平優(yōu)于對(duì)照組（P<0.05）。治療后，兩組CD3⁺、CD4⁺水平均高于治療前，但CD8⁺水平均低于治療前（P<0.05）；且治療后，治療組淋巴細(xì)胞水平優(yōu)于對(duì)照組（P<0.05）。結(jié)論 定坤丹聯(lián)合替勃龍治療圍絕經(jīng)期綜合征具有較好的臨床療效，可有效減輕患者負(fù)面情緒，調(diào)節(jié)雌激素水平，改善血脂代謝，提高免疫應(yīng)答能力，具有一定的臨床推廣應(yīng)用價(jià)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