目的 探讨断血流颗粒联合屈螺酮炔雌醇片（Ⅱ）治疗异常子宫出血的临床疗效。方法 选取2022年1月—2024年11月上海市第一妇婴保健院收治的98例异常子宫出血患者，按照随机数字表法将患者分为对照组和治疗组，每组各49例。对照组口服屈螺酮炔雌醇片（Ⅱ），1片/次，每8 h重复1次，止血3 d后减量至1片/d，维持至本月经周期结束。治疗组在对照组治疗的基础上开水冲服断血流颗粒，1袋/次，3次/d。1个月经周期为1个疗程，两组治疗3个疗程后评估疗效。比较两组的临床疗效、出血量、血清性激素和炎症因子。结果 治疗组的总有效率为95.92%，较对照组的总有效率81.63%显著提高（P＜0.05）。两组治疗后月经失血图（PBAC）评分均降低（P＜0.05），且治疗组的PBAC评分低于对照组（P＜0.05）。两组治疗后血清雌二醇（E₂）、黄体生成素（LH）和促卵泡激素（FSH）水平均降低（P＜0.05），且治疗组血清E₂、LH、FSH水平显著低于对照组（P＜0.05）。治疗组治疗后血清白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平降低（P＜0.05），且治疗组血清IL-1β、IL-6、TNF-α水平低于对照组（P＜0.05）。结论 断血流颗粒联合屈螺酮炔雌醇片（Ⅱ）能够提高异常子宫出血患者的止血效果，改善性激素水平，抑制炎症因子水平。

Objective To study the effect of Duanxueliu Granules combined with Drospirone Ethinylestradiol Tablets (II) in treatment of abnormal uterine bleeding. Methods 98 Patients with abnormal uterine bleeding admitted to Shanghai First Maternal and Infant Health Care Hospital from January 2022 to November 2024 were divided into control group and treatment group using a random number table method, with 49 patients in each group. The control group took orally Drospirone Ethinylestradiol Tablets (II), 1 tablets/time, repeated every 8 h. After stopping bleeding for 3 d, the dosage was reduced to 1 tablets daily and maintained until the end of this menstrual course. On the basis of the control group, the treatment group took Duanxueliu Granules with boiling water, 1 bag/time, 3 times daily. One menstrual cycle was one course of treatment, and the efficacy of two groups was evaluated after 3 courses of treatment. The clinical efficacy, bleeding volume, serum sex hormones, and inflammatory factors were compared between two groups. Results The total effective rate of the treatment group was 95.92%, significantly higher than the total effective rate of 81.63% in the control group (P < 0.05). After treatment, the menstrual bleeding chart (PBAC) scores of two groups decreased (P < 0.05), and the PBAC score of the treatment group was lower than that of the control group (P < 0.05). After treatment, the serum levels of estradiol (E₂), luteinizing hormone (LH), and follicle stimulating hormone (FSH) in two groups decreased (P < 0.05), and the serum levels of E₂, LH, and FSH in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in the treatment group decreased (P < 0.05), and the serum levels of IL-1β, IL-6, and TNF-α in the treatment group were lower than those in the control group (P < 0.05). Conclusion Duanxueliu Granules combined with Drospirone Ethinylestradiol Tablets (II) can improve the hemostatic effect in patients with abnormal uterine bleeding, improve sex hormone levels, and inhibit inflammatory cytokine levels.

R984

上海市第一妇婴保健院院级临床研究培育项目（2024B11）