青春期功能失调性子宫出血的中医体质特点及止血组方对中医体质的影响

TCM Constitution Characteristics of Adolescent Dysfunctional Uterine Bleeding and the Effect of Hemostatic Prescription on It

目的:探究青春期功能失调性子宫出血(简称功血)的中医体质特点,以及止血组方对中医体质的影响。方法:选取2016年9月至2018年9月华北石油管理局总医院收治的青春期功血患者455例作为研究对象,按照简单随机化分组法分为对照组(n=224)和观察组(n=231)。对照组患者口服妈富隆治疗;观察组患者分阶段中药辨证口服治疗,以止血组方加减止血治疗,血止后(包括次月月经结束后)开始服补肾调周方,连续治疗3个月经周期。停药后观察6个月。结果:青春期功血患者的中医体质以气虚质、阳虚质、血瘀质、痰湿质为主。患者气虚质与月经周期负相关(P<0.05)、与血红蛋白含量负相关(P<0.01),气虚质评分与子宫内膜厚度正相关(P<0.01),阳虚质评分与经期及子宫内膜厚度正相关(P<0.05),与血红蛋白含量负相关(P<0.01),痰湿质评分与经期正相关(P<0.05),血瘀质评分与月经周期正相关(P<0.05)。止血组方可以显著提高平和质比例及评分,降低其他各体质评分。结论:气虚质、阳虚质、血瘀质和痰湿质与青春期功血的发生密切相关,止血组方可以显著改善青春期功血患者的中医体质。

Objective:To explore the TCM constitution characteristics of adolescent dysfunctional uterine bleeding(abbreviated as dysfunctional uterine bleeding)and the influence of hemostatic prescription on TCM constitution.Methods:From September 2016 to September 2018,455 cases of adolescent dysfunctional uterine bleeding in the General Hospital of North China Petroleum Administration were selected as the research objects and divided into a control group(n=224)and an observation group(n=231)according to the simple randomized grouping method.The control group were treated with oral marvelon,while the observation group were given oral treatment of syndrome differentiation of traditional Chinese medicine by stages.The hemostasis prescription was modified to stop bleeding.After stopping bleeding(including the end of next month′s menstruation),the patients in the observation group began to take Bushen Tiaozhou prescription for 3 menstrual cycles,and were observed for 6 months after drug withdrawal.Results:The TCM constitution of patients with adolescent dysfunctional uterine bleeding was mainly composed of qi deficiency,Yang deficiency,blood stasis and phlegm dampness.Qi deficiency of patients was negatively correlated with menstrual period(P<0.05),and was negatively correlated with hemoglobin content(P<0.01).The score of qi deficiency was positively correlated with endometrial thickness(P<0.01),the score of Yang deficiency was positively correlated with menstrual period and endometrial thickness(P<0.05),and negatively correlated with hemoglobin content(P<0.01).The score of phlegm dampness was positively correlated with menstrual period(P<0.05),blood stasis score was positively correlated with menstrual cycle(P<0.05).Hemostasis prescription can significantly improve the proportion and score of the quality of peace,and reduce the scores of other constitution.Conclusion:Qi deficiency,Yang deficiency,blood stasis and phlegm dampness are closely related to the occurrence of adolescent dysfunctional uterine bleeding.Hemostatic prescription can significantly improve the TCM constitution of adolescent dysfunctional uterine bleeding patients.