自拟芪参收敛固涩方联合西药治疗对更年期无排卵性功血脾肾阳虚证患者PBAC评分及血清VEGF、MMP2水平的影响

Effect of Self-made Qishen Shoulian Gu'se Formula Combined with Western Medicine on PBAC Score and Serum VEGF and MMP2 Level for Patients with Anovulatory Functional Uterine Bleeding of Spleen-kidney Yang-deficiency Syndrome in Menopause

目的:观察自拟芪参收敛固涩方联合西药治疗对更年期无排卵性功血脾肾阳虚证患者PBAC评分及血清VEGF、MMP2水平的影响。方法:选取在本院进行治疗的围绝经期功能性子宫出血患者68例,按照随机数字表法分为两组,每组各34例。对照组采用欣妈富隆治疗,试验组在对照组基础上接受自拟芪参收敛固涩方治疗。比较治疗前后两组患者中医症候积分、子宫内膜厚度变化、血清性激素[促卵泡生成素(FSH)、促黄体生成素(LH)及雌二醇(E2)]、血管内皮生长因子(VEGF)、基质金属蛋白酶2(MMP2)水平差异、PBAC评分差异及复发率差异。结果:试验组治疗有效率88.24%显著高于对照组67.65%(P<0.05);治疗后,两组患者中医症候积分、子宫内膜厚度、FSH、LHE2、VEGF、MMP2、PBAC评分均较治疗前降低,且试验组显著低于对照组(P<0.05);且随访半年中,试验组复发率8.82%低于对照组复发率29.41%(P<0.05)。结论:应用自拟芪参收敛固涩方联合欣妈富隆对围绝经期功能性子宫出血患者疗效显著,有助于改善临床症状,降低子宫内膜厚度,促使性激素恢复,预防复发。

Objective:To explore the effect of Self-made Qishen Shoulian Gu'se Formula combined with Marvelon on PBAC score and serum VEGF and MMP2 levels for patients with menopausal anovulatory functional uterine bleeding of spleen-kidney Yang-deficiency syndrome.Methods:Sixty-eight patients with perimenopausal functional uterine bleeding treated in the hospital were selected and divided into two groups by the random number table method,with 34 patients in each group.The controlled group was given Marvelon,and the experimental group was treated with Self-made Qishen Shoulian Gu'se Formula on the basis of the controlled group.The TCM symptoms scores,endometrial thickness,serum sex hormones[follicle stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)],vascular endothelial growth factor(VEGF)and matrix metalloproteinase 2(MMP2)levels,PBAC score and recurrence rate were compared between the two groups before and after treatment.Results:The effective rate of treatment in the experimental group was significantly higher than that in the controlled group(88.24%vs 67.65%)(P<0.05).After treatment,the TCM symptoms scores,endometrial thickness,FSH,LH,E2,VEGF,MMP2 and PBAC score in the two groups were decreased compared with those before treatment,and the indexes in the experimental group were significantly lower than those in the controlled group(P<0.05).During the six months of follow-up,the recurrence rate in the experimental group was lower than that in the controlled group(8.82%vs 29.41%)(P<0.05).Conclusion:Using Self-made Qishen Shoulian Gu'se Formula combined with Marvelon is markedly effective in the treatment of patients with perimenopausal functional uterine bleeding.It can help improve clinical symptoms,reduce endometrial thickness,promote the recovery of sex hormones and prevent recurrence.