目的 探讨妇科养荣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 选取上海市嘉定区南翔医院在2024年3月—2026年2月收治的功能失调性子宫出血患者共120例。患者依据随机数字表法分为对照组和治疗组，各有60例。对照组患者月经第5天开始口服复方炔诺酮片，1片/次，1次/d，连服22 d，然后下个月经周期继续治疗。治疗组在对照组基础上口服妇科养荣胶囊，4粒/次，3次/d。两组的疗程均为3个月。比较两组的治疗效果、超声指标、血清激素和因子。结果 治疗组的总有效率为96.67%，对照组的总有效率为85.00%，组间比较差异有统计学意义（P＜0.05）。两组治疗后的子宫内膜血流阻力指数（RI）明显升高，收缩期峰值流速（PSV）和厚度明显降低（P＜0.05）；治疗组治疗后的子宫内膜RI高于对照组，PSV、厚度低于对照组（P＜0.05）。两组治疗后的雌二醇（E₂）、睾酮（T）水平明显降低，孕酮（P）水平明显升高（P＜0.05）；治疗组治疗后的E₂、T水平低于对照组，P水平高于对照组（P＜0.05）。两组治疗后的血清基质金属蛋白酶-9（MMP-9）、可溶性fms样酪氨酸激酶1（sFlt-1）、血管内皮生长因子（VEGF）水平均显著降低（P＜0.05），且治疗组治疗后的血清MMP-9、sFlt-1、VEGF水平低于对照组（P＜0.05）。结论 妇科养荣胶囊联合复方炔诺酮片可提高功能失调性子宫出血的效果，改善子宫状态，调节内分泌激素，减轻血管的异常生长。

Objective To investigate the clinical efficacy of Fuke Yangrong Capsules combined with Compound Norethisterone Tablets in treatment of dysfunctional uterine bleeding. Methods A total of 120 patients with dysfunctional uterine bleeding admitted to Shanghai Jiading Nanxiang Hospital from March 2024 to February 2026 were selected. The patients were divided into control group and treatment group according to the random number table method, with 60 cases each group. The control group took Compound Norethisterone Tablets orally on the 5th day of menstruation, at a dose of 1 tablet per dose and once daily for 22 consecutive days, followed by continued treatment in the next menstrual cycle. The treatment group received additional oral Fuke Yangrong Capsule on the control group regimen, at a dose of 4 capsules per dose and three times daily. Two groups underwent treatment for 3 months. The therapeutic efficacy, ultrasound indicators, serum hormones, and factors were compared between two groups. Results The total effective rate of the treatment group was 96.67%, while the total effective rate of the control group was 85.00%, and the difference between two groups was statistically significant (P < 0.05). After treatment, the endometrial blood flow resistance index (RI) of two groups increased significantly, while the peak systolic velocity (PSV) and thickness decreased significantly (P < 0.05). The endometrial RI of the treatment group was higher than that of the control group, while PSV and thickness was lower than that of the control group (P < 0.05). After treatment, the levels of estradiol (E₂) and testosterone (T) in two groups decreased significantly, while the level of progesterone (P) increased significantly (P < 0.05). The E₂ and T levels in the treatment group were lower than those in the control group, while the P level was higher than that in the control group (P < 0.05). After treatment, the serum levels of matrix metalloproteinase-9 (MMP-9), soluble fms like tyrosine kinase 1 (sFlt-1), and vascular endothelial growth factor (VEGF) in two groups were significantly reduced (P < 0.05), and the levels of MMP-9, sFlt-1, and VEGF in the treatment group were lower than those in the control group (P < 0.05). Conclusion The combination of Fuke Yangrong Capsules and Compound Norethisterone Tablets can improve the effect of dysfunctional uterine bleeding, improve uterine condition, regulate endocrine hormones, and alleviate abnormal blood vessel growth.

R984

上海市嘉定区卫生健康委员会科研课题（2021-KY-06）