【摘要】：目的:探討中西醫(yī)結(jié)合治療圍絕經(jīng)期功能失調(diào)性子宮出血(簡(jiǎn)稱圍絕經(jīng)期功血)的臨床療效及對(duì)性激素水平的影響。方法:將128例患者按隨機(jī)數(shù)字表法分為對(duì)照組和觀察組各64例。對(duì)照組口服米非司酮片,于刮宮術(shù)后第5天開始服用,10 mg·d-1。觀察組在對(duì)照組用藥基礎(chǔ)上,加服固本功血停煎劑,每日1劑,服用時(shí)間同對(duì)照組。兩組均連續(xù)服用3個(gè)月,并進(jìn)行3個(gè)月隨訪,記錄治療前后出血量、出血時(shí)間、月經(jīng)周期等癥狀評(píng)分,檢測(cè)治療前后促卵泡生成素(follicle stimulating hormone,FSH)、黃體生成素(luteinizing hormone,LH)、雌激素(estrogen,E2)和孕激素(progesterone,P)水平,測(cè)量治療前后子宮內(nèi)膜厚度,對(duì)患者進(jìn)行3個(gè)月的隨訪,記錄復(fù)發(fā)情況,并進(jìn)行安全性評(píng)價(jià)。結(jié)果:觀察組調(diào)經(jīng)療效有效率為98.44%,對(duì)照組為87.50%,觀察組優(yōu)于對(duì)照組(χ2=4.305,P0.05);觀察組中醫(yī)證候療效有效率為96.88%,對(duì)照組為82.81%,觀察組優(yōu)于對(duì)照組(χ2=6.935,P0.01);治療后觀察組血清FSH、LH、E2和P水平均顯著低于對(duì)照組(P0.01);觀察組出血量、出血時(shí)間、月經(jīng)周期評(píng)分低于對(duì)照組,子宮內(nèi)膜厚度較對(duì)照組顯著變薄(P0.01);在3個(gè)月的隨訪周期中,觀察組復(fù)發(fā)率為6.25%,顯著低于對(duì)照組的18.75%(χ2=4.571,P0.05);對(duì)照組不良反應(yīng)發(fā)生率為21.87%,觀察組未發(fā)現(xiàn)與中藥相關(guān)的不良反應(yīng)。結(jié)論:中西醫(yī)結(jié)合治療圍絕經(jīng)期功血療效顯著,具有止血、調(diào)經(jīng)和改善相關(guān)癥狀的作用,并能調(diào)節(jié)失衡的性激素,抑制子宮內(nèi)膜增生,降低復(fù)發(fā)率,臨床使用安全。
[Abstract]:Objective: to investigate the clinical efficacy of combined traditional Chinese medicine and western medicine in the treatment of dysfunctional uterine bleeding during perimenopausal period and its effect on the level of sex hormones. Methods: 128 patients were randomly divided into two groups: control group (n = 64) and observation group (n = 64). In the control group, mifepristone tablets were taken orally on the 5th day after curettage, 10 mg 路d-1. On the basis of the medicine used in the control group, the observation group was given a daily dose of Gubengongxue stop decoction for the same time as that in the control group. The two groups were taken for 3 months and followed up for 3 months. The bleeding volume, bleeding time, menstrual cycle and other symptoms were recorded before and after treatment. Follicle stimulating hormone (follicle stimulating hormone,FSH) and luteinizing hormone (luteinizing hormone,LH) were measured before and after treatment. The levels of estrogen (estrogen,E2) and progesterone (progesterone,P) were measured and the endometrial thickness was measured before and after treatment. The patients were followed up for 3 months. The recurrence was recorded and the safety was evaluated. Results: the effective rate was 98.44% in the observation group and 87.50% in the control group, which was better than that in the control group (蠂 2, 4.305, P0.05). The effective rate of TCM syndrome was 96.88% in the observation group and 82.81% in the control group, which was better than that in the control group (蠂 2, 6.935, P0.01), and the serum FSH,LH,E2 and P levels in the observation group were significantly lower than those in the control group after treatment (P0.01). The bleeding volume, bleeding time and menstrual cycle score in the observation group were lower than those in the control group, and the endometrial thickness was significantly thinner than that in the control group (P0.01). In the 3-month follow-up period, the recurrence rate in the observation group was 6.25%, which was significantly lower than that in the control group (18.75%) (蠂 2 / 4.571, P0.05). The incidence of adverse reactions in the control group was 21.87%, and no adverse reactions related to traditional Chinese medicine were found in the observation group. Conclusion: the combination of traditional Chinese and western medicine is effective in the treatment of perimenopausal dysfunctional blood, has the effect of hemostasis, regulation of menstruation and improvement of related symptoms, and can regulate the unbalance sex hormone, inhibit endometrial hyperplasia, reduce the recurrence rate, and be safe in clinical use.
【作者單位】： 延安市博愛醫(yī)院;
【分類號(hào)】：R711.52

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