宫血宁胶囊联合醋酸甲羟孕酮和戊酸雌二醇治疗青春期功能失调性子宫出血的疗效观察

目的探讨宫血宁胶囊联合醋酸甲羟孕酮和戊酸雌二醇治疗青春期功能失调性子宫出血的临床疗效。方法选取2014年1月—2015年1月在海南省第三人民医院接受治疗的青春期功能失调性子宫出血患者76例,随机分为对照组和治疗组,每组各38例。所有患者均给予必要的心理干预。对照组口服醋酸甲羟孕酮片,8 mg/d,止血3 d后开始减量,每3天减量1/3,维持量为1 mg/d;同时口服戊酸雌二醇片,4~6 mg/次,3次/d。治疗组在对照组基础上口服宫血宁胶囊,2粒/次,3次/d。两组患者均连续治疗21 d。观察两组患者的临床疗效,同时比较治疗前后两组患者止血时间、性激素水平和WHOQOL-BREF评分的变化情况。结果治疗后,对照组和治疗组总有效率分别为84.21%、97.37%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组的有效控制出血时间和完全止血时间明显短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平均明显降低(P0.05);且治疗组上述性激素指标水平降低更显著(P0.05)。治疗后,两组患者生理健康评分、心理状态评分、社会关系评分、周围环境评分和总分均较同组治疗前升高(P0.05);治疗组上述各项WHOQOL-BREF评分升高的更明显(P0.05)。结论宫血宁胶囊联合醋酸甲羟孕酮和戊酸雌二醇治疗青春期功能失调性子宫出血疗效确切,可有效提高患者生活质量,具有一定的临床应用推广价值。

Clinical observation of Gongxuening Capsules combined with medroxyprogesterone acetate and estradiol valerate in treatment of adolescent dysfunctional uterine bleeding

Objective To study the clinical effect of Gongxuening Capsules combined with medroxyprogesterone acetate and estradiol valerate in treatment of adolescent dysfunctional uterine bleeding. Methods Patients (76 cases) with adolescent dysfunctional uterine bleeding in the Third People''s Hospital of Hainan Province from January 2014 to January 2015 were divided into control and treatment groups, and each group had 38 cases. All patients were given necessary psychological interventions. The patients in the control group was po administered with Medroxyprogesterone Acetate Tablets, 8 mg/d, the dosage was reduced by 1/3 every 3 d after hemostasis for 3 d, and maintenance dose was 1 mg/d; And they were po administered with Estradiol Valerate Tablets, 4~6 mg/time, three times daily. The patients in the treatment group were po administered with Gongxuening Capsules, 2 grains/time, three times daily. The patients in two groups were treated for 21 d. The clinical effect in two groups were observed, and the changes of haemostatic time, sex hormone levels, and WHOQOL-BREF scores were compared. Results After treatment, the clinical effect in the control and treatment groups were 84.21% and 97.37%, respectively, and there was difference between two groups (P<0.05). After treatment, the effective control bleeding time and completely haemostatic time in treatment group were shorter than those in the control group, with significant difference between two groups (P<0.05). After treatment, FSH, LH, and E2 in two groups were obviously decreased (P<0.05); And the decreasing degree of those sex hormone levels in treatment group was more obvious (P<0.05). After treatment, scores of physical health, psychological state, social relations, environmental, and total score in two groups were significantly increased (P<0.05). The improved degree of those WHOQOL-BREF scores in the treatment group was more significant (P<0.05). Conclusion Gongxuening Capsules combined with medroxyprogesterone acetate and estradiol valerate in treatment of adolescent dysfunctional uterine bleeding has a reliable clinical effect, and can effectively improve the quality of life, which has a certain clinical application value.