加味固经汤治疗肾虚瘀热型更年期功血的临床疗效及机制探讨

Clinical efficacy and mechanism of Jiawei Gujing Decoction in treating climacteric dysfunctional uterine bleeding

目的探讨肾虚瘀热型更年期功血应用加味固经汤治疗的临床疗效及相关作用机制。方法选取本院2017年1月至2018年12月间收治100例中医诊断证型肾虚瘀热型更年期功血患者作为本研究对象,将患者随机分为对照组与研究组,各50例。对照组患者予以西药米非司酮治疗,研究组患者予以加味固经汤治疗。分别对比两组患者治疗后止血疗效、兼具症状积分、血清LH、血清FSH、血清E2指标水平变化。结果两组患者临床止血疗效对比差异无统计学意义;对照组患者失眠盗汗、耳鸣头晕、五心烦热等兼具症状评分相比治疗前更高(P<0.05);两组患者治疗前性激素指标水平对比差异无统计学意义;研究组治疗后血清LH及FSH相比对照组差异无统计学意义;研究组治疗后E2指标相比对照组明显升高(P<0.05)。结论加味固经汤在肾虚瘀热型更年期功血治疗中可有效调节患者性激素指标水平,在更年期功血兼具症状的改善方面相比西药米非司酮更明显。

Objective To explore the clinical efficacy and related mechanism of the application of Jiawei Gujing Decoction in the treatment of gynecological dysfunctional dysfunctional uterine bleeding. Methods 100 patients with menopausal dysfunctional uterine bleeding diagnosed as syndrome of kidney deficiency and heat syndrome were enrolled in our hospital from January 2017 to December 2018. The patients were randomLy divided into control group and study group, with 50 cases in each group. The patients in the control group were treated with western medicine mifepristone, and the patients in the study group were treated with Jiawei Gujing Decoction. The effects of hemostasis after treatment, symptom score, serum LH, serum FSH and serum E2 levels were compared between the two groups. Results There was no significant difference in clinical hemostasis between the two groups. In the control group, the symptoms of insomnia, night sweats, tinnitus and dizziness, and five upset fever were higher than those before treatment(P<0.05). There was no significant difference in the level of pre-sex hormones. There was no significant difference in serum LH and FSH between the study group and the control group. The E2 index of the study group was significantly higher than that of the control group(P<0.05). Conclusion Jiawei Gujing Decoction can effectively regulate the level of sex hormones in patients with kidney deficiency and heat-type menopausal dysfunctional uterine bleeding. It is more obvious than the western medicine mifepristone in improving menopausal dysfunctional dysfunction.