目的 探讨宫血宁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 选取2021年9月—2023年9月无锡市锡山人民医院收治的96例功能失调性子宫出血患者，根据用药差别将所有患者分为对照组和治疗组，各48例。对照组于月经周期第5天开始口服复方炔诺酮片，1片/d。在此基础上，治疗组口服宫血宁胶囊，2粒/次，3次/d。两组连服22 d，为1个周期，均治疗2个周期。比较两组临床疗效、中医证候积分、性激素水平、凝血功能和血清学指标。结果 治疗组的总有效率明显高于对照组（P＜0.05）。治疗后，两组小腹胀痛评分、腰骶酸痛评分、精神不振评分降低（P＜0.05），治疗组小腹胀痛评分、腰骶酸痛评分、精神不振评分低于对照组（P＜0.05）。治疗后，两组卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E₂）降低（P＜0.05），且治疗组FSH、LH、E₂低于对照组（P＜0.05）。治疗后，两组凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）降低（P＜0.05），且治疗组TT、PT、APTT低于对照组（P＜0.05）。治疗后，两组血清碱性成纤维细胞生长因子（bFGF）、前列腺素2α（PGF2α）水平升高，血清促血管生长素-Ⅱ（Ang-Ⅱ）水平降低（P＜0.05），且治疗组血清bFGF、PGF2α水平高于对照组，血清Ang-Ⅱ水平低于对照组（P＜0.05）。结论 宫血宁胶囊联合复方炔诺酮片可缓解功能失调性子宫出血患者临床症状，调节性激素水平和凝血功能，改善机体血清因子水平。

Objective To explore the clinical efficacy of Gongxuening Capsules combined with Compound Norethisterone Tablets in treatment of dysfunctional uterine bleeding. Methods 96 Patients with dysfunctional uterine bleeding in Wuxi Xishan People's Hospital from September 2021 to September 2023 were divided into control group and treatment group based on medication differences, with 48 cases in each group. The control group started taking orally Compound Norethisterone Tablets on the 5th day of the menstrual cycle, 1 tablets daily. On this basis, the treatment group took orally Gongxuening Capsules, 2 capsules per time, 3 times daily. One course had 22 d, and two groups were treated for two courses. The clinical efficacy, TCM syndrome score, sex hormone level, coagulation function, and serological indicators were compared. Results The total effective rate of the treatment group was higher than that of the control group (P < 0.05). After treatment, abdominal distension and pain score, lumbosacral soreness score, and mental fatigue score in both groups were decreased (P < 0.05), and these TCM syndrome scores in the treatment group were lower than those of the control group (P < 0.05). After treatment, FSH, LH, and E₂ in both groups were decreased (P < 0.05), and FSH, LH, and E₂ in the treatment group were lower than those of the control group (P < 0.05). After treatment, TT, PT, and APTT of the two groups were decreased (P < 0.05), and TT, PT, and APTT of the treatment group were lower than those of the control group (P < 0.05). After treatment, bFGF and PGF2α in two groups were increased, but Ang-II were decreased (P < 0.05), and bFGF and PGF2α in the treatment group were higher than those of the control group, but Ang-II were lower (P < 0.05). Conclusion The combination of Gongxuening Capsules and Compound Norethisterone Tablets has a definite therapeutic effect on dysfunctional uterine bleeding, which can alleviate clinical symptoms, regulate sex hormone levels and coagulation function, and improve serum cytokine levels.

R984

江苏省妇幼健康科研项目（F201903)