目的 探討采用二至丸與屈螺酮炔雌醇片（Ⅱ）聯(lián)合治療排卵障礙性異常子宮出血的臨床療效。方法 選取2022年9月—2024年10月青島市城陽(yáng)區(qū)人民醫(yī)院收治的90例患者，隨機(jī)分為對(duì)照組（45例）和治療組（45例）。對(duì)照組患者口服屈螺酮炔雌醇片（Ⅱ），1片/次，1次/d，連續(xù)用藥21 d后停藥7 d。28 d為1個(gè)周期，連續(xù)服藥3個(gè)周期。在對(duì)照組基礎(chǔ)上，治療組口服二至丸，9 g/次，2次/d。兩組治療12周。觀察兩組患者臨床療效，比較治療前后兩組患者月經(jīng)失血圖評(píng)分（PBAC）評(píng)分、子宮內(nèi)膜厚度，卵泡刺激素（FSH）、促黃體素（LH）和雌二醇（E₂）水平，及炎性因子白細(xì)胞介素-1β（IL-1β）、轉(zhuǎn)錄激活蛋白-1（AP-1）、基質(zhì)金屬蛋白酶-9（MMP-9）和環(huán)氧合酶-2（COX-2）水平。結(jié)果 治療后，治療組總有效率（95.56%）明顯高于對(duì)照組（80.00%，P＜0.05）。治療后，兩組子宮內(nèi)膜厚度、PBAC評(píng)分比治療前明顯下降（P＜0.05），且與對(duì)照組比較，治療組的子宮內(nèi)膜厚度、PBAC評(píng)分均顯著降低（P＜0.05）。治療后，兩組FSH、E₂、LH、IL-1β、AP-1、MMP-9、COX-2水平比治療前明顯降低（P＜0.05），且治療后治療組性激素和炎性因子水平均明顯低對(duì)照組（P＜0.05）。結(jié)論 二至丸與屈螺酮炔雌醇片（Ⅱ）協(xié)同治療展示了良好的療效，可調(diào)節(jié)性激素含量，減弱炎癥反應(yīng)狀態(tài)。

Objective To investigate the clinical efficacy of Erzhi Pills combined with Quercetone Ethynylestradiol Tablets (Ⅱ) in treatment of ovulation disorders with abnormal uterine bleeding.Methods Patients (90 cases) with ovulation dysfunctional abnormal in Qingdao Chengyang People′s Hospital from September 2022 to October 2024 were randomly divided into control (45 cases) and treatment (45 cases) group. Patients in the control group were po administered with Drospirenone and Ethinylestradiol Tablets (Ⅱ), 1 tablet/time, once daily, the drug was continuously administered for 21 d and then stopped for 7 d. 28 d was one cycle, and the drug was taken continuously for 3 cycles. Patients in the treatment group were po administered with Erzhi Pills on the basis of the control group, 9 g/time, twice daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluations were evaluated, and the PBAC scores, endometrial thickness, sex hormone FSH, E₂ and LH levels, and the levels of inflammatory factors IL-1β, AP-1, MMP-9 and COX-2 in two groups before and after treatment were compared.Results After treatment, the effective rate in the treatment group (95.56%) was significantly higher than that in the control group (80.00%, P < 0.05). After treatment, the endometrial thickness and PBAC score in two groups were significantly decreased compared with those before treatment (P < 0.05). Compared with the control group, the endometrial thickness and PBAC score in the treatment group were significantly decreased (P < 0.05). After treatment, the levels of FSH, E₂, LH, IL-1β, AP-1, MMP-9, and COX-2 in two groups were significantly lower than those before treatment (P < 0.05), and the levels of sex hormones and inflammatory factors in the treatment group were significantly lower than those in the control group (P < 0.05).Conclusion The synergistic treatment effect of Quespirone Ethynylestradiol Tablets (Ⅱ) and Erzhi Pills is significant, which can improve the thickness of the endometrium in patients, regulate the content of sex hormones, and reduce the inflammatory response state.

R984

山東省中醫(yī)藥科技項(xiàng)目（Q-2023009）