培坤丸联合左炔诺孕酮治疗围绝经期功能失调性子宫出血的疗效观察

目的探讨培坤丸联合左炔诺孕酮治疗功能失调性子宫出血患者的安全性与有效性。方法选取2013年2月—2018年2月在自贡市妇幼保健院诊治的功能失调性子宫出血患者78例,根据用药差别分成对照组(39例)和治疗组(39例)。对照组患者口服左炔诺孕酮片,2片/次,2次/d,待阴道停止流血3 d后,药量改为1次/d,1片/次,维持治疗14 d,1个月经周期为1个疗程。治疗组患者在对照组基础上口服培坤丸,9g/次,2次/d。两组患者均连续治疗3个疗程。观察两组患者临床疗效,同时比较治疗前后两组患者血红蛋白水平、经期天数、WHOQOL-BREF评分及性激素水平。结果治疗后,对照组和治疗组临床有效率分别为76.92%和94.87%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血红蛋白水平和WHOQOL-BREF评分均显著升高(P0.05),经期天数均显著减少(P0.05),且治疗组上述指标明显优于对照组(P0.05)。治疗后,两组患者雌二醇、卵泡刺激素和促黄体生成素均显著降低(P0.05),且治疗组雌二醇、卵泡刺激素和促黄体生成素水平明显低于对照组(P0.05)。结论培坤丸联合左炔诺孕酮治疗功能失调性子宫出血疗效显著,不良反应少,且能够显著提升排卵率,具有一定的临床推广应用价值。

Clinical observation of Peikun Pills combined with levonorgestrel in treatment of perimenopausal dysfunctional uterine bleeding

Objective To investigate the safety and efficacy of Peikun Pills combined with levonorgestrel in treatment of perimenopausal dysfunctional uterine bleeding. Methods Patients (78 cases) with perimenopausal dysfunctional uterine bleeding in Zigong Maternal and Child Health-Care Hospital from February 2013 to February 2018 were divided into control (49 cases) and treatment (49 cases) groups according to different treatments. Patients in the control group were po administered with Levonorgestrel Tablets, 2 tablets/time, twice daily, dosage adjusted to 1 tablet/time after 3 d of vaginal stop bleeding for 14 d, once daily, and one menstrual cycle was a course of treatment. Patients in the treatment group were po administered with Peikun Pills on the basis of the control group, 9 g/time, twice daily. Patients in two groups were treated for 3 courses of treatment. After treatment, the clinical efficacy was evaluated, and the hemoglobin levels, menstrual days, WHOQOL-BREF scores, and the sex hormone levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 76.92% and 94.87%, respectively, and there were differences between two groups (P<0.05). After treatment, the hemoglobin levels and WHOQOL-BREF scores in two groups were significantly increased (P<0.05), but the menstrual days were significantly decreased (P<0.05), and the indicators in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the estradiol, follicle stimulating hormone and luteinizing hormone levels in two groups were significantly decreased (P<0.05), and these sex hormone levels in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Peikun Pills combined with levonorgestrel has significant curative effect on perimenopausal dysfunctional uterine bleeding with less adverse reactions, and can significantly improve the ovulation rate, which has a certain clinical application value.