健脾祛瘀固冲法治疗围绝经期崩漏39例

Treatment for 39 Cases of Metrorrhagia and Metrostaxis during Peri-menopausal Period with the Method of Invigorating Spleen, Eliminating Stasis and Strengthening Thoroughfare Vessels

目的:观察健脾祛瘀固冲法治疗围绝经期崩漏的临床疗效。方法:将75例围绝经期崩漏患者随机分为治疗组39例、对照组36例。治疗组出血期用宫血立停方,血止后用加减归脾汤,1剂/d,水煎,分2次温服。对照组出血期口服炔诺酮5 mg,3次/d,血止后每隔3天递减1/3量,直至维持量(每日2.5 mg),持续用药至血止后20天停药,停药后撤药性出血第5日开始下1周期,2.5 mg/次,1次/d,连用20天。2组均以1个月经周期为1个疗程,连续治疗3个疗程。结果:治愈率治疗组为48.72%,对照组为27.78%,2组相比差异有统计学意义(P<0.05);总有效率治疗组为89.74%,对照组为69.44%,2组相比差异有统计学意义(P<0.05)。子宫内膜厚度2组治疗后均明善改善(P<0.05),治疗组改善较对照组明显(P<0.05)。结论:健脾祛瘀固冲法治疗围绝经期崩漏临床疗效显著。

Objective： To investigate clinical effects of the method of invigorating spleen, eliminating stasis and strengthening thoroughfare vessels in treating metrorrhagia and metrostaxis during peri-menopausal period. Method： All 75 patients were randomly divided into 39 cases in the treatment group and 36 cases in the control group. The treatment group received GongXue LiTingFang during the bleeding period and modified GuiPiTang when the bleeding was stopped, one dose each day, water decocted and taking twice. The control group took norethindrone, 5 mg each time, three times each day, when the bleeding was stopped, the dosage was gradually decreased by 1/3 amounts every three days until it was maintained at 2.5mg for 20 consecutive days. The cycle was begun at the 5 th day of withdrawal bleeding and the medicine was given for 20 consecutive days, 2.5 mg/time, ltime/d. One menstrual cycle was one course of treatment and both groups were treated for three courses of treatment. Result： Cure rates of the treatment group and the control group were 48.72% and 27.78%, the difference of both groups demonstrated statistical meaning （P〈0.05）; total effective rates of both groups were 89.74% and 69.44% and the difference between both groups showed statistical meaning （P〈0.05）. Endometrial thickness of both groups was improved significantly after treating （P〈0.05） and the treatment group improved greater than the control group （P〈 0.05）. Conclusion： The method of invigorating spleen, eliminating stasis and strengthening thoroughfare vessels could gain clinical effects in treating metrorrhagia and metrostaxis during peri-menopausal period.