目的 探究红花如意丸联合地屈孕酮片在血瘀型月经不调治疗中的临床效果。方法 将2023年1月—2025年12月在江阴市中医院就诊的血瘀型月经不调患者80例作为研究对象，将患者采用随机数字表法分为对照组和治疗组，各40例。对照组口服地屈孕酮片，从月经周期第11天开始，1片/次，2次/d，每连续服用15 d计为1个疗程。治疗组在对照组用药基础上口服红花如意丸，1 g/次，2次/d，经期停服。两组均连续治疗3个月。比价两组的临床疗效、中医症状积分、月经失血图（PBAC）评分、性激素水平。结果 较对照组总有效率80.00%，治疗组的总有效率95.00%更高（P＜0.05）。两组治疗后经期不定、量多或少、色紫有块、经行不畅积分均较治疗前降低（P＜0.05），且治疗组的经期不定、量多或少、色紫有块、经行不畅积分低于对照组（P＜0.05）。两组治疗后PBAC评分均较治疗前降低（P＜0.05），且治疗组的PBAC评分较对照组低（P＜0.05）。两组治疗后雌二醇（E₂）、孕酮（P）均较治疗前升高，黄体生成素（LH）、卵泡刺激素（FSH）均较治疗前降低（P＜0.05），且治疗组E₂、P较对照组更高，LH、FSH较对照组更低（P＜0.05）。结论 红花如意丸联合地屈孕酮片治疗血瘀型月经不调疗效显著，能明显改善患者临床症状、减少月经失血量，调节性激素水平。

Objective To explore the clinical efficacy of the combination therapy of Honghua Ruyi Pills and Dextroprogesterone Tablets in treatment of menstrual disorders of blood stasis type. Methods A total of 80 patients with menstrual disorders of blood stasis type who visited Jiangyin Hospital of Traditional Chinese Medicine from January 2023 to December 2025 were selected as the study subjects. They were divided into control group and treatment group using a random number table method, with 40 cases in each group. The control group took orally Dextroprogesterone Tablets at a dosage of 1 tablets per dose, starting from the 11th day of the menstrual cycle, twice daily, with each continuous 15-day course considered as one treatment cycle. The treatment group received Honghua Ruyi Pills in addition to the control group's medication, at a dosage of 1 g/time and twice daily, with the medication discontinued during menstruation. Two groups were treated continuously for three months. The clinical efficacy, TCM symptom scores, PBAC (Period Blood Amount Chart) scores, and sex hormone levels were compared between two groups. Results The total effective rate in the treatment group (95.00%) was higher than 80.00% in the control group (P< 0.05). After treatment, the scores for irregular menstruation, excessive or scanty menstrual flow, dark or clotted menstrual blood, and poor menstrual flow in two groups were decreased (P < 0.05), and these scores of the treatment group were lower than those of the control group (P < 0.05). The PBAC scores in two groups were decreased (P < 0.05), and the PBAC scores of the treatment group were lower than those of the control group (P< 0.05). After treatment, the levels of estradiol (E₂) and progesterone (P) in two groups increased, while luteinizing hormone (LH) and follicle-stimulating hormone (FSH) decreased (P < 0.05). And the treatment group's E₂ and P levels were higher, while LH and FSH levels were lower than those of the control group (P < 0.05). Conclusion Honghua Ruyi Pills combined with Dydrogesterone Tablets show significant efficacy in treating menstrual disorders of blood stasis type, effectively improving clinical symptoms, reducing menstrual blood loss, and regulating sex hormone levels.

R984

江阴市中医药学会科研项目（Z202408）