摘要：
目的 探讨生血宁片结合炔雌醇环丙孕酮片对宫腔镜子宫内膜息肉电切术(transcervical resection of polyp,TCRP)后子宫内膜厚度及血红蛋白水平的影响.方法 将符合入选标准的150例TCRP患者采用随机数字表法分为3组,每组50例.对照组采用TCRP治疗,西医组在对照组基础上加服炔雌醇环丙孕酮片,联合组在西医组基础上加服生血宁片.观察3组治疗前、治疗后3、6、12个月的月经量、子宫内膜厚度与血红蛋白水平,记录复发情况,评价临床疗效.结果 联合组总有效率为98.0％(49/50)、西医组为96.0％(48/50)、对照组为86.0％(43/50),联合组与西医组总有效率高于对照组(χ2=6.643,P=0.036).治疗后3、6、12个月,3组月经量(F值分别为28.096、49.096、33.303)、子宫内膜厚度(F值分别为11.214、20.265、63.947)比较,差异有统计学意义(P值均<0.01),且联合组月经量(t值分别为4.747、2.244、4.489,P<0.01或P<0.05)、子宫内膜厚度(t值分别为3.293、3.356、5.293,P值均<0.01)均低于西医组.治疗后3、6、12个月,3组血红蛋白水平比较,差异有统计学意义(F值分别为11.002、8.662、8.958,P值均<0.01),且联合组高于西医组(t值分别为2.722、2.074、2.028,P值均<0.05).治疗后12个月,联合组复发率为4.1％(2/49)、西医组为6.3％(3/48)、对照组为20.9％(9/43),联合组与西医组复发率低于对照组(χ2=6.775,P=0.034),联合组与西医组复发率比较未见明显差异(χ2=0.211,P=0.646).结论 生血宁片结合炔雌醇环丙孕酮片可减少TCRP患者的月经量,减轻子宫内膜厚度,升高血红蛋白水平,降低复发率.%Objective To investigate the effects of Shengxuening tablets combined with ethinylestradiol and cycloproterone acetate on endometrial thickness and hemoglobin level in patients with endometrial polyps for transcervical resection of polyp. Methods A total of 150 patients with hysteroscopic endometrial polypectomy were randomly divided into three groups, 50 in each group. The control group was treated with hysteroscopy endometrial polyp electrotomy, while the western medicine group was treated with ethinylestradiol and cycloprogesterone acetate tablets on the basis of the control group, and the combined group was treated with Shengxuening tablets on the basis of the western medicine group. The menstrual volume, endometrial thickness and hemoglobin levels were observed before treatment, at 3 month, 6 month and 12 month after treatment, and the clinical efficacy and recurrence during follow-up were evaluated. Results The total effective rate was 98.0％(49/50) in the combined group, 96.0％ (48/50) in the western medicine group, 86.0％ (43/50) in the control group. The total effective rate in the combined group and the western medicine group was significantly higher than that in the control group (χ2=6.643, P=0.036). The menstrual volume (F=28.096, 49.096, 33.303), endometrial thickness (F=11.214, 20.265, 63.947) in the three groups were significantly different after treatment (P<0.01), and which in the combined group were significantly lower than those in the western medicine group, menstrual volume at 36,12 after treatment (t value were 4.747, 2.244, 4.489, P<0.01); endometrial thickness at 3, 6, 12 month after treatment (t value were 3.293, 3.356, 5.293, P<0.01); there were significant differences in hemoglobin levels in the three groups (F=11.002, 8.662, 8.958, P<0.01), and which in the combined group was significantly higher than that in the western medicine group at 3,6,12 month after treatment (t value were 2.722, 2.074, 2.028, P<0.05). During the follow-up period, 2 cases (4.1％) recurred in the combined group, 3 cases (6.3％) recurred in the western medicine group and 9 cases (20.9％) recurred in the control group. The recurrence rate in the combined group or the western medicine group was significantly lower than that in the control group (χ2=6.775, P=0.034). There was no significant difference in the recurrence rate in the combined group and the western medicine group (χ2=0.211, P=0.646). Conclusions The Ethynestradiol and Cyproterone acetate combined with Shengxuening tablets could improve the curative effect, reduce menstrual volume and endometrial thickness, increase hemoglobin level and reduce recurrence rate in patients with endometrial polyps for transcervical resection of polyp.
