目的 探討坤寧顆粒聯(lián)合米非司酮治療圍絕經(jīng)期功能性子宮出血的臨床療效。方法 回顧性納入2019年3月-2019年8月于新鄉(xiāng)醫(yī)學(xué)院第一附屬醫(yī)院婦產(chǎn)科接受治療的102例圍絕經(jīng)期功能性子宮出血患者作為研究對(duì)象，按治療方案分為對(duì)照組和觀察組，每組各51例。對(duì)照組口服米非司酮片，10 mg/次，1次/d；觀察組在對(duì)照組治療的基礎(chǔ)上口服坤寧顆粒，1袋/次，3次/d，兩組共計(jì)治療3個(gè)月。觀察兩組患者的臨床療效、平均控制出血時(shí)間、平均完全止血時(shí)間，比較兩組治療前后的血紅蛋白水平、子宮內(nèi)膜厚度及卵泡雌激素（FSH）、雌二醇（E2）、孕酮（P）、血管內(nèi)皮生長因子（VEGF）、血管緊張素2（Ang-2）水平。結(jié)果 與對(duì)照組總有效率82.35%相比，觀察組治療后總有效率96.08%顯著升高，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，觀察組平均控制出血時(shí)間、平均完全止血時(shí)間均顯著低于對(duì)照組，而血紅蛋白水平顯著高于對(duì)照組，差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組FSH、E2、P和子宮內(nèi)膜厚度均顯著降低，差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，觀察組FSH、E2、P和子宮內(nèi)膜厚度均顯著低于對(duì)照組，差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組VEGF和Ang-2水平均顯著降低（P<0.05）；且觀察組VEGF和Ang-2水平顯著低于對(duì)照組，差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 坤寧顆粒聯(lián)合米非司酮能有效降低圍絕經(jīng)期功能性子宮出血患者的子宮出血量及縮短子宮出血時(shí)間，能顯著降低FSH、E2、P、VEGF及Ang-2水平。

Objective To investigate the clinical effect of Kunning Granules combined with mifepristone in treatment of perimenopausal functional uterine bleeding. Methods A total of 102 patients with perimenopausal functional uterine bleeding who received treatment in the Department of Gynecology and Obstetrics of the First Affiliated Hospital of Xinxiang Medical University from March 2019 to August 2019 were retrospectively included as the research subjects. According to the treatment plan, they were divided into control group and observation group, with 51 patients in each group. Patients in the control group were po administerd with Mifepristone Tablets, 10 mg/time, once daily. Patients in the observation group were po administered with Kunning Granuleson the basis of control group, 1 bag/time, three times daily. The two groups were treated for three months. The clinical efficacy, mean bleeding control time, and mean complete hemostasis time of two groups were observed. The hemoglobin level, endometrial thickness, and the levels of FSH, E2, P, VEGF, and Ang-2 before and after treatment were compared between two groups. Results The total effective rate of 82.35% in the control group, was significantly lower than 96.08% in the observation group after treatment, with statistical significance (P<0.05). After treatment, the average bleeding control time and the average complete hemostasis time in the observation group were significantly lower than those in the control group, while the hemoglobin level was significantly higher than that in the control group, with statistical significance (P<0.05). After treatment, FSH, E2, P, and endometrial thickness in two groups were significantly decreased, with statistical significance (P<0.05). After treatment, FSH, E2, P, and endometrial thickness in the observation group were significantly lower than those in the control group, with statistical significance (P<0.05). After treatment, the levels of VEGF and Ang-2 in two groups were significantly decreased (P<0.05). VEGF and Ang-2 levels in the observation group were significantly lower than those in the control group, with statistical significance (P<0.05). Conclusion Kunning Granules combined with mifepristone can effectively reduce the amount of uterine bleeding, and shorten the time of uterine bleeding in perimenopausal patients with functional uterine bleeding, and can significantly reduce the levels of FSH, E2, P, VEGF and Ang-2.

R984