固冲汤联合针刺治疗脾虚型功血的临床观察

Clinical Observation of Guchong Decoction(固冲汤)Combined with Acupuncture in Treatment of Dysfunctional Uterine Bleeding of Spleen Deficiency Type

目的观察固冲汤联合针刺治疗脾虚型功血(DUB)对患者中医证候积分、经量及子宫内膜情况的疗效。方法选取2021年6月—2021年12月医院收治的60例脾虚型DUB患者为研究对象,按随机数字法分为对照组和观察组各30例,对照组给予常规西药治疗,观察组在对照组基础上给予固冲汤联合针刺治疗,比较两组临床疗效、中医证候积分、经量、雌二醇(E_(2))及子宫内膜组织中血管内皮生长因子(VEGF)、低氧诱导因子-1α(HIF-1α)含量、不良反应发生率和内膜形态学。结果观察组治疗有效率高于对照组[96.67%(29/30)vs 83.33%(25/30)](P<0.05)。治疗后,两组中医证候积分、子宫内膜厚度及血清E_(2)水平均降低,经量减少,子宫内膜组织中VEGF、HIF-1α含量均升高(P<0.05);且观察组中医证候积分、子宫内膜厚度及血清E_(2)水平均显著低于对照组,经量少于对照组,子宫内膜组织中VEGF、HIF-1α含量均显著高于对照组(P<0.05)。观察组不良反应发生率低于对照组[6.67%(2/30)vs 20.00%(6/30)](P<0.05)。治疗3个疗程后,宫腔镜下显示观察组患者子宫内膜厚度较均匀,颜色为色白,透明度为微透明,表面较光滑;对照组子宫内膜增厚且不均匀,颜色为色白,透明度为不透明,表面欠光滑,内血管不能明显显示。结论固冲汤联合针刺治疗脾虚型DUB的疗效显著,可降低中医证候积分,减少经量,改善血清激素水平和子宫内膜形态,增强子宫内膜VEGF、HIF-1α表达,且安全性较高。

Objective To observe the effect of Guchong Decoction(固冲汤)combined with acupuncture on TCM syndrome scores,menstrual volume and endometrial conditions of patients with functional uterine bleeding(DUB)of spleen deficiency type.Methods A total of 60 patients with DUB of spleen deficiency type were admitted to the hospital from June to December 2021.They were selected as the research subjects,and divided into control group and observation group by random number table method with 30 cases in each group.All patients were treated with conventional western medicine.On this basis,the patients in the observation group were treated with Guchong Decoction combined with acupuncture.The clinical efficacy,TCM syndrome score,menstrual volume,estradiol(E_(2))and the contents of vascular endothelial growth factor(VEGF)and hypoxia-inducible factor-1(HIF-1α)in endometrial tissue,the incidence of adverse reactions and endometrial morphology were compared between the two groups.Results The treatment response rate in the observation group was higher than that in the control group[96.67%(29/30)vs.83.33%(25/30),P<0.05].After treatment,TCM syndrome score,endometrial thickness and serum E_(2) level were decreased in both groups,while the amount of endometrial tissue VEGF and HIF-1α contents were increased(P<0.05).The TCM syndrome score,endometrial thickness and serum E_(2) level in the observation group were significantly lower than those in the control group,and the amount of meridian was lower than that in the control group,and the contents of VEGF and HIF-1α in the endometrial tissue were significantly higher than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group[6.67%(2/30)vs.20.00%(6/30),P<0.05].After 3 courses of treatment,hysteroscopy showed that the endometrial thickness of the observation group was uniform,the color was white,the transparency was slightly transparent,and the surface was smooth.The endometrium of the control group was thickened and uneven,with white color,opaque transparency,less smooth surface and no obvious display of internal vessels.Conclusion Guchong Decoction combined with acupuncture has significant efficacy in the treatment of spleen deficiency type DUB,which can reduce TCM syndrome score,reduce menstrual volume,improve serum hormone level and endometrium morphology,and enhance the expressions of VEGF and HIF-1α in endometrium,with high safety.