清热凉血法治疗高雌激素血症合并子宫不规则出血临床研究

Clinical efficacy of heat clearing and blood cooling therapy in the treatment of hyperestrogenemia with irregular bleeding

目的:研究探讨清热凉血法治疗高雌激素血症合并子宫不规则出血(AUB)的临床疗效。方法:选择80例高雌激素血症合并子宫不规则出血患者,按治疗方案分为对照组(口服地屈孕酮治疗)38例和观察组(口服地屈孕酮+清热凉血法治疗)42例,观察比较两组治疗前、治疗后及停药3个月后的血清雌二醇(E2)、血红蛋白含量(Hb)及子宫内膜厚度;比较两组治疗前后的中医症候积分、平均经期天数、平均月经周期、凝血相关指标变化;并比较两组治疗后平均止血天数、总有效率和停药3个月的复发率。结果:观察组治疗后与停药3个月后的血清E2、Hb水平及子宫内膜厚度比较差异无统计学意义(P>0.05);观察组治疗后与停药3个月后的血清E2、子宫内膜厚度均比治疗前明显下降(P<0.05),Hb水平比治疗前明显升高(P<0.05),改善程度均优于对照组同期水平(P<0.05)。观察组治疗后的中医症候积分、各项凝血指标均比治疗前明显下降(P<0.05),平均经期天数、平均月经周期均比治疗前明显缩短(P<0.05),改善程度均优于对照组同期水平(P<0.05)。观察组治疗后平均止血天数明显低于对照组(P<0.05),治疗总有效率明显高于对照组(P<0.05),停药3个月的复发率明显低于对照组(P<0.05)。结论:清热凉血法治疗高雌激素血症合并AUB可获得满意止血效果,有效改善相关中医症候,缩短止血时间,加快重建月经周期,减少复发。

Objective:To investigate the clinical efficacy of clearing heat and cooling blood method in the treatment of hyperestrogenemia with irregular uterine bleeding(AUB).Methods:A total of 80 patients with hyperestrogenemia and irregular uterine bleeding diagnosed and treated at the traditional Chinese medicine.According to the treatment plan,they were divided into a control group(treated with oral dexamethasone) of 38 cases and an observation group(treated with oral dexamethasone+heat clearing and blood cooling method) of 42 cases.The serum estradiol(E2) levels before treatment,after treatment,and after stopping treatment for 3 months were observed and compared between the two groups hemoglobin content(Hb) and endometrial thickness.Compare the changes in traditional Chinese medicine symptom scores,average menstrual period days,average menstrual cycle,and coagulation related indicators between the two groups before and after treatment;and compare the average hemostatic days,total effective rate,and recurrence rate after stopping medication for 3 months between the two groups after treatment.Results:There were no significant changes in serum E2,Hb levels,and endometrial thickness in the observation group after treatment compared to 3 months after discontinuation of medication(P>0.05).The serum E2 and endometrial thickness of the observation group decreased significantly(P<0.05),after treatment and after 3 months of discontinuation compared to before treatment,while the Hb level increased significantly(P<0.05).The degree of improvement was better than that of the control group during the same period(P<0.05).After treatment,the scores of traditional Chinese medicine symptoms and various coagulation indicators in the observation group significantly decreased compared to before treatment(P<0.05),and the average number of menstrual days and average menstrual cycle were significantly shortened compared to before treatment(P<0.05).The degree of improvement was better than that of the control group during the same period(P<0.05).The average hemostatic days after treatment in the observation group were significantly shorter than those in the control group(P<0.05),and the total effective rate of treatment was significantly higher than that in the control group(P<0.05).The recurrence rate after stopping medication for 3 months was significantly lower than that in the control group(P<0.05).Conclusion:The method of clearing heat and cooling blood can achieve satisfactory hemostatic effect in the treatment of hyperestrogenemia with AUB,effectively improve relevant traditional Chinese medicine symptoms,shorten hemostatic time,accelerate the reconstruction of menstrual cycle,and reduce recurrence.