止崩汤干预子宫腺肌病曼月乐治疗后异常子宫出血临床观察
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摘要
目的:观察止崩汤治疗子宫腺肌病患者宫内放置曼月乐后出现异常子宫出血的临床疗效。方法:将74例宫内放置曼月乐后出现异常子宫出血的患者随机分为治疗组和对照组各37例,治疗组给予止崩汤治疗,对照组给予肾上腺色腙片口服。治疗后评估临床疗效,记录患者经期阴道流血天数及月经失血图评分法(PBAC)评分。结果:治疗3个月经周期,治疗组治愈率和总有效率分别为8.11%、83.78%,对照组治愈率和总有效率分别为5.41%、70.27%。2组治愈率及总有效率比较,差异均无统计学意义(P>0.05)。治疗6个月经周期,治疗组治愈率和总有效率分别为35.14%、94.59%,对照组治愈率和总有效率分别为10.81%、78.38%。2组治愈率及总有效率比较,差异均有统计学意义(P<0.05)。治疗6个月经周期,2组经期阴道流血天数均较治疗前减少(P<0.05);治疗组经期阴道流血天数少于对照组(P<0.05)。治疗3个月经周期及6个月经周期后,2组PBAC评分均较治疗前降低(P<0.05);治疗组PBAC评分低于同期对照组(P<0.05)。治疗组取环1例,取环率为2.70%,对照组取环3例,取环率为8.11%。2组取环率比较,差异无统计学意义(P>0.05)。结论:止崩汤能有效缩短子宫腺肌病曼月乐治疗后异常子宫出血患者的经期阴道流血天数,减少阴道流血量,提高治愈率及总有效率,但需较长的治疗周期。
Objective:To observe the clinical effect of Zhibeng tang for adenomyosis patients with abnormal uterine bleeding induced by Mirena. Methods:Divided 74 cases of adenomyosis patients who suffered abnormal uterine bleeding after intrauterine placement of Mirena into the treatment group and the control group randomly,37 cases in each group. The treatment group was given Zhibeng tang,while the control group was given oral carbazochrome tablets. Results:After treatment of three menstrual cycles,the cure rate was 8.11% and the total effective rate was 83.78% in the treatment group,while the cure rate was 5.41% and the total effective rate was 70.27% in the control group. No significant difference was found in the comparisons of cure rate and total effective rate between the two groups(P > 0.05). After treatment of six menstrual cycles,the cure rate was 35.14% and the total effective rate was 94.59% in the treatment group,while the cure rate was 10.81% and the total effective rate was 78.38% in the control group. The comparisons of cure rate and total effective rate between the two groups showed significance in differences(P < 0.05). After treatment of six menstrual cycles,the number of days of vaginal bleeding during menstrual period in both groups was decreased when compared with those before treatment(P < 0.05). The number of days of vaginal bleeding during menstrual period in the treatment group was less than those in the control group(P < 0.05). After treatment of three and six menstrual cycles,scores of pictorial blood loss assessment chart(PBAC) in both groups were decreased when compared with those before treatment(P < 0.05). The PBAC scores in the treatment group were lower than those in the control group during the same period(P < 0.05). There was one case of patient with removal of intrauterine device in the treatment group,the rate of removing intrauterine device being 2.70%. There were three cases of patient with removal of intrauterine device in the control group,the rate of removing intrauterine device being 8.11%. No significant difference was found in the comparison of the rate of removing intrauterine device between the two groups(P > 0.05). Conclusion:Zhibeng tang can effectively shorten the duration of vaginal bleeding in patients with adenomyosis who suffered abnormal uterine bleeding after intrauterine placement of Mirena,reduce the amount of vaginal bleeding during menstrual period,as well as improve the cure rate and total effective rate,but it needs a longer treatment cycle.
Objective:To observe the clinical effect of Zhibeng tang for adenomyosis patients with abnormal uterine bleeding induced by Mirena. Methods:Divided 74 cases of adenomyosis patients who suffered abnormal uterine bleeding after intrauterine placement of Mirena into the treatment group and the control group randomly,37 cases in each group. The treatment group was given Zhibeng tang,while the control group was given oral carbazochrome tablets. Results:After treatment of three menstrual cycles,the cure rate was 8.11% and the total effective rate was 83.78% in the treatment group,while the cure rate was 5.41% and the total effective rate was 70.27% in the control group. No significant difference was found in the comparisons of cure rate and total effective rate between the two groups(P > 0.05). After treatment of six menstrual cycles,the cure rate was 35.14% and the total effective rate was 94.59% in the treatment group,while the cure rate was 10.81% and the total effective rate was 78.38% in the control group. The comparisons of cure rate and total effective rate between the two groups showed significance in differences(P < 0.05). After treatment of six menstrual cycles,the number of days of vaginal bleeding during menstrual period in both groups was decreased when compared with those before treatment(P < 0.05). The number of days of vaginal bleeding during menstrual period in the treatment group was less than those in the control group(P < 0.05). After treatment of three and six menstrual cycles,scores of pictorial blood loss assessment chart(PBAC) in both groups were decreased when compared with those before treatment(P < 0.05). The PBAC scores in the treatment group were lower than those in the control group during the same period(P < 0.05). There was one case of patient with removal of intrauterine device in the treatment group,the rate of removing intrauterine device being 2.70%. There were three cases of patient with removal of intrauterine device in the control group,the rate of removing intrauterine device being 8.11%. No significant difference was found in the comparison of the rate of removing intrauterine device between the two groups(P > 0.05). Conclusion:Zhibeng tang can effectively shorten the duration of vaginal bleeding in patients with adenomyosis who suffered abnormal uterine bleeding after intrauterine placement of Mirena,reduce the amount of vaginal bleeding during menstrual period,as well as improve the cure rate and total effective rate,but it needs a longer treatment cycle.
引文
[1]陈爱兰,钟子健,涂青翠.左炔诺孕酮宫内缓释系统(LNG-IUS)副反应的中药治疗调控[J].河北中医药学报,2011,26(3):18-19.
[2]余洁,区宝珠.自拟止崩汤治疗宫内节育器(IUD)致经期延长30例疗效观察[J].光明中医,2006,21(1):35-36.
[3]国家中医药管理局.ZY/T001.1-94中医病证诊断疗效标准[S].北京:中国医药科技出版社,2012:233-236.
[4]王景莲.保阴煎合失笑散治疗上环后出血30例[J].中国社区医师(医学专业半月刊),2009,11(24):141.
[2]余洁,区宝珠.自拟止崩汤治疗宫内节育器(IUD)致经期延长30例疗效观察[J].光明中医,2006,21(1):35-36.
[3]国家中医药管理局.ZY/T001.1-94中医病证诊断疗效标准[S].北京:中国医药科技出版社,2012:233-236.
[4]王景莲.保阴煎合失笑散治疗上环后出血30例[J].中国社区医师(医学专业半月刊),2009,11(24):141.