目的 探讨春血安胶囊联合复方炔诺酮片治疗功能失调性子宫出血的临床疗效。方法 选择2020年2月-2021年2月于天津医科大学总医院就诊的98例功能失调性子宫出血患者为研究对象，依据用药的差距分为治疗组和对照组，每组各49例。对照组口服复方炔诺酮片，于月经周期第5天开始用药，1片/d，连用22 d；治疗组在对照组的基础上口服春血安胶囊，2 g/次，3次/d。两组均治疗2个月经周期治疗。观察两组患者临床疗效，比较治疗前后两组患者临床症状改善时间、子宫内膜厚度、子宫平滑肌收缩幅，性激素促卵泡生成素（FSH）、促黄体生成素（LH）和雌二醇（E₂）水平及血清血管内皮生长因子A（VEGFA）、血清抑制素B（INHB）、血管内皮生长因子受体-1（sFIt-1）、碱性成纤维细胞生长因子（bFGF）和前列腺素2α（PGF2α）水平。结果 经治疗，治疗组总有效率显著高于对照组（97.96%vs 81.63%，P<0.05）。经治疗，治疗组症状改善时间明显早于对照组（P<0.05）。经治疗，两组子宫内膜厚度明显减小，子宫平滑肌收缩幅明显增加（P<0.05），且治疗组患者子宫内膜厚度和子宫平滑肌改善更明显（P<0.05）。经治疗，两组血清FSH、LH、E₂水平均显著下降（P<0.05），且治疗组最明显（P<0.05）。经治疗，两组血清VEGFA、INHB、bFGF和PGF2α水平明显升高，而sFIt-1水平明显降低（P<0.05），且治疗组改善更显著（P<0.05）。结论 春血安胶囊联合复方炔诺酮片治疗功能失调性子宫出血可有效改善患者临床症状，降低子宫内膜厚度，具有一定临床推广应用价值。

Objective To investigate the clinical efficacy of Chunxuean Capsules combined with compound norethisterone in treatment of dysfunctional uterine bleeding. Methods Patients (98 cases) with dysfunctional uterine bleeding in Tianjin Medical University General Hospital from February 2020 to February 2021 were divided into control and treatment groups based on different treatments, and each group had 49 cases. Patients in the control group were po administered with Compound Norethisterone Tablets from the fifth day of the menstrual cycle, 1 tablet/d for 22 d. Patients in the treatment group were po administered with Chunxuean Capsules on the basis of the control group, 2 g/time, three times daily. Patients in two groups were treated for 2 menstrual cycle. After treatment, the clinical efficacy was evaluated, the improvement time of clinical symptoms, the endometrial thickness, the contraction amplitude of uterine smooth muscle, the sex hormone levels of FSH, LH and E₂, and the serological indicators levels of VEGFA, INHB, bFGF, PGF2α and sFIt-1 in two groups before and after treatment were compared. Results After treatment, the effective rate of the treatment group was significantly higher than that of the control group (97.96% vs 81.63%, P<0.05). After treatment, the improvement time of symptom in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, the thickness of endometrium were significantly decreased and the contraction amplitude of uterine smooth muscle were significantly increased in two groups (P<0.05), and the endometrial thickness and uterine smooth muscle were improved more obviously in treatment group (P<0.05). After treatment, the levels of FSH, LH, and E₂ were significantly decreased in two groups (P<0.05), especially in the treatment group (P<0.05). After treatment, the serum levels of VEGFA, INHB, bFGF and PGF2α in two groups were significantly increased, while the level of sFIt-1 was significantly decreased (P<0.05), especially in the treatment group (P<0.05). Conclusion Chunxuean Capsules combined with compound norethisterone in treatment of dysfunctional uterine bleeding can effectively improve the clinical symptoms and reduce the inner thickness of the uterus, which has a certain clinical application value.

R984

天津市教委科研计划项目（2018KB140）