目的 探讨坤宁颗粒联合屈螺酮炔雌醇片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5月在苏州科技城医院就诊的78例功能失调性子宫出血患者，按照随机数字表法将所有患者分为对照组和治疗组，每组各39例。对照组口服屈螺酮炔雌醇片，于月经来潮第5天开始，1片/次，1次/d，连续口服21 d，以1个月经周期为1个疗程，连续治疗6个疗程。治疗组在对照组基础上温水冲服坤宁颗粒，1袋/次，3次/d，连续治疗6个月。观察两组的临床疗效，比较两组的症状改善时间、螺旋动脉的搏动指数（PI）、阻力指数（RI）、收缩末期峰值/舒张末期峰值的比值（S/D）以及血清中促卵泡激素（FSH）、促黄体生成素（LH）、泌乳素（PRL）、前列腺素E₂（PGE₂）、血管生成素-2（Ang-2）水平。结果 治疗后，治疗组总有效率为94.87%，明显高于对照组的总有效率76.92%（P<0.05）。治疗后，治疗组患者月经周期恢复时间、完全止血时间、小腹坠痛消失时间均明显短于对照组，差异有统计学意义（P<0.05）。治疗后，两组的螺旋动脉PI、RI、S/D均显著降低（P<0.05），治疗组螺旋动脉PI、RI、S/D明显低于对照组（P<0.05）。治疗后，两组的血清FSH水平高于治疗前，血清LH、PRL、PGE₂、Ang-2水平低于治疗前（P<0.05）；治疗后，治疗组的血清FSH水平高于对照组，血清LH、PRL、PGE₂、Ang-2水平低于对照组（P<0.05）。结论 坤宁颗粒联合屈螺酮炔雌醇片可提高功能失调性子宫出血的临床疗效，改善临床症状，改善子宫血流动力学指标，调节患者的性激素分泌，药物安全性良好。

Objective To investigate the clinical effect of Kunning Granules combined with Drospirenone and Ethinylestradiol Tablets in treatment of dysfunctional uterine bleeding. Methods Patients (78 cases) with dysfunctional uterine bleeding in Suzhou Science & Technology Town Hospital from February 2020 to May 2022 were divided into control and treatment groups according to the random number table method, and each group had 39 cases. Patients in the control group were po administered with Drospirenone and Ethinylestradiol Tablets on the 5th day of menstrual cycle, 1 tablet/time, once daily, continuous oral administration for 21 d, take one menstrual cycle as a course of treatment, and continuously treated for 6 courses. Patients in the treatment group were po administered with Kunning Granules on the basis of the control group, 1 bag/time, three times daily, continuous treatment for 6 months. After treatment, the clinical efficacies were evaluated, and the symptom improvement time, PI, RI, and S/D in two groups were compared, and the levels of FSH, LH, PRL, PGE₂, and Ang-2 in two groups were compared. Results After treatment, the total effective rate of the treatment group was 94.87%, significantly higher than the total effective rate of the control group of 76.92% (P< 0.05). After treatment, the recovery time of menstrual cycle, the complete hemostasis time, and the disappearance time of abdominal pain in the treatment group were significantly shorter than those in the control group, with a statistically significant difference (P < 0.05). After treatment, the PI, RI, and S/D of spiral arteries in two groups were significantly decreased (P < 0.05), while the PI, RI, and S/D of spiral arteries in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of FSH in two groups were higher than before treatment, while the serum levels of LH, PRL, PGE₂, and Ang-2 were lower than those before treatment (P < 0.05); After treatment, the serum levels of FSH in the treatment group were higher than those in the control group, while the serum levels of LH, PRL, PGE₂, and Ang-2 were lower than those in the control group (P < 0.05). Conclusion Kunning Granules combined with Drospirenone and Ethinylestradiol Tablets can improve the efficacy of dysfunctional uterine bleeding, improve clinical symptoms, improve uterine hemodynamic indicators, regulate the secretion of sexual hormones in patients, and the drug safety is good.

R984

苏州高新区医疗卫生科技计划项目（2019Z014）