益氣化瘀方聯合米非司酮治療圍絕經期子宮功能失調性出血的臨床效果評價

劉晶靜 唐苗苗 董利琴 李亞俐

【摘要】目的：觀察圍絕經期女性功能失調性子宮出血（簡稱功血）在西藥基礎上應用益氣化瘀法治療的臨床效果，并該方法治療圍絕經期功血的臨床應用價值。方法：選取2013年4月至2014年12月期間醫院收治的86例圍絕經期功血患者作為研究對象，按照不同治療方式將研究對象分為西藥組40例、聯合組46例。西藥組經診斷性刮宮術5d后服用米非司酮，聯合組在西藥組基礎上應用益氣化瘀法治療。比較兩組一般情況。結果：經治療后，聯合組總有效率為93.48%，與對照組（77.50%）相比，差異存在統計學意義（P<0.05）；兩組患者的子宮內膜厚度、血紅蛋白水平以及中醫證候積分方面比較，差異均存在統計學意義（P<0.01）。兩組在血流變學指標（高/低切全血粘度、血漿粘度、血沉與PCV）比較，差異存在統計學意義（P<0.01）。結論：益氣化瘀法在西藥治療基礎上應用的臨床療效顯著，子宮內膜厚度明顯降低，良好改善患者血流指標，值得進一步研究應用。

【關鍵詞】圍絕經期；功能失調；子宮出血；益氣化瘀法；臨床價值

【Abstract】Objectives： To research the clinical effect of Yiqihuayu Method joint western medicine in treating peri menopausal dysfunctional uterine bleeding and its clinical application value. Methods： 86 patients with dysfunctional uterine bleeding treated in the hospital from April 2013 to December 2014 were selected as the research subjects， who were divided into western medicine group （40 cases） and combination group （46 cases） according to different treatment methods. The western medicine group was assigned to receive mifepristone 5 days after curettage. On such basis， the combined group received both western medicine and Yiqihuayu therapy. The general situation of patients in two groups was compared. Results： After treatment， the total effective rate was 93.48%， and compared with control group （77.50% ） was of statistical significance （P< 0.05）. Thedifference in the endometrial thickness， hemoglobin level and TCM syndrome integral of patients in two groups were statistically significant （P< 0.01）， and difference in the blood rheology index （high / low shear whole blood viscosity， plasma viscosity， erythrocyte sedimentation rate （ESR） and PCV） of patients in the two groups was statistically significant （P< 0.01）. Conclusion： The curative effect of joint use of Yiqihuayu method and western medicine is remarkable， which can significantly reduce the thickness of endometrium and improve the hemorheology， worth further study and application.

【Key words】Peri menopausal period； Dysfunctional uterine bleeding； Uterine bleeding； Yiqihuayu method； Clinical value

【中圖分類號】R271.9；R711.74【文獻標志碼】A

圍絕經期婦女功血的發生與生殖調節軸功能異常相關，非生殖系統中發生的器質性病變或者其他全身性病變引起子宮出血[1]。患者月經紊亂是該癥主要癥狀，主要表現在月經周期、經量與經期紊亂上。此癥遷延難愈，長時間患病易導致機體出血、免疫力低下等，還可能伴隨外源性感染、繼發性貧血等。既往臨床應用常規止血藥物、外科手術止血、各類激素止血措施等具有一定止血作用，但對患者整體癥狀的效果并不明顯，難以治愈。中醫根據該癥臨床表現將其納入崩漏范疇，且在該癥臨床治療中顯現出了明顯優勢[2]。本研究特在西藥基礎上應用益氣化瘀法治療圍絕經期功血，旨在對中西醫聯合治療的效果進行評價，現報道如下。

1資料與方法……