臺灣博碩士論文加值系統

停經和卵巢切除婦女都會因荷爾蒙 (動情激素) 的缺少, 使身體許多
系統發生改變; 因而以荷爾蒙來作為補充療法是相當普及的. 最近幾年
醫療單位開始採用經皮動情激素貼片治療. 經皮動情激素貼片為含有雌素
二醇 (Estradiol) 的經皮治療貼片, 病患使用方便. 雖然國外研究經皮
動情激素治療已有許多成果, 但是國內引進此方式治療於台灣婦女身上,
仍屬萌芽階段. 國內只有少數學者研究在經皮動情激素治療之後, 血中荷
爾蒙的變化效果. 因此我們以經皮動情激素貼片劑型, 作為 HRT 的投藥
途徑, 研究其對血中荷爾蒙及代謝方面的影響. 病患分為 A , B 二組.
A 組共 22 位停經婦女, 於門診接受每週二次的經皮動情激素貼片治療,
其中 5 位病患因為無法忍受皮膚搔癢的副作用而中止此項療程, 其餘 17
位則完成所有療程以及血清測定. 病患定期於使用前以及使用後的 3 個
月內, 分別固定每隔一個月抽血測定血中荷爾蒙數值, 肝功能的測定, 腎
功能的測定, 以及膽固醇和三酸甘油酯的測定. 病患治療結果在荷爾蒙的
測定方面, 均比使用貼片之前具有顯著差異, 其中 FSH , LH 明顯降低,
而 E2 呈明顯增加現象, 尤以第三個月效果最佳, 表示使用貼片治療能
有效改善病患的荷爾蒙缺乏現象. 肝功能, 腎功能以及膽固醇與三酸甘油
酯的測定, 在三個月內, 均較使用貼片之前無顯著差異; 而更長期的影
響, 則有待更進一步的觀察. B 組共 5 位婦女, 為婦科疾病而接受子
宮全切除以及兩側輸卵管, 卵巢全切除的婦女, 病患於術後 14 天開始接
受經皮動情激素貼片的使用. 病患於使用前先抽血測定血中荷爾蒙數值,
並於貼上經皮動情激素貼片後的 24 或 48 小時內, 再間隔抽血測定血中
荷爾蒙的數值. 結果各項荷爾蒙均在 24 小時以後才比使用貼片之前具有
顯著差異. 總而言之, 對於停經和卵巢切除的婦女使用經皮動情激素
貼片治療, 能有效地補充荷爾蒙, 並且無其它肝功能, 腎功能或脂肪方面
的副作用出現, 實不失為一個良好的荷爾蒙補充療法.

Although various regimens of hormonal replacement therapy
(HRT) have beenestablished, HRT can certainly be improved in
several ways. A transdermaldelivery system of estradiol was
applied to two groups of menopausal women.Group A included 22
menopausal women followed at gynecological OPD. The transdermal
patch, Estraderm TTS 50, which contains 4 mg Estradiol-17B
withdrug delivering rate of 50 ug of E2 per day, was applied to
the arms legsand lower abdomen twice a week. Serum hormone
levels (such as FSH,LH,E2),liver function test, renal function
test and cholesterol levels were measured before skin patches
usedand 1, 2, 3 months after application, respectively.
Seventeen of 22 womencompleted the treatment course and the
other 5 women could not tolerate theskin irritation. Significant
increase in estradiol serum levels as well as asignificant
decline in FSH, LH, serum levels were noted. However, there
wasno significant change in other parameters. Group B included 5
menopausal women,used patches 14 days after bilateral
oophorectomy. Short term changes of FSH,LH, E2 were evaluated.
Significant changes were noted only at 24 hours after
application. It seems that the rate of drug uptake by the skin
of menopausalwomen in south Taiwan is not quite optimal, or that
the subtropical climateof Kaohsiung influences the skin
characters, such as hydration. Further surveysare needed to
evaluate the detailed changes. Despite of its side effect of
skin irritation, the transdermal delivery system of estradiol is
still a goodregimen of HRT.