龜鹿二仙膠治療更年期綜合症之臨床評估

Clinical Evaluation of Guilu Erxian Jiao in Treating Perimenopausal Syndrome

在台灣，有46%絕經前後女性經歷過更年期綜合症。常見的症狀有失眠、熱潮紅、潮熱盜汗及心悸。目前治療的主流為賀爾蒙替代療法。但許多患有更年期綜合症的婦女會自行選用龜鹿二仙膠而不願使用賀爾蒙替代療法。因此，本研究的主要目標在於研究龜鹿二仙膠是否能緩解更年期綜合症。本研究將患有更年期綜合症的婦女分為三組，分別為每天服用龜鹿二仙膠200 毫克、100 毫克、及安慰劑（澱粉）之三組。各組每日均服用一顆膠囊一次，內含上述三組成分，共連續服用兩個月。分別在治療前、治療中（治療後一個月）、及治療後（治療後兩個月）測量三組婦女血中雌激素、促濾泡成熟素濃度。臨床症狀部分，則以問卷方式分別在治療前及治療後（治療後兩個月）評估婦女生理及心理等不同面向的更年期症狀。結果顯示，經歷兩個月的治療，血中雌激素濃度在高劑量組（每日服用200 毫克龜鹿二仙膠）有顯著上升（p < 0.05）。但是在血中促濾泡成熟素濃度方面，三組均無顯著差異。臨床症狀方面，雖然高劑量組及低劑量組分別比安慰組在許多面向均有改善（p < 0.05），但整體看來，低劑量組（每日服用100 毫克龜鹿二仙膠）的治療效益較高，尤其表現在改善潮熱盜汗及心悸上。因此，我們的結論為龜鹿二仙膠對於治療更年期綜合症是有效的。In Taiwan, approximately 46% of women during perimenopause have experienced perimenopausal syndrome, which mostly includes insomnia, hot flushes and sweating, and palpitation. Hormonal replacement therapy (HRT) is the mainstream treatment of perimenopausal syndrome. However, many women suffering from perimenopausal syndrome would prefer to take Guilu Erxian Jiao (GEJ) rather than receive HRT. Therefore, the aim of this study is to determine whether GEJ helps relieve perimenopausal syndrome. We treated perimenopausal women who suffered from perimenopausal symptoms and divided them into three groups, administering GEJ at 200 mg per day, 100 mg per day, and a placebo (GEJ-free starch powder), all of which were in the same capsule form with one capsule administered per day for 2 months. Serum estradiol and follicle-stimulating hormone (FSH) levels were tested at three stages: pre-treatment, 1-month post-treatment, and 2-month post-treatment. The clinical symptoms were estimated using the questionnaire of physical and mental symptoms during perimenopause before and after 2 months of treatment. After 2 months of treatment, serum estradiol levels were significantly elevated in the high-dose group (200 mg/day) (P < 0.05). However, no significant differences of serum FSH levels were observed among the three groups after GEJ treatment. Although improvements were observed in both the high-dose and low-dose groups, more amelioration in clinical symptoms was noted in the low-dose group (100 mg/day) than in the high-dose group, especially for hectic sweats and palpitation. GEJ is effective for relieving perimenopausal syndrome, and taking high-dose GEJ once per day for 2 months elevates more serum estradiol levels than does taking a low dose. Therefore, we concluded that GEJ is beneficial for treating perimenopausal syndrome.