中西医结合治疗围绝经期功能失调性子宫出血临床研究

发布时间：2019-04-27 02:26

【摘要】：目的:探讨中西医结合治疗围绝经期功能失调性子宫出血(简称围绝经期功血)的临床疗效及对性激素水平的影响。方法:将128例患者按随机数字表法分为对照组和观察组各64例。对照组口服米非司酮片,于刮宫术后第5天开始服用,10 mg·d-1。观察组在对照组用药基础上,加服固本功血停煎剂,每日1剂,服用时间同对照组。两组均连续服用3个月,并进行3个月随访,记录治疗前后出血量、出血时间、月经周期等症状评分,检测治疗前后促卵泡生成素(follicle stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、雌激素(estrogen,E2)和孕激素(progesterone,P)水平,测量治疗前后子宫内膜厚度,对患者进行3个月的随访,记录复发情况,并进行安全性评价。结果:观察组调经疗效有效率为98.44%,对照组为87.50%,观察组优于对照组(χ2=4.305,P0.05);观察组中医证候疗效有效率为96.88%,对照组为82.81%,观察组优于对照组(χ2=6.935,P0.01);治疗后观察组血清FSH、LH、E2和P水平均显著低于对照组(P0.01);观察组出血量、出血时间、月经周期评分低于对照组,子宫内膜厚度较对照组显著变薄(P0.01);在3个月的随访周期中,观察组复发率为6.25%,显著低于对照组的18.75%(χ2=4.571,P0.05);对照组不良反应发生率为21.87%,观察组未发现与中药相关的不良反应。结论:中西医结合治疗围绝经期功血疗效显著,具有止血、调经和改善相关症状的作用,并能调节失衡的性激素,抑制子宫内膜增生,降低复发率,临床使用安全。
[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.
【作者单位】：延安市博爱医院;
【分类号】：R711.52

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