目的 探讨培坤丸联合戊酸雌二醇治疗月经不调的临床疗效。方法 选取2021年1月—2022年1月中山市小榄人民医院收治的106例月经不调患者,按照随机数字表法分为对照组和治疗组,每组各53例。对照组于月经周期第5天开始口服戊酸雌二醇片,1 mg/次,1次/d,连续用药21 d为1个周期。治疗组在对照组基础上口服培坤丸,9 g/次,2次/d。两组疗程均为3个月经周期。观察两组的临床疗效,比较治疗前后两组月经不调症状评分、月经症状量表(MDQ)评分、90项症状自评量表(SCL-90)总分、36项健康调查简表(SF-36)总分及血清性激素[孕酮(P)、雌二醇(E₂)、促卵泡刺激素(FSH)、促黄体生成素(LH)]水平。统计两组不良反应情况。结果 治疗后,治疗组总有效率是96.23%,显著高于对照组的84.91%(P<0.05)。治疗后,两组小腹胀痛评分、腰骶酸痛评分、精神不振评分、乳房胀痛评分、神疲乏力评分、少气懒言评分均显著降低(P<0.05),且治疗后治疗组月经不调症状评分低于对照组(P<0.05)。治疗后,两组MDQ评分、SCL-90总分均显著降低,而SF-36总分均显著增加(P<0.05),均以治疗组改善更显著(P<0.05)。治疗后,两组血清P、E₂水平均显著上升,而血清FSH、LH水平均显著下降(P<0.05),治疗后,治疗组血清性激素水平改善更显著(P<0.05)。治疗后,治疗组和对照组不良反应发生率分别是5.66%、3.77%,差异无统计学意义。结论 培坤丸联合戊酸雌二醇治疗月经不调有确切疗效,能有效减轻患者月经不调相关症状,改善心理健康状态和生活质量,调节机体性激素分泌水平,且患者耐受性较好。

Objective To investigate the clinical effect of Peikun Pills combined with estradiol valerate in treatment of menstrual disorder.Methods A total of 106 patients with irregular menstruation admitted to Zhongshan Xiaolan People's Hospital from January 2021 to January 2022 were randomly divided into two groups according to random number table method. Patients in the control group were po administered with Estradiol Valerate Tablets from the 5th day of the menstrual cycle, 1 mg/time, once daily. 21 Days of continuous drug usage was a cycle. Patients in the treatment group were po administered with Peikun Pills on the basis of the control group, 9 g/time, twice daily. The treatment course of both groups was 3 menstrual cycles. After treatment, the clinical efficacy of the two groups was observed. The score of menstrual disorder symptoms, the score of Menstrual Symptom Scale(MDQ), the score of 90-item Symptom Self-Rating Scale(SCL-90), the score of 36-item Health Survey Brief Form(SF-36), and the levels of serum sex hormones [progesterone(P), estradiol(E₂), follicle-stimulating hormone(FSH), luteinizing hormone(LH)] before and after treatment were compared between the two groups. The adverse reactions of the two groups were analyzed.Results After treatment, the total effective rate of the treatment group was 96.23%, significantly higher than that of the control group(84.91%)(P<0.05). After treatment, lower abdominal distension pain score, lumbosacral pain score, lethargy score, breast distension pain score, fatigue score,low qi lazy talk score were significantly decreased in both groups(P<0.05), and after treatment, the score of irregular menstruation symptom in the treatment group was lower than that in the control group(P<0.05). After treatment, MDQ score and SCL-90 score were significantly decreased in both groups, while SF-36 score were significantly increased(P<0.05), and the improvement was more significant in the treatment group(P<0.05). After treatment, serum P and E₂ levels were significantly increased in both groups, while serum FSH and LH levels were significantly decreased(P<0.05). After treatment, serum sex hormone levels in the treatment group were more significantly improved(P<0.05). After treatment, the incidence of adverse reactions in the treatment group and the control group was 5.66% and 3.77%, respectively, with no statistically significant difference.Conclusion Peikun Pills combined with estradiol valerate has definite curative effect in treatment of menstrual disorder, and can effectively reduce the symptoms related to irregular menstruation, improve mental health status and quality of life, which can regulate the body sex hormone secretion level with good tolerance.

R984

中山市医学科研项目(2021J355)