中国临床药学杂志

目的 调查绝经综合征患者的治疗现状，并分析激素治疗中断的原因。方法 选取2023年1至12月就诊并诊断为绝经综合征的患者351例作为研究对象，在门诊病历系统中收集患者相关资料，统计并分析患者治疗现状。对患者进行电话随访，调查患者选择非激素治疗和激素治疗中断的原因。结果 351例绝经综合征患者的主诉以血管舒缩症状为主（占57.5%）。就诊科室以妇科为主（占69.2%）。351例患者年龄为[50(48,54)]岁。绝经综合征患者中接受过健康宣教和生活方式指导的占74.9%，其中妇科和内分泌科的健康宣教率分别为93.4%和29.3%。在治疗方案的选择方面，选择绝经激素治疗的患者占45.0%,48.1%的患者采用非绝经激素治疗。开启绝经激素治疗的患者中，采用雌孕激素序贯治疗的患者占63.3%，采用雌激素制剂的患者占17.7%。非绝经激素治疗的患者多采用有绝经综合征适应证的中药治疗（占81.7%）。随访调查结果显示，采用非绝经激素治疗的患者有169例（占48.1%），原因以“自觉症状较轻，先尝试非激素治疗”为主（占28.0%）。随访到的采用绝经激素治疗的患者有123例，其中19.5%中断治疗，原因以“嫌麻烦，不愿经常复查”为主（占41.7%）。结论 非妇科的医务人员对绝经综合征患者的健康宣教率和患者对绝经激素治疗的认知水平均有待提高。有适应证的中药是不采用绝经激素治疗患者的主要选择。启动绝经激素治疗的患者大多能遵医嘱用药，少数自行中断治疗，“不愿经常复查”是影响患者持续绝经激素治疗的主要原因。

AIM To investigate the current situation of treatment for patients with menopausal syndrome and the reasons for interruption of hormone therapy. METHODS The patients who visited the outpatient clinic from January 2023 to December 2023 and were diagnosed with menopausal syndrome were recruited retrospectively. Materials were collected by logging into the outpatient medical record system, followed by statistical analysis of the current status of patient treatment. Telephone follow-up was conducted among the patients who had received treatment to determine the reasons for choosing non-hormonal therapy and the reasons for hormone therapy interruption. RESULTS A total of 351 patients with menopausal syndrome were enrolled. The main chief complaint was vasomotor symptoms(57.5%). The first department of consultation was gynecology(69.2%). The 351 patients had a mean age of 50(48, 54) years. Among menopausal syndrome patients, 74.9% received health education and lifestyle guidance. The gynecology department achieved a 93.4% health education rate, followed by the endocrinology department at 29.3%. Regarding the choice of treatment regimen, 45.0% of patients initiated MHT, and 48.1% chose non-MHT. Estrogen-progestin sequential therapy was the most commonly used in patients who turned on MHT, accounting for 63.3%, followed by estrogen-only therapy(17.7%). For patients receiving non-MHT therapy, treatment primarily involved the use of traditional Chinese medicine with indications of menopausal syndrome(81.7%). The follow-up survey results showed that 169 patients(48.1%) received non-menopausal hormone therapy, and the primary reason was "My symptoms were mild, just started with non-MHT", which amounted to 28.0%. Of the patients who turned on MHT, 123 received telephone follow-up, 19.5% of whom interrupted treatment. The main reason for interrupting treatment was "too much trouble and unwilling to undergo clinical follow-up frequently" which amounted to 41.7%. CONCLUSION Both the rate of health education provided by non-gynecological medical personnel to patients with menopausal syndrome and patients' knowledge level of menopausal hormone therapy require improvement. Traditional Chinese medicine with indications is the primary treatment option for patients who used non-MHT therapies. Among patients initiating MHT, most adhered to medical advice, while a minority of patients discontinued treatment on their own. The need for frequent follow-up examinations is the primary factor affecting patients' continuation of MHT.