中西医结合治疗绝经过渡期崩漏病阴虚火旺证的临床研究

Clinical study on the treatment of menopause metrorrhagia and Yin Deficiency and Heat Hyperactivity syndrome by integrated traditional Chinese medicine and western medicine

目的:系统评价经期验方、非经期验方配合炔诺酮治疗崩漏病的疗效。方法:将100例单纯性子宫内膜增生患者随机分为中西医结合治疗组和单纯西药治疗组,每组各50例,进行RCT。单纯西药治疗组患者服用炔诺酮5mg,1日3次,阴道出血停止后,每3天减三分之一量,逐渐递减至2.5mg,每日1次,阴道出血停止满20天停药,月经来潮,月经周期第5天,继续服药,服法同上,3个月后进行评价。中西医结合治疗组在单纯西药治疗组治疗的基础上,经期服用经期方,非经期服用非经期方,均为日2次,治疗3个月。结果:单纯西药治疗组患者阴道出血症状、中医症状痊愈率分别为28%、12%,有效率分别为72%、76%,中西医结合治疗组痊愈率分别为34%、42%,有效率分别为86%、84%;单纯西药治疗组阴道出血时间基本正常及以上占比58%,中西医结合治疗组该指标基本正常及以上占比70%;上述数据结果均有统计学意义。结论:经期方剂、非经期方剂加炔诺酮中西医结合治疗阴虚火旺型崩漏病在阴道出血量、阴道出血时间、阴虚火旺症候上的疗效均明显优于仅使用炔诺酮治疗。

Objective： Comprehensive evaluation of curative effect with menstrual period formula or non menstrual period formu la and norethisterone in treatment of metropathia hemorrhagica. Methods： A randomized, single blind controlled trial （RCT） was designed. There are 100 metropathia hemorrhagica patients are divided into two treatment groups： Integrated traditional Chinese and Western medicine treatment group （n=50） and Western medicine treatment group（n= 50）. The therapeutic course of both groups are three months. The patients in the western medicine treatment group are prescribed norethisterone 5mg, 3 times a day, after vaginal bleeding stops, decreased 1/3 dosage every 3 days to 2. 5mg, 1 times daily, not taking norethisterone until menstrual bleeding stopped 20 days until the next period starts. To continue medication on the fifth day of menstrual peri od, the same as above. Patients in the integrated traditional Chinese and Western medicine treatment group on the basis of the treatment of western medicine treatment group, taking menstrual period formula in menstrual period, and taking non menstrual period formula in non menstrual period, two times per day, patients in the both of groups were treated for 3 courses, a course of 1 months. Results： For the amount of vaginal bleeding and the syndromes of Yin deficiency and heat hyperactivity, patients treated with western medicine cure rates are 28% and 12%, the effective rates are 72% and 76%, the cure rates of integrated traditional Chinese and Western medicine treatment group are 30% and 42 %, effective rates are 86% and 84% ; for the index of vaginal bleeding time, barely abnormal and above patients of western medicine treatment group accounted for 58%, barely ab normal and above patients of integrated traditional Chinese and western medicine treatment group accounted for 70 % ; The data results were significant statistically. Conclusion： The effect of the menstrual period formula or non menstrual period formula combined norethisterone for therapy of vaginal bleeding amount, vaginal bleeding time, and symptoms of hyperactivity of heat due to yin deficiency is better than using only norethisterone therapy.