固冲止崩汤联合地屈孕酮在围绝经期异常子宫出血中的应用观察
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摘要
目的:探讨固冲止崩汤联合地屈孕酮治疗围绝经期异常子宫出血对患者临床效果、子宫内膜厚度、症状恢复、激素水平和炎性因子的影响。方法:选取新疆维吾尔自治区中医医院异常子宫出血的围绝经期患者124例,按入院时间分为治疗组与对照组,每组62例,治疗组予固冲止崩汤联合地屈孕酮,对照组予地屈孕酮,比较两组治疗后临床效果、子宫内膜厚度、控制出血和完全止血时间、中医证候积分、血红蛋白、激素水平以及炎性因子。结果:治疗组治愈率、显效率和总有效率分别为35.5%、33.9%和95.2%,均高于对照组,差异均有统计学意义(P<0.05);治疗组治疗后子宫内膜厚度小于对照组,控制出血时间和完全止血时间均少于对照组,差异具有统计学意义(P<0.05);治疗组治疗后月经色淡有块、小腹疼痛、气短神疲和面色萎黄等症状积分均低于对照组,差异均有统计学意义(P<0.05);治疗组治疗后FSH和LH值均低于对照组,E2值高于对照组,差异均有统计学意义(P<0.05);治疗组治疗后血红蛋白值高于对照组,炎性因子IL-2和TNF-α值均低于对照组,差异均有统计学意义(P<0.05)。结论:固冲止崩汤联合地屈孕酮治疗围绝经期异常子宫出血临床效果较好,子宫内膜厚度降低明显,可缩短止血时间,改善激素水平,缓解炎性反应,症状恢复更快。
Object: To investigate the clinical effect, endometrial thickness, symptom recovery, hormone levels and inflammatory factors of Guchong Zhipeng Decoction combined with dydrogesterone in the treatment of abnormal uterine bleeding in perimenopausal period. Method: A total of 124 perimenopausal patients with abnormal uterine bleeding in TCM Hospital of Xinjiang Uygur Autonomous Region were divided into observation group and control group according to admission time, 62 cases in each group.The observation group was treated with Guchong Zhipeng Decoction and dydrogesterone, while the control group was given dydrogesterone. The clinical effect, endometrial thickness, control bleeding and complete hemostasis time, TCM syndrome score,hemoglobin, hormone levels and inflammatory factors were compared between the two groups after treatment.Result: The cure rate, marked effective rate and total effective rate of the observation group were 35.5%, 33.9%and 95.2% respectively, which were higher than those of the control group, the difference were statistically significant(P<0.05). The endometrial thickness of the observation group was less than that of the control group,and t he control bleeding time and complete hemostasis time were less than those of the control group, the difference was statistically significant(P<0.05). The scores of symptoms such as pale menstrual lump, abdominal pain, shortness of breath and mental fatigue, and yellowness of complexion in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). FSH and LH values of the observation group were lower than those of the control group, the E2 values were higher than those of the control group, the difference were statistically significant(P<0.05). The hemoglobin level of the observation group was higher than that of the control group, and the inflammatory factors IL-2 and TNF-alpha levels were lower than those of the control group, the difference were statistically significant(P<0.05). Conclusion: The application of Guchong Zhipeng Decoction combined with dydrogesterone in the treatment of abnormal uterine bleeding in peri-menopausal period has a better clinical effect, which can reduce the endometrial thickness more obviously,shorten hemostasis time, improve the hormone level, alleviate the inflammatory response and fasten the symptoms recover time.
Object: To investigate the clinical effect, endometrial thickness, symptom recovery, hormone levels and inflammatory factors of Guchong Zhipeng Decoction combined with dydrogesterone in the treatment of abnormal uterine bleeding in perimenopausal period. Method: A total of 124 perimenopausal patients with abnormal uterine bleeding in TCM Hospital of Xinjiang Uygur Autonomous Region were divided into observation group and control group according to admission time, 62 cases in each group.The observation group was treated with Guchong Zhipeng Decoction and dydrogesterone, while the control group was given dydrogesterone. The clinical effect, endometrial thickness, control bleeding and complete hemostasis time, TCM syndrome score,hemoglobin, hormone levels and inflammatory factors were compared between the two groups after treatment.Result: The cure rate, marked effective rate and total effective rate of the observation group were 35.5%, 33.9%and 95.2% respectively, which were higher than those of the control group, the difference were statistically significant(P<0.05). The endometrial thickness of the observation group was less than that of the control group,and t he control bleeding time and complete hemostasis time were less than those of the control group, the difference was statistically significant(P<0.05). The scores of symptoms such as pale menstrual lump, abdominal pain, shortness of breath and mental fatigue, and yellowness of complexion in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). FSH and LH values of the observation group were lower than those of the control group, the E2 values were higher than those of the control group, the difference were statistically significant(P<0.05). The hemoglobin level of the observation group was higher than that of the control group, and the inflammatory factors IL-2 and TNF-alpha levels were lower than those of the control group, the difference were statistically significant(P<0.05). Conclusion: The application of Guchong Zhipeng Decoction combined with dydrogesterone in the treatment of abnormal uterine bleeding in peri-menopausal period has a better clinical effect, which can reduce the endometrial thickness more obviously,shorten hemostasis time, improve the hormone level, alleviate the inflammatory response and fasten the symptoms recover time.
引文
[1]孟燕,彭宇洪.复方18甲基炔诺酮联合雌激素治疗功能失调性子宫出血的临床分析[J].中国生化药物杂志,2014,34(3):140-142.
[2]岳明明,孙炜星,沙塔娜提·穆罕默德.中西医结合治疗对气虚血瘀型无排卵性功能失调性子宫出血患者子宫内膜厚度、生殖激素及炎性因子水平的影响[J].中国卫生检验杂志,2017,27(14):1987-1989.
[3]张伟凤.小剂量米非司酮联合宫血宁对围绝经期功能失调性子宫出血临床疗效及性激素水平的影响[J].海南医学院学报,2016,22(7):683-685.
[4]程红,梁文珍,钮缓缓,等.固经汤治疗气虚型无排卵性功能失调性子宫出血出血期的临床研究[J].上海中医药大学学报,2016,30(5):30-33.
[5]Mescihaftaci S,Ankarali H,Yavuzcan A,et al.Endometrial curettage in abnormal uterine bleeding and efficacy of progestins for control in cases of hyperplasia[J].Asian Pacific J Cancer Prevention Apjcp,2014,15(8):3737-3740.
[6]何华,余小蓉,张正琼.宫血宁胶囊联合米非司酮对围绝经期功能失调性子宫出血患者血清性激素水平的影响[J].中国性科学,2015,24(9):25-27.
[7]曹伟丽.白眉蛇毒血凝酶联合复方戊酸雌二醇片对绝经过渡期功能失调性子宫出血患者血清性激素水平的影响[J].中国妇幼保健,2016,31(21):4494-4495.
[8]牛晶娟.固冲汤加减联合米非司酮治疗围绝经期功能失调性子宫出血的效果分析[J].河南医学研究,2017,26(7):1297-1298.
[9]Gan Q,Lian X Q,Luo Z M,et al.Efficacy observation of compound procaine hydrochloride capsules in treatment of perimenopausal dysfunctional uterine bleeding[J].China Modern Medicine,2015,20(5):1005-1007.
[10]李妮,李花繁.固冲益肾方联合左炔诺孕酮治疗功能失调性子宫出血的疗效及对患者性激素水平的影响[J].中国性科学,2017,26(6):50-52.
[11]Liu W,Ma S,Pan W,et al.Combination of motherwort injection and oxytocin for the prevention of postpartum hemorrhage after cesarean section[J].J Matern Fetal Neonatal Med,2016,29(15):2489-2492.
[12]马秀芳.固冲止崩汤联合妈富隆治疗更年期功能性子宫出血40例临床观察[J].西部中医药,2013,26(6):97-99.
[13]张翠云.固冲止崩汤联合去氧孕烯炔雌醇片治疗更年期功能性子宫出血的临床疗效[J].实用妇科内分泌杂志,2014,5(1):9-11.
[14]周月琴.地屈孕酮与安宫黄体酮及妇康片治疗围绝经期功血的疗效对比[J].内蒙古医学杂志,2016,48(10):1168-1169.
[15]夏鄂雁.地屈孕酮治疗围绝经期功能失调性子宫出血临床研究[J].系统医学,2017,2(9):96-98.
[16]Khan R,Sherwani RK,Rana S,et al.ClincoPathological Patterns in Women with Dysfunctional Uterine Bleeding[J].Iran J Pathol,2016,11(1):20-26.
[2]岳明明,孙炜星,沙塔娜提·穆罕默德.中西医结合治疗对气虚血瘀型无排卵性功能失调性子宫出血患者子宫内膜厚度、生殖激素及炎性因子水平的影响[J].中国卫生检验杂志,2017,27(14):1987-1989.
[3]张伟凤.小剂量米非司酮联合宫血宁对围绝经期功能失调性子宫出血临床疗效及性激素水平的影响[J].海南医学院学报,2016,22(7):683-685.
[4]程红,梁文珍,钮缓缓,等.固经汤治疗气虚型无排卵性功能失调性子宫出血出血期的临床研究[J].上海中医药大学学报,2016,30(5):30-33.
[5]Mescihaftaci S,Ankarali H,Yavuzcan A,et al.Endometrial curettage in abnormal uterine bleeding and efficacy of progestins for control in cases of hyperplasia[J].Asian Pacific J Cancer Prevention Apjcp,2014,15(8):3737-3740.
[6]何华,余小蓉,张正琼.宫血宁胶囊联合米非司酮对围绝经期功能失调性子宫出血患者血清性激素水平的影响[J].中国性科学,2015,24(9):25-27.
[7]曹伟丽.白眉蛇毒血凝酶联合复方戊酸雌二醇片对绝经过渡期功能失调性子宫出血患者血清性激素水平的影响[J].中国妇幼保健,2016,31(21):4494-4495.
[8]牛晶娟.固冲汤加减联合米非司酮治疗围绝经期功能失调性子宫出血的效果分析[J].河南医学研究,2017,26(7):1297-1298.
[9]Gan Q,Lian X Q,Luo Z M,et al.Efficacy observation of compound procaine hydrochloride capsules in treatment of perimenopausal dysfunctional uterine bleeding[J].China Modern Medicine,2015,20(5):1005-1007.
[10]李妮,李花繁.固冲益肾方联合左炔诺孕酮治疗功能失调性子宫出血的疗效及对患者性激素水平的影响[J].中国性科学,2017,26(6):50-52.
[11]Liu W,Ma S,Pan W,et al.Combination of motherwort injection and oxytocin for the prevention of postpartum hemorrhage after cesarean section[J].J Matern Fetal Neonatal Med,2016,29(15):2489-2492.
[12]马秀芳.固冲止崩汤联合妈富隆治疗更年期功能性子宫出血40例临床观察[J].西部中医药,2013,26(6):97-99.
[13]张翠云.固冲止崩汤联合去氧孕烯炔雌醇片治疗更年期功能性子宫出血的临床疗效[J].实用妇科内分泌杂志,2014,5(1):9-11.
[14]周月琴.地屈孕酮与安宫黄体酮及妇康片治疗围绝经期功血的疗效对比[J].内蒙古医学杂志,2016,48(10):1168-1169.
[15]夏鄂雁.地屈孕酮治疗围绝经期功能失调性子宫出血临床研究[J].系统医学,2017,2(9):96-98.
[16]Khan R,Sherwani RK,Rana S,et al.ClincoPathological Patterns in Women with Dysfunctional Uterine Bleeding[J].Iran J Pathol,2016,11(1):20-26.