止崩汤加针灸治疗围绝经期功能失调性子宫大出血320例

目的:观察止崩汤加针灸治疗围绝经期功能失调性子宫出血(功血)大出血的疗效及探讨止血机理。方法:将320例围绝经期功血大出血患者口服止崩汤加针灸观察止血疗效、治疗前后临床症状改善情况、子宫内膜厚度、APTT、PT、血色素(HB)、血清雌二醇(E2)、孕酮(P)的含量。结果:(1)止崩汤加针灸治疗功血大出血止血疗效总有效率为91.3%.(2)治疗后APTT时间明显延长(P≤0.05),PT时间明显缩短(P≤0.05)。(3)子宫内膜的厚度变薄,治疗后与治疗前比较有显著性差异(P0.05);(4)治疗后E2含量明显下降(P0.01),P含量则明显上升(0.01),与治疗前比较有极显著性差异(P0.01)。(5)治疗后血色素明显提高。结论:止崩汤加针灸治疗围绝经期功血大出血具有良好的止血作用,起到药物性刮宫的作用,止血迅速快捷便利,无手术刮宫的疼痛及创伤,可调节卵巢激素。

320Cases of Perimenopausal Dysfunctional Uterine Bleeding Patients Treated by Zhibeng Decoction Combined with Acupuncture

Objective ： To study the curative effect and mechanism of using Zhibeng Decoction combined acupuncture to treat perimenopausal dysfunctional uterine bleeding. Methods ： 320patients with perimenopausal functional bleeding orally took Zhibeng Decoction and used acupuncture, and then observed the hemostatic effect, clinical symptoms before and after treatment, endom- etrial thickness, APTF, PT, hemoglobin （HB）, serum levels of estradiol （E2）and progesterone （P）content, the change of related parameters of pelvic blood flow resistance index. Results ： （ 1 ） Significantly prolong APTF time after treatment （P = 0. 05） or less, PT time significantly shortened （P = 0.05） or less. （2） The endometrial thickness thinning, after treatment compared with before treatment with significant difference （P〈0.05 ） ; （3） E2 levels significantly decreased after treatment （P〈 0. 01 ）, the P content was a significant increase （P〈0. 01 ）, compared with before treatment there was a very significant differ ence （ P〈0.01 ）, （5） In the aspect of improving syndromes, symptoms improved significantly after treatment, obvious pain relief, hemoglobin increased significantly; （6） Pelvic blood flow resistance index decreased obviously after treatment. Conclusion： Zhibeng Decoction combined with acupuncture treatment of perimenopausal dysfunctional uterine bleeding has good effect,have the effect of drug curettage, hemostatic quick and convenient quickly, without the pain of surgery and curettage and trauma. Adjustable ovarian hormones, E2 levels significantly decreased, P content is increased obviously; to reduce pain and improve the syndromes of curative effect, can improve the pelvic blood circulation, reduce the uterine artery blood flow resistance ; resume the function of the contraction of the uterus ; to promote blood clotting, and so on play a role of the bleeding.