目的 探究復(fù)方炔諾酮片聯(lián)合戊酸雌二醇治療功能失調(diào)性子宮出血的療效觀察。方法 選取2014年1月—2014年12月攀鋼集團總醫(yī)院婦產(chǎn)科收治的功能失調(diào)性子宮出血患者80例,隨機分為對照組和治療組,每組各40例。對照組患者口服戊酸雌二醇片,4～6 mg/次,3次/d,止血3 d后開始減量,每3天減量1/3,維持量1 mg/d,至患者病情穩(wěn)定后,加服黃體酮膠囊200 mg/d,5 d后停藥。于撤退性出血的第5天進行人工周期治療,口服戊酸雌二醇片,1 mg/d,連續(xù)服用21 d,后10天加用黃體酮膠囊,200 mg/d。治療組不用黃體酮膠囊,在對照組的基礎(chǔ)上口服復(fù)方炔諾酮片,1片/次,1次/d,連續(xù)服用21 d。兩組均連續(xù)治療3個周期。觀察兩組的臨床療效,同時比較兩組治療前后促卵泡生成素(FSH)、黃體生成素(LH)、雌激素(E₂)、WHO生存質(zhì)量測定量表簡表(WHOQOL-BREF)評分的變化。比較兩組控制出血時間、完全止血時間。結(jié)果 治療后,對照組和治療組的總有效率分別為80.0%、95.0%,兩組比較差異有統(tǒng)計學(xué)意義(P< 0.05)。治療后,治療組FSH、LH、E₂水平均較治療前顯著降低,同組治療前后差異具有統(tǒng)計學(xué)意義(P< 0.05);治療后治療組這些激素水平顯著低于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P< 0.05)。治療組控制出血時間和完全止血時間均顯著短于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P< 0.05)。治療后,兩組患者的身體、心理、環(huán)境、總分均顯著性升高,同組治療前后差異具有統(tǒng)計學(xué)意義(P< 0.05),且治療組這些評分的改善程度優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P< 0.05)。結(jié)論 復(fù)方炔諾酮片聯(lián)合戊酸雌二醇治療功能失調(diào)性子宮出血療效顯著,可提高患者的生活質(zhì)量,值得進一步推廣和研究。

Objective To investigate the clinical efficacy of Compound Norethisterone Tablets combined with estradiol valerate in treatment of dysfunctional uterine bleeding. Methods Patients (80 cases) with dysfunctional uterine bleeding in Department of Obstetrics and Gynecology of Pangang Group General Hospital from January 2014 to December 2014 were randomly divided into control and treatment groups, and each group had 40 cases. The patients in the control group were po administered with Estradiol Valerate Tablets, 4—6 mg/time, three times daily. After 3 d, the dosage was reduced with every 3 d on a third, and the maintain dosage was 1 mg/d. After the patients were in stable condition, they were po administered with Progesterone Capsules, 200 mg/d for 5 d. Artificial cycle was conducted in day 5 of the retreat hemorrhages, the patients in the control group were po administered with Estradiol Valerate Tablets, 1 mg/d for 21 d, and they were po administered with Progesterone Capsules after 11 d, 200 mg/d. The patients in the treatment group without progesterone capsules, and they were po administered with Compound Norethisterone Tablets on the basis of the control group, 1 mg/d for 21 d. The patients in two groups were treated for three cycles. After treatment, the efficacy was evaluated, the changes of FSH, LH, E₂, and WHOQOL-BREF scores in the two groups before and after treatment were compared. The control bleeding time and completely bleeding time in two groups were compared. Results After the treatment, the efficacies in the control and treatment groups were 80.0% and 95.0%, respectively, and there was difference between two groups (P < 0.05). After treatment, FSH, LH, and E₂ in treatment group were reduced, and the difference was statistically significant in the same group (P < 0.05). After treatment, those hormone levels in treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). The control bleeding time and completely bleeding time in treatment group were shorter than those in the treatment group, with significant difference between two groups (P < 0.05). After treatment, scores of physical, psychological, environmental, and total score in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). The improved degree of those observations indicators in the treatment group was better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Compound Norethisterone Tablets combined with estradiol valerate has good clinical efficacy in treatment of dysfunctional uterine bleeding, and can improve the life quality of patients, which has a certain clinical application value.