目的 探讨坤宁颗粒联合米非司酮治疗围绝经期功能性子宫出血的临床疗效。方法 回顾性纳入2019年3月-2019年8月于新乡医学院第一附属医院妇产科接受治疗的102例围绝经期功能性子宫出血患者作为研究对象，按治疗方案分为对照组和观察组，每组各51例。对照组口服米非司酮片，10 mg/次，1次/d；观察组在对照组治疗的基础上口服坤宁颗粒，1袋/次，3次/d，两组共计治疗3个月。观察两组患者的临床疗效、平均控制出血时间、平均完全止血时间，比较两组治疗前后的血红蛋白水平、子宫内膜厚度及卵泡雌激素（FSH）、雌二醇（E2）、孕酮（P）、血管内皮生长因子（VEGF）、血管紧张素2（Ang-2）水平。结果 与对照组总有效率82.35%相比，观察组治疗后总有效率96.08%显著升高，差异具有统计学意义（P<0.05）。治疗后，观察组平均控制出血时间、平均完全止血时间均显著低于对照组，而血红蛋白水平显著高于对照组，差异均具有统计学意义（P<0.05）。治疗后，两组FSH、E2、P和子宫内膜厚度均显著降低，差异均具有统计学意义（P<0.05）；治疗后，观察组FSH、E2、P和子宫内膜厚度均显著低于对照组，差异均具有统计学意义（P<0.05）。治疗后，两组VEGF和Ang-2水平均显著降低（P<0.05）；且观察组VEGF和Ang-2水平显著低于对照组，差异均具有统计学意义（P<0.05）。结论 坤宁颗粒联合米非司酮能有效降低围绝经期功能性子宫出血患者的子宫出血量及缩短子宫出血时间，能显著降低FSH、E2、P、VEGF及Ang-2水平。

Objective To investigate the clinical effect of Kunning Granules combined with mifepristone in treatment of perimenopausal functional uterine bleeding. Methods A total of 102 patients with perimenopausal functional uterine bleeding who received treatment in the Department of Gynecology and Obstetrics of the First Affiliated Hospital of Xinxiang Medical University from March 2019 to August 2019 were retrospectively included as the research subjects. According to the treatment plan, they were divided into control group and observation group, with 51 patients in each group. Patients in the control group were po administerd with Mifepristone Tablets, 10 mg/time, once daily. Patients in the observation group were po administered with Kunning Granuleson the basis of control group, 1 bag/time, three times daily. The two groups were treated for three months. The clinical efficacy, mean bleeding control time, and mean complete hemostasis time of two groups were observed. The hemoglobin level, endometrial thickness, and the levels of FSH, E2, P, VEGF, and Ang-2 before and after treatment were compared between two groups. Results The total effective rate of 82.35% in the control group, was significantly lower than 96.08% in the observation group after treatment, with statistical significance (P<0.05). After treatment, the average bleeding control time and the average complete hemostasis time in the observation group were significantly lower than those in the control group, while the hemoglobin level was significantly higher than that in the control group, with statistical significance (P<0.05). After treatment, FSH, E2, P, and endometrial thickness in two groups were significantly decreased, with statistical significance (P<0.05). After treatment, FSH, E2, P, and endometrial thickness in the observation group were significantly lower than those in the control group, with statistical significance (P<0.05). After treatment, the levels of VEGF and Ang-2 in two groups were significantly decreased (P<0.05). VEGF and Ang-2 levels in the observation group were significantly lower than those in the control group, with statistical significance (P<0.05). Conclusion Kunning Granules combined with mifepristone can effectively reduce the amount of uterine bleeding, and shorten the time of uterine bleeding in perimenopausal patients with functional uterine bleeding, and can significantly reduce the levels of FSH, E2, P, VEGF and Ang-2.

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