青春期异常子宫出血伴贫血临床特点及滋肾补血中药分期疗法的疗效评价  

Clinical characteristics of abnormal uterine bleeding with anemia in adolescents and efficacy evaluation of staged treatment with kidney-nourishing and blood-supplementing traditional Chinese medicines

作　　者：富洋 曾巧钱 赵雯 孙雯 汪永红 FU Yang;ZENG Qiaoqian;ZHAO Wen;SUN Wen;WANG Yonghong(Department of Hematology,National Children's Medical Center,Children's Hospital of Fudan University,Shanghai 201102,China;Department of Rheumatology,National Children's Medical Center,Children's Hospital of Fudan University,Shanghai 201102,China;Department of Traditional Chinese Medicine,National Children's Medical Center,Children's Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]国家儿童医学中心/复旦大学附属儿科医院血液科,上海201102 [2]国家儿童医学中心/复旦大学附属儿科医院风湿科,上海201102 [3]国家儿童医学中心/复旦大学附属儿科医院中医科,上海201102

出　　处：《上海中医药杂志》2025年第3期64-68,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市科委中医引导项目(19401931000)。

摘　　要：目的分析青春期异常子宫出血(AUB)合并贫血患儿的临床特点,评价滋肾补血分期疗法治疗肾阴亏虚、血热内扰型AUB患儿的疗效。方法收集青春期AUB合并贫血患儿的病历资料,包括初潮年龄、病程等一般资料,经量、经色、面色、舌脉等中医证候资料,血常规、性激素6项等实验室资料,以及生殖系统B超检查资料,分析其临床特点及中医证型分布情况;从月经和贫血恢复情况两方面评估滋肾补血分期疗法治疗肾阴亏虚、血热内扰型AUB患儿的疗效。结果①共纳入96例患儿,发病中位年龄为13.5岁,41.7%的患儿在初潮后1年内起病,54.2%的患儿就诊时病程已持续1年以上;贫血程度以轻度为主(70.8%),55.2%的患儿为小细胞低色素性贫血。②共有82例患儿在就诊时进行了完整的性激素水平检测,其中56例(68.3%)存在性激素紊乱,20例(24.4%)存在2项以上激素指标异常,各项异常指标中以睾酮升高最多(50.0%)。③共有76例患儿在就诊时进行了子宫与卵巢B超检查,子宫体积5.45~58.05cm3,卵巢体积2.23~14.16cm3。④青春期AUB最常见的中医证型为肾阴亏虚证(61.5%)和血热内扰证(29.2%)。⑤共有87例患儿采用了滋肾补血分期疗法联合铁剂进行治疗,有9例随访时间不足3个月,最终78例患儿纳入疗效评价,崩漏总有效率为98.7%,贫血总有效率为69.2%。结论青春期AUB伴贫血的患儿以肾阴亏虚、血热内扰为主要中医证型,采用中药滋肾补血分期疗法进行治疗,疗效满意。Objective To analyze the clinical characteristics of adolescents with abnormal uterine bleeding(AUB)and anemia,and evaluate the efficacy of the staged treatment with kidney-nourishing and blood-supplementing(KNBS)traditional Chinese medicines(TCMs)for AUB adolescents with kidney-yin deficiency syndrome and internal disturbance of blood-heat syndrome.Methods Medical records of adolescents with AUB and anemia were collected,including general data on menarche age and disease duration,TCM syndrome and symptom data on menstrual volume and color,facial complexion,tongue and pulse patterns,laboratory results such as complete blood count and six sex hormones,and reproductive system ultrasound findings.Clinical characteristics and the TCM syndrome distribution were analyzed.The efficacy of the staged treatment with kidney-invigorating and blood-nourishing TCMs was evaluated in terms of menstrual recovery and anemia improvement for AUB adolescents with kidney-yin deficiency syndrome and internal disturbance of blood-heat syndrome.Results①A total of 96 patients were included,with a median age of onset of 13.5 years old.Symptoms developed in 41.7%of patients within one year after menarche,while 54.2%had a disease duration longer than one year at the time of consultation.Mild anemia was the most common(70.8%),with 55.2%of patients presenting with microcytic hypochromic anemia.②Among the 82 patients who underwent six sex hormone level testing,56 patients(68.3%)showed hormone imbalances,with 20 patients(24.4%)presenting with abnormalities in more than two hormone levels.Elevated testosterone was the most common abnormality(50.0%).③A reproductive system ultrasound was performed on 76 patients,with uterine volumes ranging from 5.45 to 58.05 cm³and ovarian volumes ranging from 2.23 to 14.16 cm³.④The most common TCM syndromes in adolescents with AUB were kidney-yin deficiency syndrome(61.5%)and internal disturbance of blood-heat syndrome(29.2%).⑤Eighty-seven patients received the staged KNBS treatment together with iron

关 键 词：青春期 异常子宫出血 崩漏 贫血 中医药疗法 回顾性研究 

分 类 号：R271.9[医药卫生—中西医结合]