刘晶静 唐苗苗 董利琴 李亚俐

【摘要】目的：观察围绝经期女性功能失调性子宫出血（简称功血）在西药基础上应用益气化瘀法治疗的临床效果，并该方法治疗围绝经期功血的临床应用价值。方法：选取2013年4月至2014年12月期间医院收治的86例围绝经期功血患者作为研究对象，按照不同治疗方式将研究对象分为西药组40例、联合组46例。西药组经诊断性刮宫术5d后服用米非司酮，联合组在西药组基础上应用益气化瘀法治疗。比较两组一般情况。结果：经治疗后，联合组总有效率为93.48%，与对照组（77.50%）相比，差异存在统计学意义（P<0.05）；两组患者的子宫内膜厚度、血红蛋白水平以及中医证候积分方面比较，差异均存在统计学意义（P<0.01）。两组在血流变学指标（高/低切全血粘度、血浆粘度、血沉与PCV）比较，差异存在统计学意义（P<0.01）。结论：益气化瘀法在西药治疗基础上应用的临床疗效显著，子宫内膜厚度明显降低，良好改善患者血流指标，值得进一步研究应用。

【关键词】围绝经期；功能失调；子宫出血；益气化瘀法；临床价值

【Abstract】Objectives： To research the clinical effect of Yiqihuayu Method joint western medicine in treating peri menopausal dysfunctional uterine bleeding and its clinical application value. Methods： 86 patients with dysfunctional uterine bleeding treated in the hospital from April 2013 to December 2014 were selected as the research subjects， who were divided into western medicine group （40 cases） and combination group （46 cases） according to different treatment methods. The western medicine group was assigned to receive mifepristone 5 days after curettage. On such basis， the combined group received both western medicine and Yiqihuayu therapy. The general situation of patients in two groups was compared. Results： After treatment， the total effective rate was 93.48%， and compared with control group （77.50% ） was of statistical significance （P< 0.05）. Thedifference in the endometrial thickness， hemoglobin level and TCM syndrome integral of patients in two groups were statistically significant （P< 0.01）， and difference in the blood rheology index （high / low shear whole blood viscosity， plasma viscosity， erythrocyte sedimentation rate （ESR） and PCV） of patients in the two groups was statistically significant （P< 0.01）. Conclusion： The curative effect of joint use of Yiqihuayu method and western medicine is remarkable， which can significantly reduce the thickness of endometrium and improve the hemorheology， worth further study and application.

【Key words】Peri menopausal period； Dysfunctional uterine bleeding； Uterine bleeding； Yiqihuayu method； Clinical value

【中图分类号】R271.9；R711.74【文献标志码】A

围绝经期妇女功血的发生与生殖调节轴功能异常相关，非生殖系统中发生的器质性病变或者其他全身性病变引起子宫出血[1]。患者月经紊乱是该症主要症状，主要表现在月经周期、经量与经期紊乱上。此症迁延难愈，长时间患病易导致机体出血、免疫力低下等，还可能伴随外源性感染、继发性贫血等。既往临床应用常规止血药物、外科手术止血、各类激素止血措施等具有一定止血作用，但对患者整体症状的效果并不明显，难以治愈。中医根据该症临床表现将其纳入崩漏范畴，且在该症临床治疗中显现出了明显优势[2]。本研究特在西药基础上应用益气化瘀法治疗围绝经期功血，旨在对中西医联合治疗的效果进行评价，现报道如下。

1资料与方法……