中西医结合治疗无排卵型功能失调性子宫出血疗效观察

摘要

目的观察中西医结合治疗无排卵型功能失调性子宫出血（简称功血）的临床疗效。方法将108例无排卵型功能失调性子宫出血患者随机分为治疗组和对照组各54例。在一般治疗的基础上，对照组给予西药常规治疗（青春期及育龄期功血给予雌孕激素序贯法连续治疗3个周期，绝经过渡期功血在诊断性刮宫排除肿瘤后给予妈富隆口服治疗），治疗组在西药常规治疗基础上加中药合剂（熟地黄、菟丝子、山萸肉、紫河车、旱莲草、五味子、泽泻、生山药、白术、香附、党参、黄芪、当归、白芍、陈皮、荆芥炭）。观察2组临床疗效、出血停止时间和随访3个月复发情况。结果（1）治疗组总有效率为100．0％，对照组为94．4％，治疗组疗效优于对照组，2组比较差异有统计学意义（P＜0．05）。（2）治疗组出血停止时间为（45．50±13．0） h，对照组为（58．0±15．0）h，治疗组的出血停止时间较对照组显著缩短，差异有统计学意义（P＜0．05）。（3）随访3个月，治疗组复发9例，对照组复发16例，治疗组的复发率显著低于对照组，差异有统计学意义（P＜0．05）。结论中西医结合治疗无排卵性功能失调性子宫出血疗效确切，值得在妇科临床中推广应用。%Objective To investigate the clinical efficacy of integrated Chinese and western medicine for the treatment of anovulatory dysfunctional uterine bleeding. Methods A total of 108 anovulatory dysfunctional uterine bleeding patients were evenly randomized into treatment group and control group. Both groups were given basic conventional treatment, estrogen-progestogen sequential therapy for 3 menstrual cycles for dysfunctional uterine bleeding patients at puberty and child-bearing period, and Marvelon for patients at menopause transition period after excluding uterine tumor by diagnostic curettage. Additionally, the treatment group was given Chinese herbal decoction of Radix Rehmanniae Preparata, Semen Cuscutae, Fructus Corni, Placenta Hominis, Herba Ecliptae, Fructus Schisandrae Chinensis, Rhizoma Alismatis, raw Rhizoma Dioscoreae, Rhizoma Atractylodis Macrocephalae, Rhizoma Cyperi, Radix Codonopsis, Radix Astragali, Radix Angelicae Sinensis, Radix Paeoniae Alba, Pericarpium Citri Reticulatae, and charred Herba Schizonepetae. Therapeutic effect, bleeding-arresting time, and recurrence rate during 3-month follow-up were observed in the two groups. Results ( 1) The treatment group had a total effective rate of 100.0%, higher than 94.4%in the control group, the difference being significant (P<0.05). (2) Bleeding-arresting time was (45.50 ± 13.0) hours in the treatment group and was (58.0 ± 15.0) hours in the control group, and the difference was statistically significant (P<0.05). (3) During the 3-month follow-up, the treatment group had the recurrence rate of 16.7% ( 9 cases) , lower than 29.6% ( 16 cases) in the control group, and the difference was statistically significant ( P<0.05). Conclusion Integrated Chinese and western medicine has certain effect for the treatment of anovulatory dysfunctional uterine bleeding, showing good prospects for extensive application in gynecological clinic.