目的 探讨妇科止血灵胶囊联合去氧孕烯炔雌醇片治疗功能失调性子宫出血的临床疗效。方法 选取2022年6月—2023年8月佳木斯市妇幼保健院收治的104例功能失调性子宫出血患者，按照随机数表法将104例功能失调性子宫出血患者分为对照组（52例）和治疗组（52例）。对照组口服去氧孕烯炔雌醇片，于月经周期第5天开始，初始剂量为1片/次，2次/d，连用3 d后改为1片/次，1次/d，连续治疗3周。治疗组患者在对照组治疗基础上口服妇科止血灵胶囊，4粒/次，3次/d。两组均连续治疗3周。观察两组的临床疗效和中医症候改善时间，比较两组治疗前后子宫内膜厚度、血红蛋白、激素指标的变化情况。结果 治疗后，治疗组患者的总有效率为94.23%，显著高于对照组80.77%（P＜0.05）。治疗后，两组子宫内膜厚度降低，而血红蛋白水平升高（P＜0.05）；与对照组比较，治疗后治疗组子宫内膜厚度减小，而血红蛋白水平更高（P＜0.05）。与对照组比较，治疗组腰膝酸软、面色晦黯、小便频数改善时间更短（P＜0.05）。与治疗前比较，治疗后两组雌二醇、促卵泡激素、孕酮水平均显著降低（P＜0.05）；与对照组比较，治疗后治疗组患者雌二醇、促卵泡激素、孕酮水平更低（P＜0.05）。结论 妇科止血灵胶囊联合去氧孕烯炔雌醇治疗功能失调性子宫出血可获得较好的治疗效果，能有效改善患者的中医症状，降低子宫内膜厚度、提高血红蛋白水平，改善机体激素紊乱的状态，且不良反应少。

Objective To explore the therapeutic effect of Fuke Zhixueling Capsules combined with desogestrel and ethinylestradiol in treatment of dysfunctional uterine bleeding. Methods A total of 104 patients with dysfunctional uterine bleeding admitted to Jiamusi Maternal and Child Health Hospital from June 2022 to August 2023 were selected and divided into control group (52 cases) and treatment group (52 cases) according to random number table method. Patients in the control group were po administered with Desogestrel and Ethinylestradiol Tablets, started on the 5th day of the menstrual cycle, the initial dosage was 1 tablet/time, twice daily, and changed to 1 tablet/time, once daily after 3 d of continuous treatment for 3 weeks. Patients in the treatment group were po administered with Fuke Zhixueling Capsules on the basis of the control group, 4 capsules/time, 3 times daily. Both groups were treated continuously for 3 weeks. The clinical effect and improvement time of TCM symptoms were observed in two groups, and the changes of endometrial thickness, hemoglobin and hormone indexes before and after treatment were compared. Results After treatment, the total effective rate of treatment group was 94.23%, which was significantly higher than that of control group (80.77%, P < 0.05). After treatment, endometrial thickness decreased and hemoglobin level increased in both groups (P< 0.05). Compared with control group, the endometrial thickness in treatment group was lower than that in control group after treatment, but the hemoglobin level was higher (P < 0.05). Compared with the control group, the improvement time of waist and knee weakness, dark complexion and urination frequency in treatment group was shorter (P < 0.05). Compared with before treatment, the levels of estradiol, follicle-stimulating hormone and progesterone were significantly decreased in both groups after treatment (P< 0.05). Compared with control group, the levels of estradiol, follicle-stimulating hormone and progesterone in treatment group were lower after treatment (P < 0.05). Conclusion Fuke Zhixueling Capsules combined with desogestrel and ethinylestradiol can obtain better treatment effect in treatment of dysfunctional uterine bleeding, and can effectively improve TCM symptoms, reduce the thickness of endometrial, increase the level of hemoglobin, which can improve the state of hormone disorder in the body with few and slight adverse reactions.

R984

黑龙江省卫生健康委科研课题（20220505021165）