目的 探討宮血寧膠囊聯(lián)合復(fù)方炔諾酮片治療功能失調(diào)性子宮出血的臨床療效。方法 選取2021年9月—2023年9月無(wú)錫市錫山人民醫(yī)院收治的96例功能失調(diào)性子宮出血患者，根據(jù)用藥差別將所有患者分為對(duì)照組和治療組，各48例。對(duì)照組于月經(jīng)周期第5天開(kāi)始口服復(fù)方炔諾酮片，1片/d。在此基礎(chǔ)上，治療組口服宮血寧膠囊，2粒/次，3次/d。兩組連服22 d，為1個(gè)周期，均治療2個(gè)周期。比較兩組臨床療效、中醫(yī)證候積分、性激素水平、凝血功能和血清學(xué)指標(biāo)。結(jié)果 治療組的總有效率明顯高于對(duì)照組（P＜0.05）。治療后，兩組小腹脹痛評(píng)分、腰骶酸痛評(píng)分、精神不振評(píng)分降低（P＜0.05），治療組小腹脹痛評(píng)分、腰骶酸痛評(píng)分、精神不振評(píng)分低于對(duì)照組（P＜0.05）。治療后，兩組卵泡刺激素（FSH）、黃體生成素（LH）、雌二醇（E₂）降低（P＜0.05），且治療組FSH、LH、E₂低于對(duì)照組（P＜0.05）。治療后，兩組凝血酶時(shí)間（TT）、凝血酶原時(shí)間（PT）、活化部分凝血活酶時(shí)間（APTT）降低（P＜0.05），且治療組TT、PT、APTT低于對(duì)照組（P＜0.05）。治療后，兩組血清堿性成纖維細(xì)胞生長(zhǎng)因子（bFGF）、前列腺素2α（PGF2α）水平升高，血清促血管生長(zhǎng)素-Ⅱ（Ang-Ⅱ）水平降低（P＜0.05），且治療組血清bFGF、PGF2α水平高于對(duì)照組，血清Ang-Ⅱ水平低于對(duì)照組（P＜0.05）。結(jié)論 宮血寧膠囊聯(lián)合復(fù)方炔諾酮片可緩解功能失調(diào)性子宮出血患者臨床癥狀，調(diào)節(jié)性激素水平和凝血功能，改善機(jī)體血清因子水平。

Objective To explore the clinical efficacy of Gongxuening Capsules combined with Compound Norethisterone Tablets in treatment of dysfunctional uterine bleeding. Methods 96 Patients with dysfunctional uterine bleeding in Wuxi Xishan People's Hospital from September 2021 to September 2023 were divided into control group and treatment group based on medication differences, with 48 cases in each group. The control group started taking orally Compound Norethisterone Tablets on the 5th day of the menstrual cycle, 1 tablets daily. On this basis, the treatment group took orally Gongxuening Capsules, 2 capsules per time, 3 times daily. One course had 22 d, and two groups were treated for two courses. The clinical efficacy, TCM syndrome score, sex hormone level, coagulation function, and serological indicators were compared. Results The total effective rate of the treatment group was higher than that of the control group (P < 0.05). After treatment, abdominal distension and pain score, lumbosacral soreness score, and mental fatigue score in both groups were decreased (P < 0.05), and these TCM syndrome scores in the treatment group were lower than those of the control group (P < 0.05). After treatment, FSH, LH, and E₂ in both groups were decreased (P < 0.05), and FSH, LH, and E₂ in the treatment group were lower than those of the control group (P < 0.05). After treatment, TT, PT, and APTT of the two groups were decreased (P < 0.05), and TT, PT, and APTT of the treatment group were lower than those of the control group (P < 0.05). After treatment, bFGF and PGF2α in two groups were increased, but Ang-II were decreased (P < 0.05), and bFGF and PGF2α in the treatment group were higher than those of the control group, but Ang-II were lower (P < 0.05). Conclusion The combination of Gongxuening Capsules and Compound Norethisterone Tablets has a definite therapeutic effect on dysfunctional uterine bleeding, which can alleviate clinical symptoms, regulate sex hormone levels and coagulation function, and improve serum cytokine levels.

R984

江蘇省婦幼健康科研項(xiàng)目（F201903)