葆宫止血颗粒联合性激素疗法治疗围绝经期功能失调性子宫出血临床观察

Clinical Observation of Baogong Zhixue Granules Combined with Sex Hormone Therapy for Dysfunctional Uterine Bleeding in Perimenopause

目的:观察葆宫止血颗粒联合性激素疗法治疗围绝经期功能失调性子宫出血阴虚血热证的疗效。方法:将110例围绝经期功能失调性子宫出血阴虚血热证患者随机分为对照组和治疗组各55例。对照组于月经周期第5天或诊刮术后1周内,采用戊酸雌二醇片与地屈孕酮片治疗,治疗组在对照组治疗基础上同期加用葆宫止血颗粒,2组疗程均为3个月经周期,疗程结束后随访3个月经周期。记录止血时间,治疗前后检测血红蛋白、促卵泡生成素(FSH)、黄体生成素(LH)、雌激素(E_2)和孕激素(P)水平,评定阴虚血热证积分,在疗程结束后的3月随访期间记录复发病例,计算复发率。结果:治疗3个月经周期后,治疗组临床疗效愈显率为83.64%,高于对照组的65.45%,差异有统计学意义(P<0.0 5)。治疗组近期止血疗效总有效率为92.73%,高于对照组的76.36%,差异有统计学意义(P<0.0 5)。2组血清FSH、LH、E_2和P水平均较治疗前降低(P<0.0 1),治疗组各项性激素水平均低于对照组(P<0.0 1)。2组血红蛋白水平均较治疗前升高,阴虚血热证积分均较治疗前下降,差异均有统计学意义(P<0.0 1);治疗组血红蛋白水平高于对照组,阴虚血热证积分低于对照组,差异均有统计学意义(P<0.0 1);治疗组复发率15.22%,低于对照组的50.0 0%(P<0.0 1)。结论:在常规性激素疗法的基础上加用葆宫止血颗粒治疗阴虚血热型围绝经期功血患者,近期能达到迅速止血的效果,并可有效改善临床症状,调节性激素水平,提高临床疗效,远期可降低复发率。

Objective： To observe the curative effect of Baogong Zhixue granules combined with sex hormone therapy for dysfunctional uterine bleeding in perimenopause with yin-deficiency and blood-heat syndrome. Methods：Divided 110 cases of patients with dysfunctional uterine bleeding in perimenopause with yin-deficiency and blood-heat syndrome into the control group and the treatment group randomly,55 cases in each group. On the fifth day of menstrual cycle or within one week after diagnostic curettage,the control group received estradiol valerate tablets and dydrogesterone tablets for treatment, while the treatment group additionally received Baogong Zhixue granules in the same period based on the treatment of the control group. The course of treatment for both groups lasted for three menstrual cycles, and the follow-up lasted for three menstrual cycles after treatment. Recorded the hemostatic time,detected levels of hemoglobin,follicle-stimulating hormone（FSH）,luteinizing hormone（LH）,estrogen（E2） and progesterone（P）before and after treatment,evaluated the scores of yin-deficiency and blood-heat syndrome,and recorded recurrent cases and calculated the recurrence rate during the three-month follow-up after treatment. Results： After treatment, the remarkably effective rate of the clinical effect was 83.64% in the treatment group,being higher than that of 65.45% in the control group,the difference being significant（P〈0.05）. The total effective rate of the hemostatic effect was 92.73% in the treatment group,being higher than that of 76.36% in the control group, the difference being significant（P〈0.05）. The levels of FSH, LH, E2 and P in serum in the two groups were all decreased when compared with those before treatment（P〈0.01）,and each index of sex hormone in the treatment group was lower than that in the control group（P〈0.01）. The levels of hemoglobin in the two groups were increased when compared with those before treatment,and the scores of yin-deficiency and blood-heat syndrome were decreased when compared with before treatment,differences being significant（P〈0.01）. The level of hemoglobin in the treatment group was higher than that in the control group,and the score of yin-deficiency and blood-heat syndrome was lower than that in the control group, differences being significant（P〈0.01）. The recurrence rate was 15.22% in the treatment group,being lower than that of 50.00% in the control group（P〈0.01）. Conclusion：The therapy of Baogong Zhixue granules combined with sex hormone therapy for patients with dysfunctional uterine bleeding in perimenopause with yin-deficiency and blood-heat syndrome can have the quick hemostatic effect in the short term,effectively improve clinical symptoms,regulate the level of sex hormone,improve the clinical effect and reduce the recurrence rate in the long term.