阚昆　李春艳　李英

摘要：目的探讨自拟固冲四草汤治疗无排卵型功能性子宫出血（脾肾亏虚证）的出血期的临床疗效。方法将60例按照随机数字表法分为实验组和对照组，各30例。实验组给予自拟固冲四草汤口服治疗，对照组给予固冲汤加减口服治疗。治疗后观察止血的时间，以及中医证候的改善情况。结果在近期止血疗效的方面，实验组及对照组的总有效率分别为77%及60%，2组比较差异具有统计学意义（P<0.05），在中医证候评分的改善情况方面，实验组及对照组的总有效率分别为90%和71%，2组比较差异具有统计学意义（P<0.05）。结论自拟固冲四草汤对于无排卵型功能性子宫出血（脾肾亏虚证）的出血期的疗效显著。

关键词：无排卵型功能性子宫出血；脾肾亏虚证；自拟固冲四草汤

中图分类号：R271.12文献标志码：B文章编号：1007-2349（2015）05-0037-03

【Abstract】Objective： To study the clinical effect of self-made Guchong Sicao Decoction on the treatment of anovulatory dysfunctional uterine bleeding patients with spleen-kidney deficiency syndrome. Methods： 60 patients were randomly divided into a test group and a control group， 30 cases per group. The test group was given the self-made Guchong Sicao Decoction treatment while the control group was treated with plus-minus of Guchong Sicao Decoction. Bleed-stopping time and TCM syndromes were observed after the treatment. Results： In terms of short-term hemostatic effectiveness， the total effective rates of the test group and the control group were 77% and 60% respectively. The comparison of the two groups was statistically significant differences （P<0.05）. In terms of the improvement of the TCM syndrome scores， the total effective rates of the two groups were 90% and 71%， respectively. The comparison of the two groups were statistically significant differences （P<0.05）. Conclusion： The self-made Guchong Sicao Decoction has a remarkable effect on the treatment of anovulatory dysfunctional uterine bleeding patients with spleen-kidney deficiency syndrome.

【Key words】anovulatory dysfunctional uterine bleeding， spleen-kidney deficiency syndrome， self-made Guchong Sicao Decoction

功能失调性子宫出血简称功血，是由于调节生殖的神经内分泌系统的功能障碍所引起的子宫异常出血，不伴有全身及生殖系统器质性病变。功血分为无排卵型和排卵型两类，无排卵型功血属中医“崩漏”范畴。现代医学认为其发病机制主要是下丘脑-垂体-卵巢轴调节机制的失调，这与祖国医学肾-天癸-冲任-胞宫生殖轴失调的基本理论是相一致的。在治疗上，现代医学多采用激素、手术的治疗方式，各种治疗方式有其适应证。由于激素作用及病人的依从性等问题，临床治疗常常受到一定的限制。故笔者跟随导师闫平主任治疗无排卵型功血，闫主任将固冲汤与四草汤相结合加减，达到安固冲任，补肾健脾，清热化瘀止血之功，笔者对导师在2013年12月—2014年06月门诊无排卵型功血（脾肾亏虚证）患者进行了出血期止血情况的临床疗效的观察，疗效满意现报道如下。……