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目的:观察吉祥安坤丸联合米非司酮片治疗更年期功能失调性子宫出血的临床疗效,及对患者血红蛋白(Hb)水平、子宫内膜厚度、性激素水平的影响。方法:选取80例更年期功能失调性子宫出血患者,按照随机数字表法分为观察组和对照组各40例。2组均进行全面刮宫,对照组给予米非司酮片治疗,观察组在对照组治疗基础上加服吉祥安坤丸,均治疗3月。治疗后比较2组临床疗效和不良反应发生率,观察治疗前后中医症状积分、子宫内膜厚度和Hb、性激素水平的变化。结果:观察组治疗总有效率92.5%,对照组治疗总有效率75.0%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组月经色淡有块、小腹疼痛、气短神疲、面色萎黄积分均较治疗前降低(P<0.05),观察组的4项中医症状积分均低于对照组(P<0.05)。治疗后,2组Hb水平均较治疗前上升(P<0.05),子宫内膜厚度均较治疗前减小(P<0.05);观察组Hb水平高于对照组(P<0.05),子宫内膜厚度小于对照组(P<0.05)。治疗后,2组促卵泡生成激素(FSH)和促黄体生成素(LH)水平均较治疗前下降(P<0.05),雌二醇(E2)水平均较治疗前升高(P<0.05);观察组的FSH和LH水平均低于对照组(P<0.05),E2水平高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)结论:吉祥安坤丸联合米非司酮片治疗更年期功能失调性子宫出血,治疗总有效率优于单纯使用米非司酮片,能进一步改善症状,提高Hb含量,改善性激素水平,安全性高。
Objective: To observe the clinical efficacy of Jixiang Ankun Pills and mifepristone tablets in the treatment of climacteric dysfunctional uterine bleeding and its effect on hemoglobin (Hb) level, endometrial thickness and sex hormone levels. Methods: Eighty menopausal dysfunctional uterine bleeding patients were selected and divided into observation group and control group according to random number table. The two groups were completely curettage, the control group was treated with mifepristone, the observation group in the control group based on the service plus auspicious Ankun Pills, were treated for 3 months. After treatment, the clinical efficacy and incidence of adverse reactions were compared between the two groups. The scores of TCM symptom score, endometrial thickness, Hb and sex hormone levels before and after treatment were observed. Results: The total effective rate was 92.5% in the observation group and 75.0% in the control group. There was significant difference between the two groups (P <0.05). After treatment, the two groups of menstruation had light color and lumpiness, lower abdomen pain, shortness of breath and fatigue, pale complexion scores were lower than those before treatment (P <0.05), and the scores of four TCM symptoms in the observation group were lower than those in the control group (P <0.05) . After treatment, the levels of Hb in both groups were significantly higher than those before treatment (P <0.05), and the thickness of endometrium was lower than that before treatment (P <0.05). The Hb level in the observation group was higher than that in the control group (P <0.05) The membrane thickness was smaller than that of the control group (P <0.05). After treatment, the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) were significantly lower than those before treatment (P <0.05) and estradiol (E2) . The levels of FSH and LH in the observation group were lower than those in the control group (P <0.05), and the levels of E2 in the observation group were higher than those in the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05) .Conclusion: The combination of Jixiang Ankun Pill and mifepristone in the treatment of climacteric dysfunctional uterine bleeding, the total effective rate is better than the simple use of mifepristone Film, can further improve the symptoms, improve Hb content, improve sex hormone levels, high safety.