Page 81 - 《中国药房》2024年17期

葆宫止血颗粒联合醋酸甲羟孕酮治疗围绝经期异常子宫出血（阴

虚血热证）的效果观察
Δ

＊
廖 丹 ，李桂花，黄广翅（海南现代妇女儿童医院妇产科，海口 570311）

中图分类号 R969.4；R984；R711.52 文献标志码 A 文章编号 1001-0408（2024）17-2131-05
DOI 10.6039/j.issn.1001-0408.2024.17.13

摘 要 目的 评价葆宫止血颗粒联合醋酸甲羟孕酮（MPA）治疗围绝经期异常子宫出血（AUB）（阴虚血热证）的临床效果。方法
前瞻性纳入海南现代妇女儿童医院2022年3月—2023年2月收治的146例围绝经期AUB（阴虚血热证）患者，采用随机数字表法
分为对照组（73例）和联合组（73例）。对照组患者口服MPA，每次10 mg，每天2次；联合组患者在对照组基础上加服葆宫止血颗
粒，每次15 g，每天3次。两组患者均从月经第5天开始用药，连续用药22 d作为1个治疗周期，均连续治疗2个周期，并随访12个
月。比较两组患者的出血控制时间、完全止血时间、子宫内膜厚度、总有效率、复发率、中医证候评分、性激素和炎症因子水平，以
及不良反应发生情况。结果 联合组患者治疗后的出血控制时间、完全止血时间均显著短于对照组（P＜0.05），经血色淡或有块、
小腹疼痛、面色萎黄及神疲气短评分均显著低于对照组（P＜0.05）；治疗后 1、3、6、12 个月的总有效率均显著高于对照组（P＜
0.05），12个月内总体复发率显著低于对照组（P＜0.05）。与治疗前相比，两组患者治疗后的子宫内膜厚度、血清性激素[卵泡刺激
素、雌二醇和黄体生成素]、炎症因子[白细胞介素6和肿瘤坏死因子α]水平均显著减小或降低（P＜0.05），而联合组较对照组的减
小或下降幅度更大（P＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论 葆宫止血颗粒联合MPA治疗
围绝经期 AUB（阴虚血热证）疗效确切，可快速止血、抑制子宫内膜增生、调节血清性激素和炎症因子水平，且复发率低、安全
性高。
关键词 异常子宫出血；葆宫止血颗粒；醋酸甲羟孕酮；阴虚血热证；围绝经期；疗效；子宫内膜厚度；性激素；炎症因子

Efficacy observation of Baogong zhixue granules combined with medroxyprogesterone acetate in the
treatment of abnormal uterine bleeding （yin deficiency and blood heat syndrome） during perimenopause
LIAO Dan，LI Guihua，HUANG Guangchi（Dept. of Obstetrics and Gynecology， Hainan Modern Women and
Children’s Hospital， Haikou 570311， China）

ABSTRACT OBJECTIVE To evaluate the clinical efficacy of Baogong zhixue granule combined with medroxyprogesterone
acetate （MPA） in the treatment of perimenopausal abnormal uterine bleeding （AUB） （yin deficiency and blood heat syndrome）.
METHODS A total of 146 patients with perimenopausal AUB （yin deficiency and blood heat syndrome） admitted to Hainan
Modern Women and Children’s Hospital from March 2022 to February 2023 were prospectively enrolled and divided into control
group （73 cases） and combined group （73 cases） by random number table method. The control group took MPA orally， 10 mg
each time， twice a day； the combined group took Baogong zhixue granule on the basis of the control group， 15 g each time， 3
times a day. Both groups started taking the medicine from the 5th day of menstruation， and took the medicine for 22 days as a
treatment cycle. Both groups were treated for 2 consecutive cycles and followed up for 12 months. The bleeding control time，
complete hemostasis time， endometrial thickness， total effective rate， recurrence rate， traditional Chinese medicine syndrome
score， sex hormone and inflammatory factor levels， and adverse reactions were compared between the two groups. RESULTS The
bleeding control time and complete hemostasis time of the combined group after treatment were significantly shorter than those of
the control group （P＜0.05）， and the scores of light-color menstrual blood or clots， lower abdominal pain， sallow complexion，
and fatigue and shortness of breath were significantly lower than those of the control group （P＜0.05）. The total effective rates of
the combined group at 1， 3， 6 and 12 months after treatment were significantly higher than those of the control group （P＜0.05），
and the overall recurrence rate within 12 months was significantly lower than that of the control group （P＜0.05）. Compared with
before treatment， the endometrial thickness， the serum sex hormones （follicle stimulating hormone， estradiol， and luteinizing
hormone）， and the inflammatory factors （interleukin-6， tumor necrosis factor-α） levels of the two groups after treatment were
significantly reduced or decreased （P＜0.05）， and the reduction or decrease in the combined group was greater than the control
group （P＜0.05）. There was no significant difference in the
Δ 基金项目 海南省重点研发项目（No.ZDYF2022SHFZ024）；海
incidence of adverse drug reactions between the two groups
南省卫生健康行业科研项目（No.22A200111）
＊ 第一作者 副 主 任 医 师 。 研 究 方 向 ：妇 产 科 学 。 E-mail： （P＞0.05）. CONCLUSIONS Baogong zhixue granules
liaodan94356@163.com combined with MPA are effective in treating perimenopausal

中国药房 2024年第35卷第17期 China Pharmacy 2024 Vol. 35 No. 17 · 2131 ·