补肾调冲止血汤治疗围绝经期非结构性异常子宫出血临床研究  

Clinical Observation of Bushen Tiaochong Zhixue Tang for Non-structural Abnormal Uterine Bleeding in Perimenopause

作　　者：高珊珊[1] 郑颖[1] 姚慕崑[1] GAO Shanshan,ZHENG Ying,YAO Mukun

机构地区：[1]浙江省立同德医院妇科,浙江杭州310000

出　　处：《新中医》2018年第5期116-119,共4页New Chinese Medicine

基　　金：浙江省中医药重点研究项目(ZJC2015-3255)

摘　　要：目的:观察补肾调冲止血汤治疗围绝经期非结构性异常子宫出血的临床疗效。方法:将110例肾气虚型围绝经期非结构性异常子宫出血患者随机分为对照组和治疗组各55例。对照组于月经周期或诊刮术后14天服地屈孕酮片10天,治疗组在对照组治疗基础上同期服用补肾调冲止血汤。2组疗程均为3个月经周期,疗程结束后随访3个月经周期。记录止血时间,治疗前后检测血红蛋白、性激素指标[促卵泡生成素(FSH)、黄体生成素(LH)、雌激素(E_2)和孕激素(P)],评定中医证候积分。3月随访期间记录复发病例和计算复发率。结果:治疗组临床疗效愈显率83.64%,高于对照组的65.45%,组间比较,差异有统计学意义(P<0.05)。治疗组近期止血效果总有效率92.73%,高于对照组的76.36%,组间比较,差异有统计学意义(P<0.05)。2组FSH、LH、E_2、P水平与中医证候积分均较治疗前下降(P<0.01),治疗组性激素各项指标水平与中医证候积分均低于对照组(P<0.01)。2组血红蛋白水平均较治疗前升高(P<0.01),治疗组高于对照组(P<0.01)。在3月的随访中,对照组复发率32.73%,治疗组复发率12.73%,2组比较,差异有统计学意义(P<0.05)。结论:补肾调冲止血汤联合性激素疗法治疗围绝经期非结构性异常子宫出血肾气虚证患者,近期能起到迅速的止血效果,改善症状,调节性激素水平,提高临床疗效,远期可降低复发率。Objective：To observe the clinical effect of Bushen Tiaochong Zhixue tang for non-structural abnormal uterine bleeding in perimenopause. Methods： Divided 110 cases of patients with non-structural abnormal uterine bleeding in perimenopause as well as syndrome of kidney-qi deficiency randomly into the control group and the treatment group, 55 cases in each group. During the menstrual cycle or 14 days after diagnostic curettage, the control group received dydrogesterone tablets for 10 days,while the treatment group additionally received Bushen Tiaochong Zhixue tang in the same period. The course of treatment for both groups lasted for 3 menstrual cycles,and the follow-up lasted for 3 menstrual cycles after treatment. Recorded the hemostatic time,detected hemoglobin and indexes of sex hormone [follicle-stimulating hormone（FSH）, luteinizing hormone（LH）, estrogen（E2） and progesterone（P）] before and after treatment, and evaluated Chinese medicine syndrome scores. During the 3-month follow-up,recorded recurrent cases and calculated the recurrence rate. Results： The remarkably effective rate of the clinical effect was 83.64% in the treatment group, being higher than 65.45% in the control group, difference being significant（P〈0.05）. The total effective rate of the hemostatic effect was 92.73% in the treatment group,being higher than 76.36% in the control group,difference being significant（P〈0.05）. The levels of FSH,LH,E2 and P as well as Chinese medicine syndrome scores in both groups were all lower than those before treatment（P〈0.01）, and each index of sex hormone and Chinese medicine syndrome scores in the treatment group was lower than that in the control group（P〈0.01）. The levels of hemoglobin in both group were higher than those before treatment（P〈0.01）, and it was higher in the treatment than the control group（P〈0.01）. During the 3-month follow-up, the recurrence rate was 32.73% in the control group and 12.73% in the treatment group,difference being significant

关 键 词：围绝经期 异常子宫出血(AUB) 肾气虚证 中西医结合疗法 补肾调冲止血汤 性激素 

分 类 号：R711.65[医药卫生—妇产科学]