目的 探討宮環(huán)養(yǎng)血顆粒聯(lián)合米非司酮治療圍絕經(jīng)期功能失調(diào)性子宮出血的臨床療效。方法 選取2013年3月-2015年3月河北省磁縣人民醫(yī)院收治的圍絕經(jīng)期功能失調(diào)性子宮出血患者74例,隨機(jī)分為對照組和治療組,每組各37例。對照組口服米非司酮片,0.5~1片/次,2次/d,連續(xù)應(yīng)用2~3 d后使藥物服用總劑量達(dá)到3片左右,服藥后嚴(yán)格禁食時間不小于2 h。治療組在對照組基礎(chǔ)上口服宮環(huán)養(yǎng)血顆粒,1~2袋/次,2次/d。兩組患者均連續(xù)治療21 d,而后完全停藥7 d,在停藥后第8天時根據(jù)患者實(shí)際情況開始另一個治療周期,共治療3個周期。比較兩組臨床療效、子宮內(nèi)膜厚度、性激素指標(biāo)雌激素(E₂)、黃體生成素(LH)和促卵泡生成素(FSH)的變化。結(jié)果 治療后,對照組和治療組的總有效率分別為70.3%、83.8%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組子宮內(nèi)膜厚度均較治療前有所好轉(zhuǎn),差異比較有統(tǒng)計(jì)學(xué)意義(P<0.05);治療組子宮內(nèi)膜改善程度顯著優(yōu)于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療組的性激素指標(biāo)E₂、LH和FSH均較治療前明顯改善,且與對照組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組患者的不良反應(yīng)發(fā)生率分別為29.7%、8.1%,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 宮環(huán)養(yǎng)血顆粒聯(lián)合米非司酮治療圍絕經(jīng)期功能失調(diào)性子宮出血具有良好的療效,能夠明顯改善性激素水平,且安全性較高,具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of Gonghuan Yangxue Granules combined with mifepristone in treatment of dysfunctional uterine bleeding in perimenopausal period.Methods Patients (74 cases) with dysfunctional uterine bleeding in perimenopausal period in Hebei Provincial Cixian People's Hospital from March 2013 to March 2015 were randomly divided into control and treatment groups. Each group had 37 cases. The patients in the control group were poadministered with Mifepristone Tablets, 0.5-1 tablet/time, twice daily, and the total dose reached almost three tablets after taking for 2-3 d. After taking medicine, the patients should be fasted at least 2 h. The patients in the treatment group were poadministered with Gonghuan Yangxue Granules on the basis of the control group, 1-2 bags/time, twice daily. The patients in two groups were treated for 21 d. Then the patients were stopped taking medicine for 7 d. On the eighth day, the patients were given another course. The patients in two groups were treated for three courses. After treatment, the efficacy was evaluated, and the changes of endometrial thickness, sex hormone indicators estrogen (E₂), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were compared.Results After treatment, the efficacies in the control and treatment groups were 70.3% and 83.8%, respectively, and there were differences between two groups (P < 0.05). After treatment, endometrial thickness in two groups was significantly improved, and the difference was statistically significant in the same group (P < 0.05). And endometrial thickness in the treatment group was significantly better than that in the control group, with significant difference between two groups (P < 0.05). Sex hormone indicators estrogen (E₂), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) in the treatment group was significantly better than those before treatment, and there were significant differences between two groups (P < 0.05). The occurrence rates of adverse reaction in the control and treatment groups were 29.7% and 8.1%, and there were differences between two groups (P < 0.05).Conclusion Gonghuan Yangxue Granules combined with mifepristone has clinical curative effect in treatment of dysfunctional uterine bleeding in perimenopausal period, and can significantly improve sex hormone levels with higher security, which has a certain clinical application value.