Abstract:

Objective　To investigate the effect of Bushen Yangxue Tiaojing Tang on endometrial thickness, coagulation function, and serum hormone levels in patients with abnormal uterine bleeding. Methods　This was a prospective study. One hundred patients with abnormal uterine bleeding treated at Yangling Demonstration Zone Hospital from January 2021 to January 2024 were selected as the study objects, and were divided into a control group and an observation group by the random number table method, with 50 cases in each group. There control group were (33.13±7.29) years old; their disease course was (3.79±0.65) years. The observation group were (32.89±7.51) years old; their disease course was (3.83±0.61) years. The control group were conventionally treated with western medicine; in addition, the observation group took Bushen Yangxue Tiaojing Tang. The clinical efficacies, scores of traditional Chinese medicine syndromes, clinically relevant indicators, coagulation function indicators [activated partial thromboplastin time (APTT), prothrombin time (PT), and fibrinogen (FIB)], sex hormone indicators [follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2)], and incidence rates of adverse reactions were compared between the two groups. The statistical methods included t test, χ² test, and rank sum test. Results　The total efficacy in the observation group was higher than that in the control group [98.0% (49/50) vs. 80.0% (40/50)], with a statistical difference (P<0.05). The scores of soreness in the waist and knees, dizziness, hyposexuality, dry mouth and tongue, red tongue with little coating, and deep and thin pulse and the levels of FIB, FSH, LH, and E₂ in the observation group were lower than those in the control group [1.12±0.23 vs. 1.65±0.31, 1.23±0.32 vs. 1.78±0.36, 1.16±0.27 vs. 1.64±0.35, 1.05±0.16 vs. 1.46±0.19, 1.13±0.15 vs. 1.49±0.23, 1.03±0.12 vs. 1.54±0.35, (2.19±0.13) g/L vs. (2.61±0.12) g/L, (14.27±1.45) mIU/L vs. (22.29±2.19) mIU/L, (6.15±1.12) mIU/L vs. (8.28±1.65)mIU/L, (179.23±15.35)ng/L vs. (254.68±20.35)ng/L]; the menstruation period, APTT, and PT in the observation group were shorter than those in the control group [(31.21±3.15) d vs. (44.26±4.19) d, (28.65±3.12) s vs. (30.35±3.26) s, and (14.23±1.35) s vs. (15.68±2.39) s]; the menstruation volume in the observation group was lower than that in the control group [(46.29±10.42) ml vs. (65.15±13.82) ml]; the endometrial thickness in the observation group was smaller than that in the control group [(5.25±0.16) mm vs. (7.05±0.21) mm]; there were statistical differences (all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the two groups (χ²=0.271; P=0.603). Conclusion　Bushen Yangxue Tiaojing Tang for patients with abnormal uterine bleeding can improve their physical signs, coagulation function, and sex hormone levels, and promote the recovery of menstrual flow, menstrual cycle, and endometrial thickness, and is safe.

Key words:

Bushen Yangxue Tiaojing Tang, Abnormal uterine bleeding, Endometrial thickness, Coagulation function, Sex hormones

摘要：

目的　探讨补肾养血调经汤对异常子宫出血患者子宫内膜厚度、凝血功能及血清激素水平的影响。方法　采用前瞻性研究，选取2021年1月至2024年1月在杨凌示范区医院治疗的异常子宫出血患者100例作为研究对象，按照随机数字表法分为对照组（50例）和观察组（50例）。对照组年龄（33.13±7.29）岁，病程（3.79±0.65）年，予以常规西药治疗；观察组年龄（32.89±7.51）岁，病程（3.83±0.61）年，在对照组基础上联合补肾养血调经汤治疗。对比两组临床疗效、中医症候积分、临床相关指标、凝血功能指标［活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、纤维蛋白原（FIB）］、性激素指标［卵泡刺激素（FSH）、促黄体生成素（LH）、雌二醇（E₂）］及不良反应发生情况。统计学方法采用t检验、χ²检验、秩和检验。结果　观察组总有效率为98.0%（49/50），高于对照组的80.0%（40/50），差异有统计学意义（P<0.05）。治疗后，观察组腰膝酸软［（1.12±0.23）分］、头晕目眩［（1.23±0.32）分］、性欲减退［（1.16±0.27）分］、口干舌燥［（1.05±0.16）分］、舌红少苔［（1.13±0.15）分］、脉沉细评分［（1.03±0.12）分］及FIB［（2.19±0.13）g/L］、FSH［（14.27±1.45）mIU/L］、LH［（6.15±1.12）mIU/L］、E₂指标［（179.23±15.35）ng/L］均低于对照组［（1.65±0.31）分、（1.78±0.36）分、（1.64±0.35）分、（1.46±0.19）分、（1.49±0.23）分、（1.54±0.35）分、（2.61±0.12）g/L、（22.29±2.19）mIU/L、（8.28±1.65）mIU/L、（254.68±20.35）ng/L］；月经周期［（31.21±3.15）d］、APTT［（28.65±3.12）s］、PT［（14.23±1.35）s］均短于对照组［（44.26±4.19）d、（30.35±3.26）s、（15.68±2.39）s］；月经量少于对照组［（46.29±10.42）ml比（65.15±13.82）ml］；子宫内膜厚度小于对照组［（5.25±0.16）mm比（7.05±0.21）mm］；差异均有统计学意义（均P<0.05）。两组不良反应发生率比较，差异无统计学意义（χ²=0.271，P=0.603）。结论　补肾养血调经汤治疗异常子宫出血患者疗效较好，可改善患者体征、症状、凝血功能和性激素水平，并促进月经量、月经周期、子宫内膜厚度的恢复，安全性较高。

关键词:

补肾养血调经汤, 异常子宫出血, 子宫内膜厚度, 凝血功能, 性激素