参芪固冲方治疗围绝经期无排卵性功能失调性子宫出血临床观察

目的观察参芪固冲方治疗气虚血瘀型围绝经期无排卵性功能失调性子宫出血(功血)的疗效并探讨其止血机制。方法选择气虚血瘀型围绝经期无排卵性功血患者,治疗组47例(口服参芪固冲方),对照组31例(口服坤宁口服液),观察两组患者止血疗效,经血6-酮-前列腺素(6-K-PGF1_(1α))、血栓素B_2(TXB_2),T淋巴细胞亚群(CD3、CD4、CD4/CD8)及血清Ca~(2+)水平变化。结果(1)治疗组止血疗效85.1%(40/47)]优于对照组51.6%(16/31),P0.05]。(2)治疗组治疗前后6-K-PGF_(1α)、TXB_2含量及6-K-PGF_(1α)/TXB_2比较差异有统计学意义,治疗后组间比较差异也有统计学意义,治疗组优于对照组(P0.05,P0.01)。(3)治疗组治疗后血清Ca~(2+)水平明显升高,治疗后组间比较差异也有统计学意义(P0.05)。(4)两组T淋巴细胞亚群指标改善明显(P0.05,P0.01),治疗后组间比较差异有统计学意义,治疗组优于对照组(P0.05)。结论参芪固冲方对气虚血瘀型围绝经期无排卵性功血止血效果明显。其机制可能与改善微循环、增强机体免疫功能、改善子宫局部微环境等有关。

Clinical Observation on Effect of Shenqi Guchong Recipe in Treating Peri-Menopausal Anovulatory Dysfunctional Uterine Bleeding

Objective To investigate the effect and hemostatic mechanism of Shenqi Guchong Recipe （ SGR ） in treating peri-menopausal anovulatory dysfunctional uterine bleeding （ADUB） of qi deficiency blood stasis syndrome type （QDBS）. Methods Patients of ADUB-QDBS were assigned to two groups, the 47 patients in the treated group administering orally with SGR and the 31 in the control group treated with Kunning Oral Liquid. The hemostatic effect, and the changes before and after treatment of 6-ketoprostaglandin α （6-K-PGF1α）, thromboxane B2 （TXB2 ）, T-lymphocyte subsets （CD3 and CD8, CD4/CD8 ratio） in menstrual blood, and serum calcium level in patients were observed. Results The hemostatic effect in the treated group 85. 1% （40/47） ] was better than that in the control group 51.6% （16/31） ] significant difference was shown between groups （ P 〈 0.05）. Changes of 6-K-PGF1 α TXB2 , and 6-K-PGF1α/TXB2 ratio in the treated group were significant after treatment and showed significant difference as compared with those in the control group （P 〈0.05 or P 〈0.01 ）. Meantime, serum Ca^2＋ level was increased and parameters of T-lymphocyte subsets improved significantly in the treated group （ P 〈 0.05 or P 〈 0.01 ）, also statistically different to those in the control group （ P 〈 0.05）. Conclusion SGR shows obvious hemostatic effect in treating patients with ADUB of QDBS type, and the mechanism may be related to its actions for improving microcirculation, enhancing immune function, and improving uterine local micro-environment, etc.