致康胶囊联合戊酸雌二醇治疗青春期功能失调性子宫出血的疗效观察

Clinical observation of Zhikang Capsules combined with estradiol valerate in treatment of dysfunctional uterine bleeding in adolescent

目的探讨致康胶囊联合戊酸雌二醇治疗青春期功能失调性子宫出血的临床效果。方法选取2015年3月-2018年1月中国人民解放军第一医院收治的青春期功能失调性子宫出血患者98例,随机分成对照组(49例)和治疗组(49例)。对照组口服戊酸雌二醇片,4 mg/次,1次/8 h,止血3 d后开始减量,每3天减量1次,减量幅度为前次剂量的1/3,逐渐减至1 mg/d,并维持用药21 d,于撤退性出血第5天开始以1 mg/d维持进入下一周期治疗,共治疗3个月经周期。治疗组在对照组基础上口服致康胶囊,2粒/次,3次/d,用药周期同对照组患者。两组连续治疗3个月经周期。观察两组患者临床疗效,同时比较治疗前后两组患者止血效果、血流变学参数、性激素水平和36项健康调查简表(SF-36)评分。结果治疗后,对照组和治疗组临床有效率分别为83.7%和95.9%,两组比较差异均具有统计学意义(P<0.05)。治疗后,治疗组患者控制出血和完全止血时间均明显短于对照组(P<0.05)。治疗后,治疗组红细胞聚集指数(EAI)、红细胞变形指数(EDI)值较治疗前均显著降低(P<0.05),红细胞比容(HCT)值显著升高(P<0.05),且治疗组患者EAI、EDI和HCT值明显好于对照组(P<0.05)。治疗后,两组血清雌二醇(E2)、孕酮(P)水平均显著升高(P<0.05),且治疗组患者血清E2、P水平明显高于对照组(P<0.05)。治疗后,两组患者SF-36中各维度评分及其总分均显著升高(P<0.05),且治疗组患者SF-36评分明显高于对照组(P<0.05)。结论致康胶囊联合戊酸雌二醇治疗青春期功能失调性子宫出血,可迅速有效的控制出血,改善机体血流变学,提高患者生活质量,减少复发。

Objective To investigate the clinical effect of Zhikang Capsules combined with estradiol valerate in treatment of dysfunctional uterine bleeding in adolescent. Methods Patients(98 cases) with dysfunctional uterine bleeding in First Hospital of Chinese PLA from March 2015 to January 2018 were randomly divided into control(49 cases) and treatment(49 cases) groups. Patients in the control group were po administered with Estradiol Valerate Tablets, 4 mg/time, 1 time/8 h, then reduced the dose after hemostasis for3 d, reduced dose1 time every 3 days, the reduction range is 1/3 of the previous dose until 1 mg/d, and maintained for 21 d, then 1 mg/d for the next treatment cycle after the 5 th d of withdrawal bleeding, they were total treated for 3 menstrual cycles. Patients in the treatment group were po administered with Zhikang Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 3 menstrual cycles. After treatment, the clinical efficacy was evaluated, and the hemostatic effect, the hemorheological parameters, the sex hormone levels and the SF-36 scores in two groups before and after treatment were compared.Results After treatment, the clinical efficacy and in the control and treatment groups was 83.7% and 95.9% respectively, and there were differences between two groups(P < 0.05). After treatment, the time of control bleeding and complete hemostasis in the treatment group was significantly shorter than that in the control group(P < 0.05). After treatment, the EAI and EDI value in two groups was significantly decreased(P < 0.05), but HCT value was significantly increased(P < 0.05), and the value of EAI, EDI and HCT in the treatment group was significantly better than that in the control group(P < 0.05). After treatment, the serum concentration of E2 and P in two groups was significantly increased(P < 0.05), and which in the treatment group was significantly higher than that in the control group(P < 0.05). After treatment, the each item of SF-36 score and total score in two groups were significantly increased(P < 0.05), and these scores in the treatment group were significantly higher than those in the control group(P < 0.05). Conclusion Zhikang Capsules combined with estradiol valerate in treatment of dysfunctional uterine bleeding in adolescent can control bleeding rapidly and effectively, improve hemorheology, improve the quality of life and reduce the recurrence.