目的 探讨吉祥安坤丸联合屈螺酮炔雌醇片治疗肝郁气滞型月经不调的临床疗效。方法 选取2022年5月—2023年12月在首都医科大学附属北京妇产医院怀柔妇幼保健院诊治的肝郁气滞型月经不调患者122例，根据不同治疗方案随机分成对照组（61例）和治疗组（61例）。对照组口服屈螺酮炔雌醇片，于月经来潮第5天开始服用，1片/次，1次/d，连续服用21 d。治疗组患者在对照组基础上口服吉祥安坤丸，12丸/次，2次/d。两组患者均进行3个月经周期的治疗。观察两组患者临床疗效，比较治疗前后两组患者中医证候评分，中华生存质量量表（ChQOL）评分，性激素雌二醇（E₂）、黄体生成素（LH）和促卵泡生成素（FSH）水平，血清表皮生长因子（EGF）、白细胞介素-1β（IL-1β）和血管内皮生长因子（VEGF）水平，以及复发率情况。结果 治疗后，对照组和治疗组总有效率分别为85.25%和96.72%，两组比较差异具有统计学意义（P＜0.05）。治疗后，两组患者中医证候评分明显下降，而ChQOL评分显著升高（P＜0.05），且治疗组各评分较对照组改善的更为显著（P＜0.05）。治疗后，两组患者E₂、EGF和VEGF水平较治疗前明显升高，而LH、FSH和IL-1β水平明显降低（P＜0.05），且治疗组性激素和血清学水平较对照组改善更为显著（P＜0.05）。治疗后，对照组6个月内的复发率为13.11%，明显高于治疗组的1.64%，两组比较差异具有统计学意义（P＜0.05）。结论 吉祥安坤丸联合屈螺酮炔雌醇片治疗肝郁气滞型月经不调疗效显著，不仅能够显著改善患者临床症状、性激素水平及生存质量，同时还能够降低停药后复发率并促进血清学指标的修复。

Objective Exploring the therapeutic effect of Jixiang Ankun Pills combined with drospirenone and ethinylestradiol in treatment of menstrual disorders of liver depression and qi stagnation. Methods Patients (122 cases) with menstrual disorders of liver depression and qi stagnation in Huairou Maternal and Child Health Care Hospital, Beijing Obstetrics and Gynecology Hospital of Capital Medical University from May 2022 to December 2023 were divided into control (61 cases) and treatment (61 cases) group based on different treatments. Patients in the control group were po administered with Drospirenone and Ethinylestradiol Tablets from the 5 d of menstruation and continuously for 21 d, 1 tablet/time, once daily. Patients in the treatment group were po administered with Jixiang Ankun Pills, 12 pills/time, twice daily. Patients in two groups were treated for 3 menstrual cycles. After treatment, the clinical evaluations were evaluated, the TCM syndrome score, ChQOL score, levels of hormone E₂, LH and FSH, serum EGF, IL-1β and VEGF levels, and the recurrence rates in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 85.25% and 96.72%, respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the TCM syndrome scores in two groups were significantly decreased, while the ChQOL scores were significantly increased (P < 0.05), and the scores in the treatment group improved more significantly than those in the control group (P < 0.05). After treatment, the levels of E₂, EGF and VEGF in two groups were significantly higher than before treatment, while the levels of LH, FSH and IL-1β were significantly lower (P < 0.05), and the sexual hormone and serum levels in the treatment group were more significantly improved than those in the control group (P < 0.05). After treatment, the recurrence rate within 6 months in the control group was 13.11%, which was significantly higher than that in the treatment group (1.64%), and the difference between the two groups was statistically significant (P < 0.05). Conclusion The combination of Jixiang Ankun Pill and Quspirone ethinylestradiol tablets has a significant therapeutic effect on liver depression and qi stagnation type menstrual disorders. It can not only significantly improve the clinical symptoms, sex hormone levels, and quality of life, but also reduce the recurrence rate after discontinuation and promote the repair of serological indicators.

R984

首都医科大学附属北京妇产医院怀柔妇幼保健院“东方育苗科研基金”（FYDY-2023-04）