目的 探究复方炔诺酮片联合戊酸雌二醇治疗功能失调性子宫出血的疗效观察。方法 选取2014年1月—2014年12月攀钢集团总医院妇产科收治的功能失调性子宫出血患者80例,随机分为对照组和治疗组,每组各40例。对照组患者口服戊酸雌二醇片,4～6 mg/次,3次/d,止血3 d后开始减量,每3天减量1/3,维持量1 mg/d,至患者病情稳定后,加服黄体酮胶囊200 mg/d,5 d后停药。于撤退性出血的第5天进行人工周期治疗,口服戊酸雌二醇片,1 mg/d,连续服用21 d,后10天加用黄体酮胶囊,200 mg/d。治疗组不用黄体酮胶囊,在对照组的基础上口服复方炔诺酮片,1片/次,1次/d,连续服用21 d。两组均连续治疗3个周期。观察两组的临床疗效,同时比较两组治疗前后促卵泡生成素(FSH)、黄体生成素(LH)、雌激素(E₂)、WHO生存质量测定量表简表(WHOQOL-BREF)评分的变化。比较两组控制出血时间、完全止血时间。结果 治疗后,对照组和治疗组的总有效率分别为80.0%、95.0%,两组比较差异有统计学意义(P< 0.05)。治疗后,治疗组FSH、LH、E₂水平均较治疗前显著降低,同组治疗前后差异具有统计学意义(P< 0.05);治疗后治疗组这些激素水平显著低于对照组,两组比较差异具有统计学意义(P< 0.05)。治疗组控制出血时间和完全止血时间均显著短于对照组,两组比较差异具有统计学意义(P< 0.05)。治疗后,两组患者的身体、心理、环境、总分均显著性升高,同组治疗前后差异具有统计学意义(P< 0.05),且治疗组这些评分的改善程度优于对照组,两组比较差异具有统计学意义(P< 0.05)。结论 复方炔诺酮片联合戊酸雌二醇治疗功能失调性子宫出血疗效显著,可提高患者的生活质量,值得进一步推广和研究。

Objective To investigate the clinical efficacy of Compound Norethisterone Tablets combined with estradiol valerate in treatment of dysfunctional uterine bleeding. Methods Patients (80 cases) with dysfunctional uterine bleeding in Department of Obstetrics and Gynecology of Pangang Group General Hospital from January 2014 to December 2014 were randomly divided into control and treatment groups, and each group had 40 cases. The patients in the control group were po administered with Estradiol Valerate Tablets, 4—6 mg/time, three times daily. After 3 d, the dosage was reduced with every 3 d on a third, and the maintain dosage was 1 mg/d. After the patients were in stable condition, they were po administered with Progesterone Capsules, 200 mg/d for 5 d. Artificial cycle was conducted in day 5 of the retreat hemorrhages, the patients in the control group were po administered with Estradiol Valerate Tablets, 1 mg/d for 21 d, and they were po administered with Progesterone Capsules after 11 d, 200 mg/d. The patients in the treatment group without progesterone capsules, and they were po administered with Compound Norethisterone Tablets on the basis of the control group, 1 mg/d for 21 d. The patients in two groups were treated for three cycles. After treatment, the efficacy was evaluated, the changes of FSH, LH, E₂, and WHOQOL-BREF scores in the two groups before and after treatment were compared. The control bleeding time and completely bleeding time in two groups were compared. Results After the treatment, the efficacies in the control and treatment groups were 80.0% and 95.0%, respectively, and there was difference between two groups (P < 0.05). After treatment, FSH, LH, and E₂ in treatment group were reduced, and the difference was statistically significant in the same group (P < 0.05). After treatment, those hormone levels in treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). The control bleeding time and completely bleeding time in treatment group were shorter than those in the treatment group, with significant difference between two groups (P < 0.05). After treatment, scores of physical, psychological, environmental, and total score in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). The improved degree of those observations indicators in the treatment group was better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Compound Norethisterone Tablets combined with estradiol valerate has good clinical efficacy in treatment of dysfunctional uterine bleeding, and can improve the life quality of patients, which has a certain clinical application value.