目的 探討坤寧顆粒聯(lián)合屈螺酮炔雌醇片治療功能失調(diào)性子宮出血的臨床療效。方法 選取2020年2月—2022年5月在蘇州科技城醫(yī)院就診的78例功能失調(diào)性子宮出血患者，按照隨機數(shù)字表法將所有患者分為對照組和治療組，每組各39例。對照組口服屈螺酮炔雌醇片，于月經(jīng)來潮第5天開始，1片/次，1次/d，連續(xù)口服21 d，以1個月經(jīng)周期為1個療程，連續(xù)治療6個療程。治療組在對照組基礎(chǔ)上溫水沖服坤寧顆粒，1袋/次，3次/d，連續(xù)治療6個月。觀察兩組的臨床療效，比較兩組的癥狀改善時間、螺旋動脈的搏動指數(shù)（PI）、阻力指數(shù)（RI）、收縮末期峰值/舒張末期峰值的比值（S/D）以及血清中促卵泡激素（FSH）、促黃體生成素（LH）、泌乳素（PRL）、前列腺素E₂（PGE₂）、血管生成素-2（Ang-2）水平。結(jié)果 治療后，治療組總有效率為94.87%，明顯高于對照組的總有效率76.92%（P<0.05）。治療后，治療組患者月經(jīng)周期恢復(fù)時間、完全止血時間、小腹墜痛消失時間均明顯短于對照組，差異有統(tǒng)計學意義（P<0.05）。治療后，兩組的螺旋動脈PI、RI、S/D均顯著降低（P<0.05），治療組螺旋動脈PI、RI、S/D明顯低于對照組（P<0.05）。治療后，兩組的血清FSH水平高于治療前，血清LH、PRL、PGE₂、Ang-2水平低于治療前（P<0.05）；治療后，治療組的血清FSH水平高于對照組，血清LH、PRL、PGE₂、Ang-2水平低于對照組（P<0.05）。結(jié)論 坤寧顆粒聯(lián)合屈螺酮炔雌醇片可提高功能失調(diào)性子宮出血的臨床療效，改善臨床癥狀，改善子宮血流動力學指標，調(diào)節(jié)患者的性激素分泌，藥物安全性良好。

Objective To investigate the clinical effect of Kunning Granules combined with Drospirenone and Ethinylestradiol Tablets in treatment of dysfunctional uterine bleeding. Methods Patients (78 cases) with dysfunctional uterine bleeding in Suzhou Science & Technology Town Hospital from February 2020 to May 2022 were divided into control and treatment groups according to the random number table method, and each group had 39 cases. Patients in the control group were po administered with Drospirenone and Ethinylestradiol Tablets on the 5th day of menstrual cycle, 1 tablet/time, once daily, continuous oral administration for 21 d, take one menstrual cycle as a course of treatment, and continuously treated for 6 courses. Patients in the treatment group were po administered with Kunning Granules on the basis of the control group, 1 bag/time, three times daily, continuous treatment for 6 months. After treatment, the clinical efficacies were evaluated, and the symptom improvement time, PI, RI, and S/D in two groups were compared, and the levels of FSH, LH, PRL, PGE₂, and Ang-2 in two groups were compared. Results After treatment, the total effective rate of the treatment group was 94.87%, significantly higher than the total effective rate of the control group of 76.92% (P< 0.05). After treatment, the recovery time of menstrual cycle, the complete hemostasis time, and the disappearance time of abdominal pain in the treatment group were significantly shorter than those in the control group, with a statistically significant difference (P < 0.05). After treatment, the PI, RI, and S/D of spiral arteries in two groups were significantly decreased (P < 0.05), while the PI, RI, and S/D of spiral arteries in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of FSH in two groups were higher than before treatment, while the serum levels of LH, PRL, PGE₂, and Ang-2 were lower than those before treatment (P < 0.05); After treatment, the serum levels of FSH in the treatment group were higher than those in the control group, while the serum levels of LH, PRL, PGE₂, and Ang-2 were lower than those in the control group (P < 0.05). Conclusion Kunning Granules combined with Drospirenone and Ethinylestradiol Tablets can improve the efficacy of dysfunctional uterine bleeding, improve clinical symptoms, improve uterine hemodynamic indicators, regulate the secretion of sexual hormones in patients, and the drug safety is good.

R984

蘇州高新區(qū)醫(yī)療衛(wèi)生科技計劃項目（2019Z014）