[关键词]
[摘要]
目的 探讨云南红药胶囊联合左炔诺孕酮治疗功能失调性子宫出血的临床疗效。方法 选取2019年3月-2020年3月在河南大学淮河医院进行治疗的102例功能失调性子宫出血患者,根据就诊顺序分为对照组(51例)和治疗组(51例)。对照组口服左炔诺孕酮片,1.5 mg/次,2次/d,待阴道停止流血3 d后,改为0.75 mg/次,1次/d,维持治疗2周;治疗组在对照组基础上口服云南红药胶囊,0.75 g/次,3次/d。两组均治疗1个月经周期。观察两组的临床疗效,比较两组临床症状消失时间、相关评分、血清学因子和性激素水平。结果 经治疗,对照组患者总有效率为82.35%,显著低于治疗组(98.04%,P<0.05)。经治疗,治疗组腰膝酸软、五心烦热、失眠、盗汗、耳鸣等症状消失时间均短于对照组(P<0.05)。经治疗,两组WHOQOL-BREF评分较治疗前显著升高,但MADRS评分、PBAC评分均显著降低(P<0.05);治疗后,治疗组WHOQOL-BREF评分高于对照组,但MADRS评分、PBAC评分低于对照组(P<0.05)。经治疗,两组患者血清促血管生成素-2(Ang-2)、抗甲状腺过氧化物酶抗体(TPOAb)水平均下降,而血管内皮生长因子(VEGF)、β-内啡肽(β-EP)、抑制素B(INHB)水平均增高(P<0.05),并以治疗组血清学指标改善更明显(P<0.05)。经治疗,两组血清雌二醇(E2)、促卵泡生成素(FSH)、促黄体生成素(LH)水平均较治疗前显著降低(P<0.05),且以治疗组性激素水平更显著(P<0.05)。结论 云南红药胶囊联合左炔诺孕酮治疗功能失调性子宫出血可有效改善患者临床症状,改善机体血清细胞因子水平,提高患者生活质量,促进月经状况及焦虑状态改善,有着良好临床应用价值。
[Key word]
[Abstract]
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.
[中图分类号]
R984
[基金项目]
河南省科技厅科技攻关项目(182102311175)