葆宫止血颗粒联合炔诺酮治疗围绝经期功能失调性子宫出血的临床研究

目的探讨葆宫止血颗粒联合炔诺酮治疗围绝经期功能失调性子宫出血的临床效果。方法选取2015年3月—2018年3月唐山市丰润区中医医院收治的围绝经期功能失调性子宫出血患者95例,随机分成对照组(47例)和治疗组(48例)。对照组口服炔诺酮片,5 mg/次,1次/8 h,连用3 d;而后减量至5 mg/次,1次/12 h,连用7 d,再以1次/d维持治疗。治疗组在对照组基础上口服葆宫止血颗粒,15 g/次,2次/d。两组均连续治疗22 d。观察两组患者临床疗效,同时比较治疗前后两组患者止血效果、外周血血红蛋白(HGB)水平、子宫内膜厚度、血清性激素水平和36项健康调查简表第二版(SF-36 v2)评分。结果治疗后,对照组和治疗组患者临床有效率分别为81.3%和95.7%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组控制出血时间和完全止血时间均明显早于对照组(P0.05)。治疗后,两组患者外周血HGB水平均显著升高(P0.05),而子宫内膜厚度均显著变薄(P0.05),且治疗组外周血HGB水平显著高于同期对照组(P0.05),子宫内膜厚度则显著薄于对照组(P0.05)。治疗后,两组患者雌二醇(E2)、促卵泡刺激素(FSH)、促黄体生成素(LH)、睾酮(T)的血清浓度均显著降低(P0.05),且治疗组上述性激素指标血清水平明显低于对照组(P0.05)。治疗后,两组患者SF-36v2生理领域总分和心理领域总分较治疗前均显著升高(P0.05),且治疗组SF-36 v2评分明显高于对照组(P0.05)。结论葆宫止血颗粒联合炔诺酮治疗围绝经期功能失调性子宫出血的整体疗效确切,可迅速控制患者急性出血,改善贫血状态,提高患者生命质量。

Clinical study on Baogong Zhixue Granules combined with norethisterone in treatment of dysfunctional uterine bleeding in perimenopause

Objective To investigate the clinical effect of Baogong Zhixue Granules combined with norethisterone in treatment of dysfunctional uterine bleeding in perimenopause. Methods Patients (95 cases) with dysfunctional uterine bleeding in perimenopause in Tangshan Fengrun District Hospital of TCM from March 2015 to March 2018 were randomly divided into control (47 cases) and treatment (47 cases) groups. Patients in the control group were po administered with Norethisterone Tablets, 5 mg/time, once every 8 h for 3 d, then decreased to once every 12 h for 7 d, and after that decreased to once daily for maintenance. Patients in the treatment group were po administered with Baogong Zhixue Granules on the basis of the control group, 15 g/time, twice daily. Patients in two groups were treated for 22 d. After treatment, the clinical efficacy was evaluated, and the hemostatic effects, HGB level of peripheral blood, endometrial thickness, serum levels of sex hormones and SF-36 v2 scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 81.3% and 95.7%, respectively, and there were differences between two groups (P<0.05). After treatment, the time of control bleeding and complete hemostasis in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, the HGB level of peripheral blood in two groups was significantly increased (P<0.05), but endometrial thickness was significantly reduced (P<0.05), and the HGB level of peripheral blood in the treatment group was significantly higher than that in the control group (P<0.05), but endometrial thickness was significantly thinner than that in the control group (P<0.05). After treatment, serum levels of E2, FSH, LH, and T in two groups were significantly decreased (P<0.05), and the sex hormones levels in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the total scores in physiological field and in psychological field in two groups were significantly increased (P<0.05), and the SF-36 v2 scores in the treatment group were significantly higher than those in the control group (P<0.05). Conclusion Baogong Zhixue Granules combined with norethisterone has definite overall curative effect in treatment of dysfunctional uterine bleeding in perimenopause, can quickly control acute hemorrhage, improve anemia and improve the quality of life.