Assessment Of Effect Of Black Cohosh For Controlling Of Peri-menopausal Symptoms In GnRH-a Treatment For Endometriosis Atfer Laparoscopic Surgey

Objective:To investigate the effect of Black cohsh treating permenopausalsymptoms in GnRH-a treatment for endometriosis after laparoscopic surgey.Methods: Clinical data of120patients with endometriosis who underwentGnRH-a treatment after laparoscopic surgery from August,2010to June,2012wereretrospectively analyzed. They were divided into3groups,which respectively,Remifemin group,Control group1and control group,based on the patient’s subjectiveintension,the economic situation,the mental ability and so on.They all has been knownto the detailed drug treatments in advance. All patients accepted injection of Goserelin(3.6mg， i.h.) once28days for6times.Starting from the second time of usedGoserelin,the patients of Remifemin group took extra Remifemin tablet (2mg per dayfor56days,then increased to4mg per day for84days)orally every day and the patientsof Control group1took extra2.5mg Livial tablet orally every day.Before and after(4w,12w,24w,respectively) the treatment, clinical parameters were recorded andanalyzed, including total score of Kupperman menopause index(KMI) and single itemscore of KM1, endometrial thickness,bone density, the serum level of FSH，LH andE2,recurrence ratio. Endometrial thickness was detected by Ultrasound．Results:①The KMI and the score of hot flashes sweating:At timepoint of4weeks,the score of all groups were significantly increased than those before the drugtreatments(P<0.05);at timepoint of12weeks and24weeks, the score of Remifemingroup and control group1were significantly decreased than those in control group2(P<0.05);for the control group2,the score were gradually increased, the difference wasstatistically significant (P<0.05);②The score of the CES-D: at timepoint of24weeks,the score of Remifemin group and control group1were significantly decreased thanthose in control group2(P<0.05); the score of the control group2were gradually increased, the difference was statistically significant (P<0.05);③The blood level ofestrogen:accepted the injection of Goserelin, the blood level of estrogen of controlgroup1were significantly increased than those in other groups (P<0.05); the blood levelof estrogen of all groups were significantly decreased than those before the drugtreatment(P<0.05);④The bone density:at the timepoint of24weeks, the bone density ofcontrol group2were significantly decreased than those in other groups(P<0.05);⑤Thereccurence ratio:After the6months,it were6.67%,13.3%,10%,the control group1significantly increased than other groups(P<0.05);⑥Side effects:There is no severe sideeffects,except for the endometrial thickness,which at the timepoint of24weeks, thecontrol group1were significantly increased than others(P<0.05).Conclusion:①Black cohosh can improve the perimenopausal symptoms inGnRH-a treatment for endometriosis after laparoscopic surgery,it has similar therapeuticeffect compared with Livial.②Black cohosh does not affect the blood level of estrogenin GnRH-a treatment for endometriosis,but has a side effect of bone loss with long-termapplication.