Effect Of Remifemin On Peri-menopausal Symptoms And Bone Metabolic Markers In GnRH-a Treatment Of Endometriosis After Laparoscopic Surgey

Objective: To investigate the efficacy of Remifemin( isopropanolic extract of black cohosh)for relieving peri-menopausal symptoms and effect on total P1 NP and β-CTx in GnRH-a treatment of endometriosis after laparoscopic surgey.Methods:A total of 68 patients with ovarian endometriosis who had underwent conservative laparoscopic surgery were randomly divided into 2 groups: 37 cases in control group and 31 cases in experimental group.Patients in control group were received GnRH-a treatment on the first postoperative day,once every 4 weeks,for 6 times;Patients in experimental group were received Remifemin 0.28 g each time, 2 times a day, for 24 weeks,on the basis of the control group treatment.Comparing the changes of plasma estradiol(E2) levels, bone metabolic markers(total P1 NP and β-CTx)levels, liver function, renal function, endometrial thickness, blood coagulation and the severity of menopausal symptoms before and after treatment.Results:(1)After 24 weeks treatment E2 levels in all patients fell to the level of menopause, the difference was statistically significant(P<0.05). However, there was no significant difference in E2 levels between the experimental group and the control group.(2)After treatment the scores of the improved Kupperman symptom in all patients had significantly increased(P<0.05).There were no statistically significant differences between two groups on the scores after 4 weeks(P>0.05)while the scores of the experimental group were significantly reduced after 12-weeks and 20-weeks treatment(P<0.05).(3)After treatment, P1 NP and β-CTx in both groups were higher than before(P<0.05).With the extension of the course of treatment, P1 NP and β-CTx levels gradually increased, the difference was statistically significant(P <0.05);In the same period,P1 NP and β-CTx levels between two groups had no significant difference(P> 0.05);(4)There was no significant difference in endometrial thickness, liver function, renal function and blood coagulation in all the patients after treatment(P>0.05).Conclusion: Remifemin can effectively alleviate the peri-menopausal symptoms in GnRH-a treatment of endometriosis after laparoscopic surgey. There was no obvious side effects during 24-weeks treatment. Clincal trails show that short term administration of Remifemin of 6 months had no significant effect on bone metabolic markers.