固冲止血方防治TCRP术后放置左炔诺孕酮宫内节育系统引起异常子宫出血的临床疗效观察  

Clinical observation on the curative effect of Guchong Zhixue Prescription on preventing abnormal uterine bleeding caused by levonorgestrel intrauterine system placement after TCRP operation

作　　者：李小丹[1] 杜娟[1] 黎丽娜[1] 林瑞盈[1] LI Xiao-dan;DU Juan;LI Li-na(Department of Gynecology,Guangdong Hospital of Traditional Chinese Medicine,Zhuhai 519000,China)

机构地区：[1]广东省中医院珠海医院妇科,广东珠海519000

出　　处：《中国处方药》2023年第12期155-158,共4页Journal of China Prescription Drug

基　　金：2022年度珠海市医学科研项目(2220009000174)。

摘　　要：目的探讨固冲止血方防治宫腔镜下子宫内膜息肉切除术(TCRP)术后放置左炔诺孕酮宫内节育系统引起异常子宫出血的临床疗效。方法选取60例TCRP术后放置左炔诺孕酮宫内节育系统的患者,根据随机数字表法分成观察组与对照组,观察组30例,其中1例因左炔诺孕酮宫内节育系统于放置后第2天脱落剔除,最终纳入29例,对照组30例。观察组在放置左炔诺孕酮宫内节育系统当日及第2个月、第3个月月经来潮时口服固冲止血方,对照组不进行中医药干预。比较两组患者术后第1、2、3个月阴道出血天数、出血量和医疗满意度。结果观察组术后第1、2、3个月的出血天数均显著少于对照组,差异有统计学意义(P<0.05)。术后第1个月两组PBCA评分无显著性差异,观察组术后第2、3个月的PBCA评分显著低于对照组,差异具有统计学意义(P<0.05)。观察组患者医疗满意度高于对照组,差异有统计学意义(P=0.033)。结论应用固冲止血方防治TCRP术后放置左炔诺孕酮宫内节育系统引起异常子宫出血临床疗效确切,可减少患者出血天数及出血量、提高患者医疗满意度。Objective To investigate the clinical efficacy of Guchong Zhixue Prescription in preventing and treating abnormal uterine bleeding caused by levonorgestrel intrauterine system placement after TCRP.Methods A total of 60 patients who were placed with levonorgestrel intrauterine system after TCRP operation were selected and divided into the observation group and the control group according to random number table method.Among the 30 patients in the observation group,one case fell off the second day after placement of levonorgestrel intrauterine system.Finally,29 cases were included and 30 cases in the control group.The observation group took Guchong Zhixue Prescription orally on the day of levonorgestrel intrauterine system placement and at the time of menstruation in the second and third months,while the control group did not add Chinese medicine intervention.The number of days of vaginal bleeding,the amount of bleeding and medical satisfaction were compared between the two groups at 1,2 and 3 months after operation.Results The bleeding days in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in PBCA scores between the two groups at the first month after surgery,and the PBCA scores of the observation group at the second and third months after surgery were significantly lower than those of the control group,with statistical difference(P<0.05).The medical satisfaction of patients in the observation group was higher than that in the control group,and the difference was statistically significant(P=0.033).Conclusion The application of Guchong Zhixue Prescription in the prevention and treatment of abnormal uterine bleeding caused by irena placement after TCRP operation has definite clinical effect,can reduce the bleeding days and blood volume of patients,and improve the medical satisfaction of patients.

关 键 词：子宫内膜息肉 宫腔镜 左炔诺孕酮宫内节育系统 异常子宫出血 固冲止血 

分 类 号：R271.9[医药卫生—中西医结合]