目的 探讨六味地黄丸联合结合雌激素片治疗更年期综合征的临床疗效。方法 纳入2025年1月—2025年9月北京市鼓楼中医医院收治的138例更年期综合征患者，按照随机数字表法分为对照组和治疗组，各69例。对照组采用结合雌激素片口服治疗，0.625 mg/次，1次/d。治疗组在此基础上联合使用六味地黄丸，6 g/次，2次/d，分别于早、晚餐后30 min服用。两组疗程均为12周。比较两组临床疗效，治疗前后中医证候评分和改良Kupperman评分量表（mKI）评分、简式抑郁–焦虑–压力量表（DASS-21）评分、围绝经期生存质量量表（MENQOL）评分及性激素[促黄体生成素（LH）、促卵泡生成素（FSH）、雌二醇（E₂）]和血常规指标[血小板与淋巴细胞比值（PLR）、Log₂血小板与中性粒细胞计数乘积（log₂PPN）]、C反应蛋白（CRP）水平。结果 治疗组总有效率（95.65%）显著高于对照组（84.06%）（P＜0.05）。治疗后，两组中医证候评分、mKI评分、DASS-21评分、MENQOL评分均低于同组治疗前（P＜0.05），且治疗后，治疗组这些评分均低于对照组（P＜0.05）。治疗后，两组血清LH、FSH水平均降低，血清E₂水平均上升（P＜0.05）；治疗组性激素水平改善优于对照组（P＜0.05）。治疗后，两组PLR、log₂PPN和CRP都低于同组治疗前（P＜0.05），且治疗后治疗组PLR、log₂PPN和CRP低于对照组（P＜0.05）。结论 采用六味地黄丸与结合雌激素片联合治疗更年期综合征具有较好疗效，能改善更年期患者的微环境失衡，显著减轻患者症状，优化激素水平、情绪状态及生活质量。

Objective To explore the clinical efficacy of Liuwei Dihuang Pills combined with Conjugated Estrogens Tablets in treatment of menopausal syndrome. Methods A total of 138 patients with menopausal syndrome who were admitted to Beijing Gulou Hospital of Traditional Chinese Medicine from January 2025 to September 2025 were included. They were divided into control group and treatment group according to random number table method, with 69 cases in each group. Patients in control group were treated with oral administration of Conjugated Estrogens Tablets, 0.625 mg each time, once daily. Patients in treatment group were additionally treated with Liuwei Dihuang Pills, 6 g each time, twice daily, taken 30 min after breakfast and dinner. Both groups had a treatment duration of 12 weeks. Compare the clinical efficacy of two groups before and after treatment, including the Traditional Chinese Medicine Syndrome Score, Modified Kuperman Rating Scale (mKI), Simplified Depression Anxiety Stress Scale (DASS-21), MenQOL score, as well as the levels of sex hormones (LH, FSH, E₂) and blood routine indicators (PLR, log₂PPN), C-reactive protein (CRP). Results The total effective rate of the treatment group (95.65%) was significantly higher than that of the control group (84.06%), (P < 0.05). After treatment, the scores of TCM syndromes, mKI score, DASS-21 score, and MENQOL score in both groups were lower than those before treatment in the same group (P < 0.05), and after treatment, the scores of these in the treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of serum LH and FSH in both groups decreased, but the level of serum E₂ increased (P < 0.05). The improvement of sex hormone levels in treatment group was better than that in control group (P < 0.05). After treatment, the PLR, log₂PPN and CRP in both groups were lower than those before treatment in the same group (P < 0.05), and after treatment, the PLR, log₂PPN and CRP in treatment group were lower than those in control group (P < 0.05). Conclusion The combined treatment with Liuwei Dihuang Pills and Conjugated Estrogens Tablets for menopausal syndrome has a good therapeutic effect, and can improve the imbalance of the micro-environment in menopausal patients, significantly alleviate their symptoms, and optimize their hormone levels, emotional state and quality of life.

R984

国家重点研发计划项目(2022YFC3502004)