子宫内膜增生患者的中医临床特点分析  

Analysis of Traditional Chinese Medicine Clinical Characteristics of Patients with Endometrial Hyperplasia

作　　者：侯建峰 卢丽波 钟文珍 李丽慧[1] 刘玲[1] HOU Jian-Feng;LU Li-Bo;ZHONG Wen-Zhen;LILi-Hui;LIU Ling(Dept,of Gynecology,Zhuhai Branch Hospital of Guangdong Provincial Traditional Chinese Medicine Hospital,Zhuhai 519000 Guangdong,China;Zhuhai Maternal and Child Health Hospital,Zhuhai 519001 Guangdong,China)

机构地区：[1]广东省中医院珠海医院妇科,广东珠海519000 [2]珠海市妇幼保健院,广东珠海519001

出　　处：《广州中医药大学学报》2021年第8期1559-1563,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：珠海市科技计划项目(编号:20191205E03004)。

摘　　要：【目的】总结分析子宫内膜增生患者的中医临床特点。【方法】采用回顾性调查方法,收集2016年5月至2020年5月期间在广东省中医院珠海医院妇科因“异常子宫出血”住院治疗,经宫腔镜检查及诊刮,病理诊断为子宫内膜增生不伴不典型增生(EH)或子宫内膜不典型增生(AH)的患者,共112例。其中EH组90例,AH组22例;而EH组中,单纯性增生组73例,复杂性增生组17例。采集患者的发病年龄、病程、中医四诊资料、宫腔镜下表现、合并疾病、治疗转归等情况,并分析其中医辨病情况。【结果】(1)一般资料方面,子宫内膜增生患者的发病年龄为(41.3±6.9)岁,中位病程为3个月,不同病理类型子宫内膜增生患者的发病年龄和病程分布情况比较,差异均无统计学意义(P>0.05)。(2)中医四诊资料方面,主症(月经情况)多见漏下淋漓[占47.3%(53/112)]、崩中暴下[占12.5%(14/112)]、经期延长[占12.5%(14/112)],而经血的色质变化多不典型;兼证常见腰膝酸软[占28.6%(32/112)]、头晕乏力[占14.3%(16/112)]、小腹隐痛[占8.0%(9/112)];舌质以淡黯或红多见,而舌苔及脉象较繁杂。除AH组的崩中暴下发生率[35.0%(7/22)]明显高于EH组[7.8%(7/90)],差异有统计学意义(P<0.01)外,不同病理类型子宫内膜增生患者的其他中医四诊资料比较,差异均无统计学意义(P>0.05)。综合中医四诊资料,其辨证以肾虚肝郁、血瘀气滞为主,出血过多时可伴血虚。(3)宫腔镜下表现方面,主要为内膜增厚,局限增生,血管丰富、扩张等,部分患者伴有内膜息肉形成[占50.9%(57/112)]。(4)合并疾病方面,合并子宫肌瘤者占34.8%(39/112),合并子宫腺肌病者占12.5%(12/112),合并乳房结节者占52.7%(59/112),未见乳房恶性肿瘤。并发贫血者占41.1%(46/112),其中发展至重度贫血者占7.1%(8/112)。(5)辨病方面,居前3位者分别为崩漏、经期延长、癥瘕,不同病理类型子宫内膜增生患者的辨病情况比�Objective To investigate the traditional Chinese medicine(TCM)clinical characteristics of patients with endometrial hyperplasia. Methods A retrospective study was conducted in 112 patients who were hospitalized in the department of gynecology of Zhuhai Branch Hospital of Guangdong Provincial Traditional Chinese Medicine Hospital due to abnormal uterine bleeding from May 2016 to may 2020. All of the patients were confirmed by the pathological diagnosis after hysteroscopic examination and diagnostic uterine curettage, and 90 cases were diagnosed as endometrial hyperplasia without atypia(EH)and 22 cases were diagnosed as atypical hyperplasia(AH).In EH group, 73 cases were classified into simple hyperplasia, and 17 cases were classified into complex hyperplasia. The age of onset, course of disease, information obtained by the four TCM diagnostic methods,hysteroscopic findings, comorbidities and treatment outcomes for the 112 cases were collected. Meanwhile, TCM disease differentiation was also undergone. Results(1)In terms of the general information, the onset age of endometrial hyperplasia patients averaged(41.3 ± 6.9)years old,and the median course of disease was 3 months.The onset age had no correlation with the course of disease in the endometrial hyperplasia patients with various pathological types,the difference being insignificant(P>0.05).(2)In respect of the clinical data obtained by the four TCM diagnostic methods, the primary symptoms of menstruation were characterized by metrostaxis(accounting for 47.3%,53/112),profuse uterine bleeding(accounting for 12.5%,14/112),and prolonged menstruation(accounting for 12.5%,14/112),and the changes in the menstrual color and menstrual quality were not obvious;the complicated symptoms were characterized by aching lumbar region and knee(accounting for28.6%, 32/112), vertigo and weakness(accounting for 14.3%, 16/112), and vague pain in the lower abdomen(accounting for 8.0%,9/112);tongue texture was usually darkish or reddish,and the manifestations of the tongue coating an

关 键 词：子宫内膜增生 异常子宫出血 崩漏 经期延长 癥瘕 中医临床特点 

分 类 号：R271.9[医药卫生—中西医结合] R711.74[医药卫生—中医妇科学]