坤宁活血汤治疗更年期功血的临床及实验研究

Clinical and Experimental Study on "Kunning Huoxue Decoction" in Treating Climacteric Dysfunctional Uterine Bleeding

观察坤宁活血汤治疗血瘀型更年期功血之出血期的疗效并探讨其止血机理 ,将 5 0例患者随机分为治疗组 (35例 )和对照组 (15例 )。治疗组予以口服坤宁活血汤 ,对照组予以口服三七片。观察两组止血疗效、治疗前后临床症状改善情况及子宫内膜厚度的变化 ;并通过动物实验观察其对离体子宫收缩、出凝血时间、血流变、血清性激素、雌孕激素受体等的影响。疗程为 2个月经周期。结果 :治疗后两组在临床表现、子宫内膜厚度方面的改变均有显著性差异 (P <0 0 5～ 0 0 1) ;近期止血疗效 ,治疗组总有效率为 91 4 % ,对照组为 6 6 7% (P <0 0 5 )。实验研究表明 ,坤宁活血汤可促进离体子宫收缩 ,缩短出、凝血时间 ,改善血液流变 ,降低子宫内膜ER、PR水平。

To observe the clinical effects and mechanism of 'Kunning Huoxue Decoction' in the treatment of climacteric dysfunctional uterine bleeding of blood-stasis syndrome, 50 subjects were randomized into two groups: treatment group in which 35 cases were treated by 'Kunning Huoxue Decoction' and control group in which 15 cases were treated by oral administration 'Sanqi Tablet'. The hemostatic effect, improvement of clinical symptoms and thickness of endometrium were observed before and after treatment; and contraction of isolated uterine, bleeding and clotting time, blood rheology, serum hormone and estrin receptor were detected in experimental study. Results: There were differences in clinical symptom and thickness of endometrium between two groups (P<0.05-0.01); the short-term hemostatic rate was 91.4% in treatment group and 66.7% in control group (P<0.05); 'Kunning Huoxue Decoction' could promote the contraction of isolated uterine, shorten bleeding and clotting time, improve blood rheology and reduce the levels of ER and PR in endometrium.