目的 探討結(jié)合雌激素片聯(lián)合醋酸甲羥孕酮片治療圍絕經(jīng)期功能失調(diào)性子宮出血的臨床療效。方法 選取2015年1月-2016年2月中國人民解放軍第313醫(yī)院收治的圍絕經(jīng)期功能失調(diào)性子宮出血患者120例，按隨機數(shù)字表法將所有患者分為對照組和治療組，每組各60例。對照組在陰道出血第15天口服醋酸甲羥孕酮片，1片/次，3次/d，連續(xù)用藥10 d。治療組在對照組基礎(chǔ)上在陰道撤退性出血第5天口服結(jié)合雌激素片，1片/次，1次/d，連續(xù)用藥21 d。每個療程21 d，兩組均治療6個療程。觀察兩組的臨床療效，比較兩組的促卵泡生成素（FSH）、促黃體生成素（LH）、孕酮（P）和雌二醇（E₂）、子宮內(nèi)膜厚度和血紅蛋白。結(jié)果 治療后，對照組和治療組的總有效率分別為75.00%、91.67%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組FSH、LH、P和E₂水平均顯著降低，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療組這些觀察指標明顯低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組子宮內(nèi)膜厚度均顯著降低，而血紅蛋白水平均顯著升高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療組這些觀察指標的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 結(jié)合雌激素片聯(lián)合醋酸甲羥孕酮片治療圍絕經(jīng)期功能失調(diào)性子宮出血具有較好的臨床療效，可改善雌激素水平，降低子宮內(nèi)膜厚度，升高血紅蛋白水平，具有一定的臨床推廣應用價值。

Objective To investigate the clinical efficacy of Conjugated Estrogens Tablets combined with Medroxyprogesterone Acetate Tablets in treatment of perimenopausal dysfunctional uterine bleeding. Methods Patients (120 cases) with perimenopausal dysfunctional uterine bleeding in the No. 313 Hospital of PLA from January 2015 to February 2016 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were po administered with Medroxyprogesterone Acetate Tablets on day 15 after vaginal bleeding, 1 tablet/time, once daily, treated for 10 d. Patients in the treatment group were po administered with Conjugated Estrogens Tablets on day 5 after vaginal withdrawal bleeding on the basis of the control group, 1 tablet/time, three times daily, treated for 21 d. Every course had 21 d, and patients in two groups were treated for 6 courses. After treatment, the clinical efficacies were evaluated, and FSH, LH, P, E₂, endometrial thickness, and hemoglobin in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.00% and 91.67%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of FSH, LH, P, and E₂ in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the endometrial thickness in two groups was significantly decreased, but the hemoglobin levels in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Conjugated Estrogens Tablets combined with Medroxyprogesterone Acetate Tablets has clinical curative effect in treatment of perimenopausal dysfunctional uterine bleeding, can improve estrogen level, decrease the endometrial thickness, and increase hemoglobin level, which has a certain clinical application value.