摘要
目的观察加味失笑散联合举元煎对围绝经期崩漏的治疗效果。方法将112例围绝经期崩漏患者按照随机数字表法分为对照组和观察组各56例。对照组患者给予地屈孕酮片治疗,观察组在对照组基础上给予加味失笑散联合举元煎口服,连续治疗3个月经周期。对比2组的治疗效果、脾虚血瘀证中医证候积分、外周血血红蛋白(Hb)浓度、子宫内膜厚度、止血情况、子宫血流动力学指标、性激素、T淋巴细胞亚群水平及不良反应。结果观察组总有效率94.23%(49/52)高于对照组总有效率80.39%(41/51)(P<0.05);治疗后,观察组的中医证候总积分低于对照组(P<0.05),外周血Hb浓度高于对照组(P<0.05),子宫内膜厚度薄于对照组(P<0.05),观察组止血情况控制出血时间、完全止血时间短于对照组(P<0.05),子宫血流动力学指标动脉阻力指数(RI)低于对照组(P<0.05),收缩期最大流速(Vmax)高于对照组(P<0.05),性激素黄体生成激素(LH)、卵泡刺激素(FSH)水平低于对照组(P<0.05);T淋巴细胞亚群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组(P<0.05),CD8^(+)低于对照组(P<0.05);2组不良反应比较差异无统计学意义(P>0.05)。结论加味失笑散联合举元煎治疗围绝经期脾虚血瘀型崩漏临床效果确切,更利于减轻临床症状,防止或改善贫血,抑制子宫内膜增生,控制出血效果更好,初步推断其起效可能与改善子宫动脉血流动力、提高免疫功能有关,用药相对安全。
Objective To observe the therapeutic effect of modified Shixiao Powder combined with Juyuan Decoction on perimenopause metrorrhagia and metrostaxisof spleen-deficiency and blood-stasis type.Methods A total of 112 patients with perimenopause metrorrhagia and metrostaxis were randomly assigned in a 1∶1 ratio to either Dydrogesterone tablets(the control group)or modified Shixiao Powder+Juyuan Decoction+Dydrogesterone tablets(the observation group)for 3 consecutive menstrual cycles.The therapeutic effect,TCM syndrome score of spleen deficiency and blood stasis syndrome,hemoglobin(Hb)concentrationin peripheral blood,endometrial thickness,levels of hemostasis,uterine hemodynamic,sex hormones,T lymphocyte subsets,as well as adverse reactions were compared between the two groups.Results The total effective rate of observation group was significantly higher than that of control group(94.23%[49/52]vs 80.39%[41/51],P<0.05).After treatment,the observation group presented significantly lower total score of TCM syndrome(P<0.05),significantly higher Hb concentration in peripheral blood(P<0.05),significantly thinner endometrial thickness(P<0.05),significantly better hemostasis effect(P<0.05),significantly shorter time to control bleeding and complete hemostasis(P<0.05),significantly lower resistance index(RI)of the uterine arteries,significantly higher Vmax(P<0.05),significantly lower luteinizing hormone(LH)and follicle-stimulating hormone(FSH)levels of sex hormones(P<0.05),significantly higher T lymphocyte subsets CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and significantly lower CD8^(+)(P<0.05)relative to the control group.There was no significant difference in adverse reactions between groups(P>0.05).Conclusion The prescription of modified Shixiao Powder combined with Juyuan Decoction has a definite clinical effect in perimenopause metrorrhagia and metrostaxisof spleen-deficiency and blood-stasis type,which is more conducive to reducing clinical symptoms,preventing or improving anemia,inhibiting endometrial hyperplasia and controlling
作者
刘开颜
王晓燕
曹霞
LIU Kaiyan;WANG Xiaoyan;CAO Xia(Department of Obstetrics and Gynecology,Nantong Third People's Hospital/Nantong Third Hospital Affiliated to Nantong University,Nantong,Jiangsu 226006)
出处
《河北中医》
2024年第10期1634-1638,共5页
Hebei Journal of Traditional Chinese Medicine
基金
南通市卫生和计划生育委员会科研项目(编号:WKEL2018059)。
关键词
失笑散
举元煎
围绝经期
脾虚血瘀型
崩漏
Shixiao Powder
Juyuan Decoction
Perimenopause
Spleen deficiency and blood stasis type
Metrorrhagia and metrostaxis
