目的 探讨宫环养血颗粒联合米非司酮治疗围绝经期功能失调性子宫出血的临床疗效。方法 选取2013年3月-2015年3月河北省磁县人民医院收治的围绝经期功能失调性子宫出血患者74例,随机分为对照组和治疗组,每组各37例。对照组口服米非司酮片,0.5~1片/次,2次/d,连续应用2~3 d后使药物服用总剂量达到3片左右,服药后严格禁食时间不小于2 h。治疗组在对照组基础上口服宫环养血颗粒,1~2袋/次,2次/d。两组患者均连续治疗21 d,而后完全停药7 d,在停药后第8天时根据患者实际情况开始另一个治疗周期,共治疗3个周期。比较两组临床疗效、子宫内膜厚度、性激素指标雌激素(E₂)、黄体生成素(LH)和促卵泡生成素(FSH)的变化。结果 治疗后,对照组和治疗组的总有效率分别为70.3%、83.8%,两组比较差异有统计学意义(P<0.05)。治疗后,两组子宫内膜厚度均较治疗前有所好转,差异比较有统计学意义(P<0.05);治疗组子宫内膜改善程度显著优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗组的性激素指标E₂、LH和FSH均较治疗前明显改善,且与对照组比较差异有统计学意义(P<0.05)。两组患者的不良反应发生率分别为29.7%、8.1%,差异有统计学意义(P<0.05)。结论 宫环养血颗粒联合米非司酮治疗围绝经期功能失调性子宫出血具有良好的疗效,能够明显改善性激素水平,且安全性较高,具有一定的临床推广应用价值。

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.