目的 探讨妇科止血灵片联合地屈孕酮治疗功能失调性子宫出血的临床疗效。方法 选取2020年2月-2022年2月海南西部中心医院收治的功能失调性子宫出血患者100例,随机分为对照组(50例)和治疗组(50例)。对照组患者口服地屈孕酮片,月经来潮第5天后口服,2次/d,10 mg/次,血止日算起,连服22 d为1个周期。在对照组的基础上,治疗组口服妇科止血灵片,4片/次,3次/d。两组服药2个周期。观察两组患者临床疗效,比较治疗前后两组患者症状缓解时间,子宫内膜厚度,性激素促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E₂)、孕酮(P)水平,及血清炎性因子血管内皮生长因子(VEGF)、促血管生成素-Ⅱ(Ang-Ⅱ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)水平。结果 治疗后,治疗组患者临床总有效率98.00%,明显高于对照组(82.00%,P<0.05)。经治疗,治疗组出现症状好转时间均明显短于对照组(P<0.05)。治疗后,两组子宫内膜厚度小于治疗前(P<0.05);治疗组的子宫内膜厚度明显小于对照组(P<0.05);治疗后,两组患者的性激素FSH、LH、E₂、P、IL-2、VEGF、TNF-α、Ang-Ⅱ水平均明显低于治疗前(P<0.05),且治疗组明显低于对照组(P<0.05)。结论 妇科止血灵片联合地屈孕酮治疗功能失调性子宫出血效果确切,可有效改善临床症状,调节性激素水平,降低子宫内膜厚度,促进机体炎性反应减弱。

Objective To explore the clinical study of Fuke Zhixueling Tablets combined with dydrogesterone in treatment of dysfunctional uterine hemorrhage. Methods Patients (100 cases) with dysfunctional uterine hemorrhage in Hainan Western Central Hospital from February 2020 to February 2022 were randomly divided into control (50 cases) and treatment (50 cases) group. Patients in the control group were po administered with Dydrogesterone Tablets on the 5th day after menstruation, 10 mg/time, twice daily, counting from the day of bleeding, 22 days as a cycle. Patients in the treatment group were po administered with Fuke Zhixueling Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 2 cycles. After treatment, the clinical evaluation was evaluated, and the improvement time of symptom, endometrial thickness, the levels of FSH, LH, E₂ and P, serological factors IL-2, VEGF, TNF-α and Ang-Ⅱ levels in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.00%, which was significantly higher than that of the control group (82.00%, P < 0.05). After treatment, the time of symptom improvement in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, endometrial thickness in both groups was less than before treatment (P < 0.05). After treatment, the thickness of endometrium in the treatment group was significantly smaller than that in the control group (P < 0.05). After treatment, the levels of FSH, LH, E₂, P, IL-2, VEGF, TNF-α and Ang-Ⅱ in two groups were significantly lower than those before treatment (P < 0.05), and the levels of these indexes in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Fuke Zhixueling Tablets combined with dydrogesterone in treatment of dysfunctional uterine hemorrhage is definite, the clinical symptom can be effectively improved, the level of sex hormone can be regulate, the thickness of endometrium can be reduced, and the inflammatory reaction of the organism can be promoted to be weakened.

R984

海南省卫生健康行业科研项目(22A200159)