目的 探討云南紅藥膠囊聯(lián)合左炔諾孕酮治療功能失調(diào)性子宮出血的臨床療效。方法 選取2019年3月-2020年3月在河南大學(xué)淮河醫(yī)院進(jìn)行治療的102例功能失調(diào)性子宮出血患者，根據(jù)就診順序分為對(duì)照組（51例）和治療組（51例）。對(duì)照組口服左炔諾孕酮片，1.5 mg/次，2次/d，待陰道停止流血3 d后，改為0.75 mg/次，1次/d，維持治療2周；治療組在對(duì)照組基礎(chǔ)上口服云南紅藥膠囊，0.75 g/次，3次/d。兩組均治療1個(gè)月經(jīng)周期。觀察兩組的臨床療效，比較兩組臨床癥狀消失時(shí)間、相關(guān)評(píng)分、血清學(xué)因子和性激素水平。結(jié)果 經(jīng)治療，對(duì)照組患者總有效率為82.35%，顯著低于治療組（98.04%，P<0.05）。經(jīng)治療，治療組腰膝酸軟、五心煩熱、失眠、盜汗、耳鳴等癥狀消失時(shí)間均短于對(duì)照組（P<0.05）。經(jīng)治療，兩組WHOQOL-BREF評(píng)分較治療前顯著升高，但MADRS評(píng)分、PBAC評(píng)分均顯著降低（P<0.05）；治療后，治療組WHOQOL-BREF評(píng)分高于對(duì)照組，但MADRS評(píng)分、PBAC評(píng)分低于對(duì)照組（P<0.05）。經(jīng)治療，兩組患者血清促血管生成素-2（Ang-2）、抗甲狀腺過氧化物酶抗體（TPOAb）水平均下降，而血管內(nèi)皮生長(zhǎng)因子（VEGF）、β-內(nèi)啡肽（β-EP）、抑制素B（INHB）水平均增高（P<0.05），并以治療組血清學(xué)指標(biāo)改善更明顯（P<0.05）。經(jīng)治療，兩組血清雌二醇（E₂）、促卵泡生成素（FSH）、促黃體生成素（LH）水平均較治療前顯著降低（P<0.05），且以治療組性激素水平更顯著（P<0.05）。結(jié)論 云南紅藥膠囊聯(lián)合左炔諾孕酮治療功能失調(diào)性子宮出血可有效改善患者臨床癥狀，改善機(jī)體血清細(xì)胞因子水平，提高患者生活質(zhì)量，促進(jìn)月經(jīng)狀況及焦慮狀態(tài)改善，有著良好臨床應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Yunnan Hongyao Capsules combined with levonorgestrel in treatment of dysfunctional uterine bleeding. Methods A total of 102 patients with dysfunctional uterine bleeding who were treated in Huaihe Hospital of Henan University from March 2019 to March 2020 were selected and divided into control group (51 cases) and treatment group (51 cases) according to the order of treatment. Patients in the control group were po administered with Levonorgestrel Tablets, 1.5 mg/time, twice daily. After the vaginal bleeding stopped for 3 d, the treatment was changed to 0.75 mg/time, once daily, and they maintained for 2 weeks. Patients in the treatment group were po administered with Yunnan Hongyao Capsules on the basis of control group, 0.75 g/time, 3 times daily. Both groups were treated for one menstrual cycle. The clinical efficacy of the two groups was observed, and the time of clinical symptom disappearance, correlation scores, serum factors and sex hormone levels were compared between the two groups. Results After treatment, the effective rate of control group was 82.35%, which was significantly lower than that of treatment group (98.04%, P<0.05). After treatment, the disappearance time of sour waist and knee, five upset heat, insomnia, night sweats, tinnitus in the treatment group was shorter than that in the control group (P<0.05). After treatment, the WHOQOL-BREF score in both groups was significantly increased, but the MADRS score and PBAC score were significantly decreased (P<0.05). After treatment, the WHOQOL-BREF score of the treatment group was higher than that of the control group, but the MADRS score and PBAC score of the treatment group were lower than that of the control group (P<0.05). After treatment, Ang-2 and TPOAb levels were decreased in two groups, while VEGF, β-EP, and INHB were increased in two groups (P<0.05), and the improvement was more obvious in the treatment group (P<0.05). After treatment, the levels of E₂, FSH, and LH in both groups were significantly decreased compared with before treatment (P<0.05), and the treatment group was more significant (P<0.05). Conclusion Yunnan Hongyao Capsules combined with levonorgestrel can effectively improve the clinical symptoms of patients with dysfunctional uterine bleeding, and improve the level of serum cytokines and the life quality of patients, also can promote the improvement of menstrual status and anxiety state, which has a good clinical application value.

R984

河南省科技廳科技攻關(guān)項(xiàng)目（182102311175）