Objective To explore the rehabilitation effects of musicokinetic therapy on perimenopausal syndrome, so as to provide scientific basis for the treatment of perimenopausal syndrome. Methods Perimenopausal women living in Yiyang city were screened and then 100 cases aged 45 to 55 years with Kupperman score ≥15 and depression score (SDS) ≥0.5 were selected. They were then divided into two groups (experimental group: 50 cases treated by musicokinetic therapy; control group: 50 cases). Evaluation was taken using Kupperman scale and SDS scale 24 weeks after training. Results Compared to the control group, Kupperman scores and SDS scores in the musicokinetic therapy group were lower with a significant difference (Plt;0.01). There were significant differences in Kupperman scores and SDS scores (Plt;0.01) and in the single items of Kupperman scores in the musicokinetic therapy group before and after the experiment (Plt;0.05). Conclusion Musicokinetic therapy could significantly alleviate physical and psychological status of women with perimenopausal syndrome.
Objective To explore the relationship between periodontitis and postmenopausal osteoporosis.Methods Databases were electronically searched from PubMed (1966 to December, 2010), EMbase (1974 to December, 2010), CBM (1978 to December, 2010), VIP (1989 to December, 2010), CNKI (1979 to December, 2010) and WanFang Data (January, 2007 to December, 2010), and the references listed in all papers were also retrieved. The literature was screened according to the inclusion and exclusion criteria by two reviewers independently; the methodology quality was evaluated after data abstraction; and then the RevMan 5.0 software was used for meta-analyses. Results Four trials were included. Among the total 678 patients involved, 263 were postmenopausal osteoporosis patients, while the other 415 were non-osteoporosis patients. The results of meta-analyses showed that: a) Clinical attachment loss (CAL) of the postmenopausal osteoporosis patients was significantly higher than that of the non-osteoporosis patients (WMD=0.60, 95%CI 0.23 to 0.96); b) The level of gingival recession of the postmenopausal osteoporosis patients was significantly higher than that of the non-osteoporosis patients (WMD=0.78, 95%CI 0.41 to 1.14); c) There were no significant differences in plaque index (PI), gingival index (GI) and periodontal probing depth (PPD) between the two groups (WMD=0.17, 95%CI 0.00 to 0.35; WMD=0.05, 95%CI –0.09 to 0.19; and WMD=–0.08, 95%CI –0.24 to 0.09); d) The results of one study indicated that the rate of periodontitis in the postmenopausal osteoporosis patients was higher than that of the non-osteoporosis patients (OR=2.45, 95%CI 1.38 to 4.34, Plt;0.01); the severe alveolar crest height loss was related to osteoporosis (OR=4.20, 95%CI 1.57 to 11.22, Plt;0.01). Conclusion Postmenopausal osteoporosis patients are more prone to suffer from periodontitis or turn to the worse stage of periodontitis. In consideration of the factors such as small scales and incomplete measure indexes of the included studies, which have influences on the intensity and comprehensiveness of this conclusion, more high-quality studies are required.
Objective To assess the benefits and harms of traditional Chinese medicine in the treatment of postmenopausal osteoporosis. Methods We electronically searched MEDLINE (1966-2003), EMBASE (1974-2003), Controlled Trials Register and The National Research Register, The Cochrane Library Issue 4, 2003, CBM disc, VIP, CNKI, and CMCC. We also handsearched some related journals. The search was conducted in Nov., 2003. The quality of included randomized controlled trials was evaluated and meta-analysis was conducted by RevMan 4.2.2. Results We identified 33 studies including 2 337 patients and 27 traditional Chinese medicines. Some traditional Chinese medicines alone or integrated Chinese and Western medicine may be effective for improving patients’ bone mineral density, serum oestradiol and serum calcium. For example, Compared with placebo, Bushen Yigu soft extraction with WMD 0.76, 95% confidence interval 0.65 to 0.87, Bushen Qianggu capsule with WMD 39.94, 95% confidence interval 35.12 to 44.76 were effective for improving the level of serum oestradiol.There were no confirmed results of the other traditional Chinese medicines because of the small number of studies or inconsistent conclusions among studies. We didn’t find obvious side effects. Conclusions Some traditional Chinese medicines may be effective for treating postmenopausal osteoporosis. Due to the limited evidence identified, we can not draw a firm conclusion. More randomised controlled trials of high quality are needed for ber evidence.
Hot flashes are a common syndrome in postmenopausal women. The treatment is complex and different for specific patients. A clinical case and hormonal replacement therapy selection are provided to show evidence-based practice in this field.
目的 探讨独活寄生汤联合唑来膦酸治疗绝经后肝肾亏虚型骨质疏松症（PO）的疗效。 方法 选取2009年2月－2012年12月收治的210例绝经后肝肾亏虚型PO患者，且所有患者均愿意接受研究。采用随机对照试验法，将患者分为A、B、C 3组各70例。A组采用独活寄生汤联合唑来膦酸治疗；B组采用唑来膦酸治疗；C组采用独活寄生汤治疗。观察3组患者治疗前后骨密度、骨源性碱性磷酸酶（NBAP）、骨钙素（BGP）、雌二醇（E2）变化，疗效及不良反应。 结果 骨密度、NBAP、BGP、E2各项指标，治疗前3组患者比较差异无统计学意义（P＞0.05）；治疗后A组各项指标明显优于B组、C组（P＜0.05）；B组与C组对比，差异无统计学意义（P＞0.05）；治疗后A组总有效率为97.14%，与B组、C组对比，差异有统计学意义（P＜0.05）。3组均未见严重不良反应。 结论 独活寄生汤联合唑来膦酸治疗绝经后肝肾亏虚型PO疗效显著，可有效提高患者骨密度、BGP、E2含量，降低骨源性碱性磷酸酶含量，缓解骨质疏松，且无严重不良反应发生，值得临床推广。
目的 探讨盐酸氨基葡萄糖联合降钙素对绝经后膝骨关节炎基质金属蛋白酶3（MMP-3）和骨桥蛋白（OPN）表达的影响。 方法 2012年1月－6月将120例绝经后膝骨关节炎妇女随机分为盐酸氨基葡萄糖组（A组）、盐酸氨基葡萄糖+依降钙素组（B组）、依降钙素组（C组），每组40例，采用酶联免疫吸附试验测定各组血清MMP-3、OPN、雌二醇、Ⅰ型胶原C端肽（CTX）和Ⅰ型胶原N端前肽（PINP）水平。 结果 A组和B组在治疗后2周和6周其膝关节评分和视觉模拟评分明显优于C组（P＜0.05），A组在治疗后2周MMP-3的表达改善明显（P＜0.05），优于其他两组。治疗后6周，B组OPN表达水平改善明显（P＜0.05），优于其他两组。C组和B组CTX和PINP水平明显改善（P＜0.05），优于A组。 结论 盐酸氨基葡萄糖联合降钙素能有效改善绝经后膝骨关节炎的症状，可能通过调节MMP-3和OPN的复合体表达，实现改善关节软骨功能的目的。
Primary osteoporosis is a severe social problem. It bothers the health of many aged people. Since May 1993, The doubleenergy density of bone test was carried out in postmenopausal women, among them, in 34 cases the concentration of estrogen, calcitonin parathyroidin, calcium and phosphorus in serum were examined. The results were as follows: the bone density decreased obviously while the serum calitonin and parathyroidun levels were high or low, was risen and fallen, but the serum calcium was higher than normal. Three types of osteoporosis in clinicspo stulated: 1.calcitonin and parathyroidin were normal or absent; 2.calcitonin was higher; 3.parathyroidin was higher. The treatment of the different types shouldbe individulized.
Objective To evaluate the efficacy and safety of mifepristone for perimenopause dysfunctional uterine bleeding (PDUB). Methods Such databases as VIP, CNKI, Wanfang and CBM were retrieved for collecting randomized controlled trials (RCTs) on mifepristone for PDUB. The quality of included studies was evaluated and Meta-analysis was performed according to the Cochrane methods. Results Forty RCTs involving 3 850 PDUB patients were included. The control group was divided into two sub-groups according to the features of intervention drugs: the sub-group of diagnostic curettage plus progestational hormone, and the sub-group of diagnostic curettage plus antiestrogenic drugs. The Meta-analysis indicated that compared with the sub-group of diagnostic curettage plus progestational hormone, the diagnostic curettage plus mifepristone group was more effective to increase the total effective rate, such as improving symptoms and signs of PDUB (RR=1.11, 95%CI 1.06 to 1.16, Plt;0.000 01), and to reduce recurrence (RR=0.44, 95%CI 0.36 to 0.52, Plt;0.000 01). But no differences were found between the two groups in the change of endometrial thickness, contents of hemoglobin, and serum level of FSH, LH, E2 and P hormone. Both the intervention and control groups appeared mild adverse reactions, such as rashes, tidal fever, nausea, anorexia, vomiting and breast distending, but with no liver and kidney damages. The long-term safety failed to be evaluated due to short follow-up time. Conclusion Based on this review, diagnostic curettage plus mifepristone shows certain advantage in the treatment of PDUB including the total effective rate and reducing recurrence. But there is no difference in regulating sex hormone level, inhibiting endometrial proliferation and improving anemia compared with the group of diagnostic curettage plus progestational hormone. However, this evidence is not b enough due to the low quality of included trials, possible bias risk, and failure of evaluating its long-term safety.
Objective To evaluate the effectiveness of hormone replacement therapy (HRT) for osteoporosis in postmenopausal women. Method Systematic reviews and meta-analyses were searched in Cochrane Library (Issue 4, 2008), MEDLINE (1978-2008) and Clinical Evidence database. Search terms included Postmenopausal (post-menopausal) osteoporosis, therapy, vertebral fracture, hormone replacement therapy, randomized controlled trial, meta analysis, female,human. Result A total of 4 protocols were found in Cochrane Library and a meta-analyse was found in MEDLINE. The result demonstrated that both cancellous and cortical bone mineral density increased after HRT. Statistically significant reductions in the risk of vertebral and non-vertebral fracture were also found. Conclusion HRT can reduce the risk of osteoporotic fracture by increasing bone density. However, other disease and adverse event were also associated with the BMD increase. Therefore, both advantage and disadvantage should be considered before applying HRT therapy to postmenopausal osteoporosis patients.
Objective To assess the efficacy and safety of parathyroid hormone (PTH) on bone mineral density (BMD) and fractures in postmenopausal women with osteoporosis. Methods We searched MEDLINE (1966 to March 2008), EMBASE (1974 to March 2008), The Cochrane Library (Issue 1, 2008), Current Controlled Trials, The National Research Register, CBM (1983 to March 2008) and CNKI (1994 to March 2008). Some related journals were hand searched as well. The quality of included randomized controlled trials (RCTs) was evaluated and meta-analysis was conducted by The Cochrane Collaboration’s software RevMan 4.2.10. Results Twelve studies involving 5550 patients were included. PTH alone or in combination with antiresorptive drugs reduced the risk of vertebral fracture (RR=0.34, 95%CI 0.26 to 0.45, Plt;0.000 01), and increased spine BMD (SMD 0.41, 95%CI 0.17 to 0.65, P=0.0009) and femoral neck BMD (SMD 0.13, 95%CI 0.03 to 0.22, P=0.008). The rate of drop out and loss to follow-up because of adverse events was significantly higher in the PTH group (Peto-OR=1.69, 95%CI 1.39 to 2.05, Plt;0.000 01). Conclusion PTH is effective in the prevention and treatment of postmenopausal osteoporosis, especially in patients with preexisting osteoporotic fractures or with very low bone density. PTH alone or in combination with antiresorptive drugs can reduce the risk of vertebral fractures and increase spine and femoral neck BMD. PTH is more effective than alendronate, but these two should not be used as a combined treatment.