目的 探讨复方益母草胶囊联合炔诺酮片治疗月经不调的临床应用价值。方法 选择2021年1月—2023年6月河北省沧州中西医结合医院收治的月经不调患者88例，随机分为对照组（44例）和治疗组（44例）。对照组患者口服炔诺酮片，于月经周期第5天服药，3.75 mg/次，2次/d。治疗组患者在对照组基础上口服复方益母草胶囊，于月经周期第2天开始服用，5粒/次，2次/d。两组患者共治疗2个月经周期。观察两组患者临床疗效，比较治疗前后两组患者中医症状积分，雌二醇、孕酮、促卵泡激素（FSH）和促黄体生成素（LH）水平及SF-36量表评分。结果 治疗后，与对照组总有效率81.82%相比，治疗组总有效率（95.45%）明显升高（P＜0.05）。与治疗前比较，治疗后两组小腹胀痛、神疲乏力、腰骶酸痛、少气懒言等中医症状积分明显降低（P＜0.05），与对照组比较，治疗后治疗组的各项等中医症状积分更低（P＜0.05）。治疗后两组雌二醇、孕酮水平明显升高，而FSH、LH水平明显降低（P＜0.05）；与对照组比较，治疗后治疗组的雌二醇、孕酮水平更高，而FSH、LH水平更低（P＜0.05）。治疗后，两组各项SF-36评分明显升高（P＜0.05），且治疗组总体健康、心理健康、躯体疼痛评分比对照组更高（P＜0.05）。结论 复方益母草胶囊联合炔诺酮片治疗月经不调具有较好的临床疗效，可有效调节激素水平、改善患者的中医症状以及生活质量。

Objective To explore the clinical application value of Compound Yimucao Capsules combined with norethisterone in treatment of menstrual irregularities. Methods Patients (88 cases) with menstrual irregularities in Cangzhou Hospital of Integrated TCM-WM Hebei from January 2021 to June 2023 were randomly divided into control (44 cases) and treatment (44 cases) group. Patients in the control group were po administered with Norethisterone Tablets from the fifth day of the menstrual cycle, 3.75 mg/time, twice daily. Patients in the treatment group were po administered with Compound Yimucao Capsules on the basis of the control group from the second day of the menstrual cycle, 5 grains/time, twice daily. Patients in two groups were treated for two menstrual cycles. After treatment, the clinical evaluations were evaluated, the TCM symptom scores, the levels of estradiol, progesterone, FSH and LH, and SF-36 scores in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (95.45% vs 81.82%, P < 0.05). Compared with before treatment, after treatment, the scores of symptoms of lower abdominal pain, fatigue, lumbosacral pain, low qi and lazy speech were significantly reduced (P < 0.05), compared with the control group, after treatment, the scores of symptoms of various TCM were lower (P< 0.05). After treatment, the levels of estradiol and progesterone were significantly increased, but the levels of FSH and LH were significantly decreased (P < 0.05). Compared with the control group, the levels of estradiol and progesterone were higher in the treatment group after treatment, but the levels of FSH and LH were lower (P< 0.05). After treatment, the SF-36 scores in two groups were significantly increased (P < 0.05), and the overall health, mental health and physical pain scores of the treatment group were higher than those of the control group (P < 0.05). Conclusion Compound Yimucao Capsules combined with norethisterone in treatment of menstrual irregularities has a good clinical effect, which can effectively regulate the level of hormones, improve patients' TCM symptoms and quality of life.

R984

河北省中医药管理局科研计划项目（2020486）