黄连阿胶汤加味联合米非司酮治疗心肾不交型围绝经期功能失调性子宫出血临床研究

Clinical Study on Modified Huanglian E'jiao Decoction Combined with Mifepristone for Dysfunctional Uterine Bleeding During Perimenopause of Failure of the Heart and Kidney to Interact Type

目的:观察黄连阿胶汤加味联合米非司酮治疗心肾不交型围绝经期功能失调性子宫出血的临床疗效。方法:按随机数字表法将118例心肾不交型围绝经期功能失调性子宫出血患者分成观察组与对照组各59例。对照组给予米非司酮片治疗,观察组在对照组基础上联用黄连阿胶汤加味治疗。比较2组临床疗效、症状控制时间及不良反应发生率;比较2组治疗前后中医证候积分、子宫超声指标、性激素指标、T细胞亚群水平。结果:治疗后,观察组总有效率93.22%,高于对照组76.27%(P<0.05)。观察组出血控制时间、完全止血时间和腹痛缓解时间均较对照组缩短(P<0.05)。2组治疗后子宫内膜厚度、中医证候积分均较治疗前降低(P<0.05),子宫平滑肌收缩幅度及频率升高(P<0.05);观察组治疗后子宫内膜厚度、中医证候积分低于对照组(P<0.05),子宫平滑肌收缩幅度及频率高于对照组(P<0.05)。2组治疗后雌二醇(E2)、促卵泡生成素(FSH)、促黄体生成素(LH)及CD8^(+)水平均较治疗前降低(P<0.05),观察组治疗后上述性激素及CD8^(+)水平均低于对照组(P<0.05)。2组治疗后CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均较治疗前升高(P<0.05),观察组治疗后CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论:黄连阿胶汤加味联合米非司酮治疗心肾不交型围绝经期功能失调性子宫出血疗效确切,能够有效抑制患者性激素分泌,提高免疫功能,安全性较高。

Objective:To observe the clinical effect of the therapy of modified Huanglian E'jiao Decoction combined with Mifepristone on dysfunctional uterine bleeding during perimenopause of failure of the heart and kidney to interact type.Methods:A total of 118 patients with dysfunctional uterine bleeding during perimenopause of non-interaction between the heart and kidney type were divided into the observation group and the control group according to the random number table method,with 59 cases in each group.The control group was given administration of Mifepristone Tablets,and the observation group was additionally treated with modified Huanglian E'jiao Decoction based on the treatment of the control group.The clinical effects,symptom control time and incidence of adverse reactions were compared between the two groups,and before and after treatment,the traditional Chinese medicine(TCM)syndrome scores,uterine ultrasound indexes,sex hormone indexes and T cell subsets were also compared between the two groups.Results:After treatment,the total effective rate was 93.22% in the observation group,higher than that of 76.27% in the control group(P<0.05).The bleeding control time,complete hemostasis time and abdominal pain relief time in the observation group were shorter than those in the control group(P<0.05).After treatment,the endometrial thickness and the TCM syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the contraction amplitude and frequency of uterine smooth muscle were increased(P<0.05);after treatment,the endometrial thickness and the TCM syndrome scores in the observation group were thinner or lower than those in the control group(P<0.05),and the contraction amplitude and frequency of uterine smooth muscle were higher than those in the control group(P<0.05).After treatment,the levels of estradiol(E2),follicle-stimulating hormone(FSH),luteinizing hormone(LH) and CD8^(+)in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of the above sex hormones and CD8^(+)in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups were increased when compared with those before treatment(P<0.05),and the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were 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(P<0.05).Conclusion:The therapy of modified Huanglian E'jiao Decoction combined with Mifepristone has a definite therapeutic effect on treating dysfunctional uterine bleeding during perimenopause of non-interaction between the heart and kidney type,which can effectively inhibit the secretion of sex hormones and improve immune function,with high safety.