目的 探討春血安膠囊聯(lián)合復(fù)方炔諾酮片治療功能失調(diào)性子宮出血的臨床療效。方法 選擇2020年2月-2021年2月于天津醫(yī)科大學(xué)總醫(yī)院就診的98例功能失調(diào)性子宮出血患者為研究對(duì)象，依據(jù)用藥的差距分為治療組和對(duì)照組，每組各49例。對(duì)照組口服復(fù)方炔諾酮片，于月經(jīng)周期第5天開(kāi)始用藥，1片/d，連用22 d；治療組在對(duì)照組的基礎(chǔ)上口服春血安膠囊，2 g/次，3次/d。兩組均治療2個(gè)月經(jīng)周期治療。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀改善時(shí)間、子宮內(nèi)膜厚度、子宮平滑肌收縮幅，性激素促卵泡生成素（FSH）、促黃體生成素（LH）和雌二醇（E₂）水平及血清血管內(nèi)皮生長(zhǎng)因子A（VEGFA）、血清抑制素B（INHB）、血管內(nèi)皮生長(zhǎng)因子受體-1（sFIt-1）、堿性成纖維細(xì)胞生長(zhǎng)因子（bFGF）和前列腺素2α（PGF2α）水平。結(jié)果 經(jīng)治療，治療組總有效率顯著高于對(duì)照組（97.96%vs 81.63%，P<0.05）。經(jīng)治療，治療組癥狀改善時(shí)間明顯早于對(duì)照組（P<0.05）。經(jīng)治療，兩組子宮內(nèi)膜厚度明顯減小，子宮平滑肌收縮幅明顯增加（P<0.05），且治療組患者子宮內(nèi)膜厚度和子宮平滑肌改善更明顯（P<0.05）。經(jīng)治療，兩組血清FSH、LH、E₂水平均顯著下降（P<0.05），且治療組最明顯（P<0.05）。經(jīng)治療，兩組血清VEGFA、INHB、bFGF和PGF2α水平明顯升高，而sFIt-1水平明顯降低（P<0.05），且治療組改善更顯著（P<0.05）。結(jié)論 春血安膠囊聯(lián)合復(fù)方炔諾酮片治療功能失調(diào)性子宮出血可有效改善患者臨床癥狀，降低子宮內(nèi)膜厚度，具有一定臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Chunxuean Capsules combined with compound norethisterone in treatment of dysfunctional uterine bleeding. Methods Patients (98 cases) with dysfunctional uterine bleeding in Tianjin Medical University General Hospital from February 2020 to February 2021 were divided into control and treatment groups based on different treatments, and each group had 49 cases. Patients in the control group were po administered with Compound Norethisterone Tablets from the fifth day of the menstrual cycle, 1 tablet/d for 22 d. Patients in the treatment group were po administered with Chunxuean Capsules on the basis of the control group, 2 g/time, three times daily. Patients in two groups were treated for 2 menstrual cycle. After treatment, the clinical efficacy was evaluated, the improvement time of clinical symptoms, the endometrial thickness, the contraction amplitude of uterine smooth muscle, the sex hormone levels of FSH, LH and E₂, and the serological indicators levels of VEGFA, INHB, bFGF, PGF2α and sFIt-1 in two groups before and after treatment were compared. Results After treatment, the effective rate of the treatment group was significantly higher than that of the control group (97.96% vs 81.63%, P<0.05). After treatment, the improvement time of symptom in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, the thickness of endometrium were significantly decreased and the contraction amplitude of uterine smooth muscle were significantly increased in two groups (P<0.05), and the endometrial thickness and uterine smooth muscle were improved more obviously in treatment group (P<0.05). After treatment, the levels of FSH, LH, and E₂ were significantly decreased in two groups (P<0.05), especially in the treatment group (P<0.05). After treatment, the serum levels of VEGFA, INHB, bFGF and PGF2α in two groups were significantly increased, while the level of sFIt-1 was significantly decreased (P<0.05), especially in the treatment group (P<0.05). Conclusion Chunxuean Capsules combined with compound norethisterone in treatment of dysfunctional uterine bleeding can effectively improve the clinical symptoms and reduce the inner thickness of the uterus, which has a certain clinical application value.

R984

天津市教委科研計(jì)劃項(xiàng)目（2018KB140）