目的 探讨采用二至丸与屈螺酮炔雌醇片（Ⅱ）联合治疗排卵障碍性异常子宫出血的临床疗效。方法 选取2022年9月—2024年10月青岛市城阳区人民医院收治的90例患者，随机分为对照组（45例）和治疗组（45例）。对照组患者口服屈螺酮炔雌醇片（Ⅱ），1片/次，1次/d，连续用药21 d后停药7 d。28 d为1个周期，连续服药3个周期。在对照组基础上，治疗组口服二至丸，9 g/次，2次/d。两组治疗12周。观察两组患者临床疗效，比较治疗前后两组患者月经失血图评分（PBAC）评分、子宫内膜厚度，卵泡刺激素（FSH）、促黄体素（LH）和雌二醇（E₂）水平，及炎性因子白细胞介素-1β（IL-1β）、转录激活蛋白-1（AP-1）、基质金属蛋白酶-9（MMP-9）和环氧合酶-2（COX-2）水平。结果 治疗后，治疗组总有效率（95.56%）明显高于对照组（80.00%，P＜0.05）。治疗后，两组子宫内膜厚度、PBAC评分比治疗前明显下降（P＜0.05），且与对照组比较，治疗组的子宫内膜厚度、PBAC评分均显著降低（P＜0.05）。治疗后，两组FSH、E₂、LH、IL-1β、AP-1、MMP-9、COX-2水平比治疗前明显降低（P＜0.05），且治疗后治疗组性激素和炎性因子水平均明显低对照组（P＜0.05）。结论 二至丸与屈螺酮炔雌醇片（Ⅱ）协同治疗展示了良好的疗效，可调节性激素含量，减弱炎症反应状态。

Objective To investigate the clinical efficacy of Erzhi Pills combined with Quercetone Ethynylestradiol Tablets (Ⅱ) in treatment of ovulation disorders with abnormal uterine bleeding.Methods Patients (90 cases) with ovulation dysfunctional abnormal in Qingdao Chengyang People′s Hospital from September 2022 to October 2024 were randomly divided into control (45 cases) and treatment (45 cases) group. Patients in the control group were po administered with Drospirenone and Ethinylestradiol Tablets (Ⅱ), 1 tablet/time, once daily, the drug was continuously administered for 21 d and then stopped for 7 d. 28 d was one cycle, and the drug was taken continuously for 3 cycles. Patients in the treatment group were po administered with Erzhi Pills on the basis of the control group, 9 g/time, twice daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluations were evaluated, and the PBAC scores, endometrial thickness, sex hormone FSH, E₂ and LH levels, and the levels of inflammatory factors IL-1β, AP-1, MMP-9 and COX-2 in two groups before and after treatment were compared.Results After treatment, the effective rate in the treatment group (95.56%) was significantly higher than that in the control group (80.00%, P < 0.05). After treatment, the endometrial thickness and PBAC score in two groups were significantly decreased compared with those before treatment (P < 0.05). Compared with the control group, the endometrial thickness and PBAC score in the treatment group were significantly decreased (P < 0.05). After treatment, the levels of FSH, E₂, LH, IL-1β, AP-1, MMP-9, and COX-2 in two groups were significantly lower than those before treatment (P < 0.05), and the levels of sex hormones and inflammatory factors in the treatment group were significantly lower than those in the control group (P < 0.05).Conclusion The synergistic treatment effect of Quespirone Ethynylestradiol Tablets (Ⅱ) and Erzhi Pills is significant, which can improve the thickness of the endometrium in patients, regulate the content of sex hormones, and reduce the inflammatory response state.

R984

山东省中医药科技项目（Q-2023009）