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目的探讨曼月乐联合中药固冲汤治疗围绝经期功能失调性子宫出血(围绝经期功血)的临床效果。方法选取2013年1月—2015年1月收治的80例围绝经期功血患者作为研究对象,随机分为对照组和观察组各40例。两组患者均选择出血期行阴道彩超检查,检测子宫内膜厚度及血红蛋白,于出血期行诊刮术。对照组采用曼月乐治疗,观察组在对照组的基础上联合固冲汤治疗。比较两组治疗前后子宫内膜厚度、月经量评分、血红蛋白、NO水平变化情况。计量资料组间比较采用t检验,组内比较采用配对t检验,P<0.05为差异有统计学意义。结果治疗后,观察组与对照组子宫内膜厚度、月经量评分、血红蛋白水平分别为(0.61±0.18)、(0.87±0.26)mm、(67.34±20.73)、(85.25±20.62)分、(100.45±5.25)、(90.15±5.00)g/L,与治疗前的(1.31±0.20)、(1.28±0.19)mm、(172.62±29.01)、(174.10±28.39)分、(76.10±5.89)、(77.20±5.70)g/L比较差异均有统计学意义(均P<0.05)。两组治疗后各指标比较差异均有统计学意义(均P<0.05)。观察组与对照组治疗后NO水平分别为(4.24±1.00)、(5.81±1.11)μmol/L,均低于治疗前的(7.91±2.05)、(7.89±2.10)μmol/L,差异均有统计学意义(均P<0.05)。治疗后,观察组血浆NO水平明显低于对照组,差异有统计学意义(P<0.05)。结论曼月乐联合固冲汤治疗围绝经期功血可有效降低子宫内膜厚度及月经量评分,促进血红蛋白水平升高,有效降低血浆NO水平,治疗安全性高,临床效果显著。
Objective To investigate the clinical efficacy of Mirena combined with traditional Chinese medicine Guchong Decoction in treating peri-menopausal dysfunctional uterine bleeding (peri-menopausal dysfunctional uterine bleeding). Methods 80 patients with peri-menopausal dysfunctional uterine bleeding admitted from January 2013 to January 2015 were selected and randomly divided into control group and observation group of 40 cases. Two groups of patients were selected bleeding during vaginal ultrasound examination, detection of endometrial thickness and hemoglobin, bleeding in the curettage surgery. The control group was treated with Mirena, the observation group in the control group based on the combination of solid red soup treatment. The changes of endometrial thickness, menstrual volume, hemoglobin and NO levels before and after treatment were compared between the two groups. Measurement data were compared between groups using t test, the group was compared using paired t test, P <0.05 for the difference was statistically significant. Results After treatment, the thickness of endometrium, menstrual volume and hemoglobin in observation group and control group were (0.61 ± 0.18), (0.87 ± 0.26) mm, (67.34 ± 20.73), (85.25 ± 20.62), (100.45 (1.31 ± 0.20), (1.28 ± 0.19) mm, (172.62 ± 29.01), (174.10 ± 28.39), (76.10 ± 5.89), (90.15 ± 5.00) g / 77.20 ± 5.70) g / L, the differences were statistically significant (all P <0.05). There was significant difference between the two groups after treatment (P <0.05). The levels of NO in observation group and control group after treatment were (4.24 ± 1.00) and (5.81 ± 1.11) μmol / L, respectively, which were lower than those before treatment (7.91 ± 2.05) and (7.89 ± 2.10) μmol / Statistical significance (all P <0.05). After treatment, the level of plasma NO in the observation group was significantly lower than that in the control group (P <0.05). Conclusion Mirena combined with Gushutang decoction for peri-menopausal dysfunctional uterine bleeding can effectively reduce the endometrial thickness and menstrual volume, promote the increase of hemoglobin level, effectively reduce the plasma level of NO, and have high safety and clinical efficacy.