四逆散合寿胎丸加减治疗生育期崩漏脾肾亏虚证疗效及对患者凝血功能的影响

目的:探讨四逆散合寿胎丸加减治疗生育期崩漏脾肾亏虚证的疗效及对患者凝血功能的影响。方法:以76例生育期崩漏患者作为研究对象,辨证为脾肾亏虚证,随机数字表分为两组,对照组38例使用地屈孕酮片治疗; 观察组38例在对照组基础上使用四逆散合寿胎丸加减治疗,均连续治疗3个月经周期后,观察两组疗效、中医症状积分、血常规指标、出血天数、子宫内膜厚度及以及不良反应发生情况。结果:观察组2例患者在治疗过程中未按时按量服药,退出本研究; 对照组38例均完成研究。停药3个周期后,观察组、对照组治疗有效率91.67%、81.58%比较,差异无统计学意义(P>0.05)。治疗3个周期后,观察组患者月经量、月经持续天数、面色和次症面浮肢肿、四肢不温、便溏的症状积分均显著低于对照组(P<0.05)。治疗3个周期后,观察组血红蛋白(Hb)水平显著高于对照组,部分活化凝血活酶时间(APTT)和凝血酶原时间(PT)均显著低于对照组(P<0.05)。治疗3个周期后,观察组出血天数和子宫内膜厚度均显著低于对照组(P<0.05)。观察组不良反应发生率2.78%和对照组0.00%比较,差异无统计学意义(P>0.05)。结论:四逆散合寿胎丸加减可显著改善生育期崩漏患者中医症状和凝血功能,提升Hb水平,减少出血持续天数,安全性较高。

Effect of Sini powder combined with modified Shoutai pill on metrorrhagia of spleen-kidney deficiency during child-bearing and its influences on coagulation function

Objective:To explore the curative effect of Sini powder combined with modified Shoutai pill on metrorrhagia of spleen-kidney deficiency during child-bearing and its influences on coagulation function.Methods:A total of 76 patients with metrorrhagia of spleen-kidney deficiency during child-bearing were enrolled as the research objects.They were divided into control group(38 cases,dydrogesterone tablets)and observation group(38 cases,Sini powder combined with modified Shoutai pill on basis of control group)by random number table method.After three menstrual cycles of consecutive treatment,the curative effect,scores of TCM symptom,blood routine indexes,duration of bleeding,endometrial thickness and occurrence of adverse reactions in both groups were observed.Results:During treatment,there were 2 cases in observation group not regularly taking medication,and dropping out from the study halfway.A total of 36 cases completed the study,while all cases in control group completed the study.After 3 cycles of drug withdrawal,there was no significant difference in the response rate of treatment between observation group and control group 91.67%(33/36)vs 81.58%(31/38)](P>0.05).After 3 cycles of treatment,menstrual volume,menstrual duration,scores of complexion and secondary superficial hematoma,cold limbs,and loose stools in observation group were significantly lower than those in control group(P<0.05).After 3 cycles of treatment,serum activated partial thromboplastin time(APTT)and prothrombin time(PT)in observation group were significantly lower than those in control group,while hemoglobin(Hb)level was significantly higher than that in control group(P<0.05).After 3 cycles of treatment,duration of bleeding and endometrial thickness in observation group were significantly lower than those in control group(P<0.05).At the end of treatment,there was no significant difference in the incidence of adverse reactions between observation group and control group 2.78%(1/36)vs 0.00%(0/38)](P>0.05).Conclusion: Sini powder combined with modified Shoutai pill can significantly improve TCM symptoms and coagulation function of patients with metrorrhagia during child-bearing,increase Hb level,and shorten bleeding duration,with high safety.