目的 探讨舒尔经胶囊联合黄体酮胶囊治疗气滞血瘀型月经不调的临床疗效。方法 选取2022年11月—2024年11月秦皇岛市妇幼保健院收治的116例月经不调患者，按照随机数字法将患者分为对照组（58例）和治疗组（58例）。对照组患者口服黄体酮胶囊，100 mg/次，每日2次。治疗组在对照组的基础上口服舒尔经胶囊，2粒/次，每日2次。两组用药4周为1个周期，共治疗3个周期。观察两组的临床疗效，比较两组中医证候积分、血清性激素水平、月经血量评分、生活质量评分、血流动力学相关指标、血清炎性因子水平的变化情况。结果 干预后，治疗组总有效率是96.55%，显著高于对照组总有效率82.76%（P＜0.05）。治疗后，两组面色晦暗积分、头晕眼花积分、经色紫暗伴血块积分、手足麻木积分均显著降低（P＜0.05）；治疗后，治疗组面色晦暗积分、头晕眼花积分、经色紫暗伴血块积分、手足麻木积分低于对照组，（P＜0.05）。治疗后，两组月经失血图评分（PBAC）评分、简明健康状况调查量表（SF-36）评分较前显著升高（P＜0.05）；治疗后，与对照组对比，治疗组的PBAC评分、SF-36评分升高（P＜0.05）。治疗后，两组搏动指数（PI）、阻力指数（RI）较前降低，而子宫动脉血流收缩期峰值流速（PSV）升高（P＜0.05）；治疗后，与对照组对比，治疗组RI、PI均较低，且治疗组的PSV升高（P＜0.05）。治疗后，两组患者促卵泡生成素（FSH）、黄体生成素（LH）、雌二醇（E₂）、孕酮（P）水平较前升高（P＜0.05）；治疗后，与对照组对比，治疗组FSH、LH、P、E₂水平均升高（P＜0.05）。治疗后，两组内皮素（ET）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平较前降低，而一氧化氮（NO）水平升高（P＜0.05）；治疗后，治疗组ET、IL-6、TNF-α水平低于对照组，NO水平高于对照组（P＜0.05）。结论 舒尔经胶囊与黄体酮胶囊协同治疗气滞血瘀型月经不调效果较佳，可较好地改善患者临床症状，并能调节子宫血流动力学指标，提升患者生活质量，值得借鉴与应用。

Objective To explore the therapeutic effect of Shuerjing Capsules combined with Progesterone Capsules in treatment of menstrual disorders of qi stagnation and blood stasis type. Methods A total of 116 patients with menstrual disorders admitted to Qinhuangdao Maternal and Child Health Hospital from November 2022 to November 2024 were selected and divided into control group of 58 cases and treatment group of 58 cases according to the random number method. Patients in control group were orally administered Progesterone Capsules, 100 mg each time, twice daily. Patients in treatment group took Shuerjing Capsules orally on the basis of control group, 2 capsules each time, twice daily. Both groups were treated for 4 weeks as one cycle, and a total of 3 cycles were completed. The clinical efficacy of two groups was observed, and the changes in TCM syndrome scores, serum sex hormone levels, menstrual blood volume scores, quality of life scores, hemodynamic-related indicators, and serum inflammatory factor levels between two groups were compared. Results After intervention, the total effective rate of the treatment group was 96.55%, significantly higher than 82.76% of control group (P < 0.05). After treatment, the scores of dull complexion, dizziness and blurred vision, dark menstrual color with blood clots, and numbness of hands and feet in both groups were significantly reduced (P < 0.05). After treatment, the scores of dull complexion, dizziness and blurred vision, dark menstrual color with blood clots, and numbness of hands and feet in the treatment group were lower than those in the control group (P < 0.05). After treatment, PBAC scores and SF-36 score in both groups were significantly increased compared with those before (P < 0.05). After treatment, compared with the control group, the PBAC score and SF-36 score of treatment group increased (P < 0.05). After treatment, PI and RI in both groups decreased compared with before, but PSV increased (P < 0.05). After treatment, compared with control group, RI and PI in treatment group were both lower, and PSV in treatment group increased (P < 0.05). After treatment, the levels of FSH, LH, E₂, and P in both groups increased compared with before (P < 0.05). After treatment, compared with control group, the levels of FSH, LH, P, and E₂ in treatment group all increased (P < 0.05). After treatment, the levels of ET, IL-6, and TNF-α in both groups decreased compared with before, but the level of NO increased (P < 0.05). After treatment, the levels of ET, IL-6, and TNF-α in treatment group were lower than those in control group, but the level of NO was higher than that in control group (P < 0.05). Conclusion The combined treatment of Shuerjing Capsules and Progesterone Capsules for menstrual disorders of qi stagnation and blood stasis type has a better effect. It can effectively improve the clinical symptoms of patients, regulate the hemodynamic indicators of the uterus, and enhance the life quality of patients, which is worth learning from and applying

R984

河北省医学科学研究重点课题计划项目（20221621）