补肾固冲汤辅助炔诺酮应用于围绝经期功血患者刮宫术后的临床观察

Effect of Bushen Guchong decoction combined with norethisterone on serum sex hormone level and endometrial thickness of perimenopausal dysfunctional uterine bleeding patients after curettage

目的:探讨补肾固冲汤辅助炔诺酮应用于围绝经期功能失调性子宫出血(简称“功血”)患者刮宫术后的效果。方法:选取围绝经期功血患者104例,简单随机化分为2组,每组52例。刮宫术后对照组采用炔诺酮治疗,观察组在对照组基础上采用补肾固冲汤治疗。治疗12周后比较两组疗效、中医证候积分、子宫内膜厚度、血清性激素[雌二醇(E2)、孕酮(P)、泌乳激素(PRL)、促卵泡激素(FSH)]水平、卵巢功能[抗苗勒管激素(AMH)、抑制素B(INHB)]及不良反应发生率。结果:观察组总有效率为94.23%,对照组为76.92%,两组总有效率差异有统计学意义(P<0.05);观察组中医证候积分、子宫内膜厚度小于对照组(P<0.05);观察组血清性激素E2、P、PRL、FSH水平低于对照组(P<0.05);观察组AMH、INHB水平高于对照组(P<0.05);观察组不良反应发生率为5.77%,对照组为11.54%,组间比较差异无统计学意义(P>0.05)。结论:补肾固冲汤辅助炔诺酮应用于围绝经期功血刮宫术后疗效显著,能减轻症状,降低子宫内膜厚度及血清性激素水平,改善卵巢功能,安全性高。

Objective:To investigate the effect of Bushen Guchong decoction combined with norethisteroneon per⁃imenopausal dysfunctional uterine bleeding(dysfunctional uterine bleeding)after curettage.Methods:A total of 104 patients with dysfunctional uterine bleeding during perimenopause were selected and randomly divided into two groups,with 52 cases in each group.The control group was treated with norethisterone,and the treatment group was treated with Bushen Guchong decoction besides norethisterone,.The curative effect,TCM syndrome score,endometrial thick⁃ness,serum sex hormone levels[estradiol(E2),progesterone(P),prolactin(PRL),follicle stimulating hormone(FSH)],ovarian function[anti mullerian hormone(AMH),inhibin B(INHB)]and incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the treatment group was 94.23%,and the control group was 76.92%,the difference between two groups was significate(P<0.05);the TCM syndrome score and endometrial thick⁃ness of the treatment group were lower than those of the control group;the levels of serum sex hormone E2,P,PRL and FSH of the treatment group were lower than those of the control group(P<0.05);the levels of AMH and INHB of the treatment group were higher than those of the control group(P<0.05);the incidence of adverse reactions of the treatment group was 5.77%,the incidence of adverse reactions in the control group was 11.54%,there was no significant dif⁃ference between the two groups(P>0.05).Conclusion:Bushen Guchong decoction combined with norethisterone is ef⁃fective in the treatment of dysfunctional uterine bleeding in the perimenopausal period.It can relieve symptoms,reduce endometrial thickness and serum sex hormone levels,improve ovarian function,with high safety.