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| 加减温经汤联合醋酸甲羟孕酮对围绝经期子宫异常出血患者子宫内膜厚度及血清学指标的影响 |
| Effects of Modified Wengjing Tang combined with medroxyprogesterone acetate on endometrial thickness and serological indexes in patients with abnormal uterine bleeding during perimenopause |
| 投稿时间：2024-12-13 修订日期：2024-12-13 |
| 中文关键词: 围绝经期 子宫异常出血 加减温经汤 醋酸甲羟孕酮 疗效 |
| 英文关键词: Perimenopause Abnormal uterine bleeding Modified Wengjing Tang Medroxyprogesterone acetate Curative effect |
| 基金项目:河南省医学科技攻关计划联合共建项目 LHGJ20211029 |
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| 中文摘要: |
| 目的 探讨加减温经汤联合醋酸甲羟孕酮(MPA)治疗围绝经期子宫异常出血(AUBP)患者的疗效,并分析其对子宫内膜厚度、性激素、炎症反应的影响。方法 选取2022年1月～2023年1月于本院诊治的98例AUBP患者开展回顾性分析,依据治疗方案分为对照组、研究组,各49例。两组均予以刮宫术治疗,对照组予以醋酸甲羟孕酮(MPA)治疗,研究组予以MPA联合加减温经汤治疗,连续治疗3个月。统计对比两组临床疗效及治疗前后月经失血图(PBAC)评分、子宫体积、子宫内膜厚度、性激素[促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮(P)]、炎症因子[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、新血管生成因子[一氧化氮(NO)、血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)]。比较两组并发症、复发率及不良反应。结果 研究组总有效率较对照组升高(P＜0.05)；与对照组比较,研究组治疗后PBAC评分、子宫体积、子宫内膜厚度降低(P＜0.05)；与对照组比较,研究组治疗后FSH、LH、E2、P水平降低(P＜0.05)；与对照组比较,研究组治疗后血清IL-1β、IL-6、TNF-α、NO水平降低,VEGF、bFGF水平升高(P＜0.05)；研究组治疗后6个月、9个月复发率及并发症发生率低于对照组(P＜0.05)；两组不良反应比较无明显差异(P＞0.05)。结论 加减温经汤联合MPA治疗AUBP患者的疗效确切,可有效控制出血症状,缩小子宫体积,抑制子宫内膜增生,改善性激素水平,缓解炎症反应,促进新血管生成,并可预防疾病复发,减少并发症发生,且具有一定安全性。 |
| 英文摘要: |
| Objective To investigate the efficacy of deoxygestrel estrone (DE) combined with medroxyprogesterone acetate (MPA) in the treatment of abnormal uterine bleeding during perimenopause (AUBP), and to analyze its effects on endometrial thickness, sex hormones and inflammatory response. Methods A total of 98 patients with AUBP treated in our hospital from January 2022 to January 2023 were selected for retrospective analysis, and were divided into control group and study group according to treatment plan, with 49 cases each. Both groups underwent curettage surgery, the control group was treated with medroxyprogesterone acetate (MPA), while the study group was treated with MPA combined with modified Wenjing Tang. Both groups underwent continuous treatment for 3 months. The clinical efficacy, pre- and post-treatment PBAC scores, uterine volume, endometrial thickness, sex hormones [follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P)], inflammatory factors [interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], and new angiogenesis factors [nitric oxide (NO), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF)] were statistically compared between the two groups. The complications, recurrence rate, and adverse reactions were compared between the two groups. Results The total effective rate of the study group was higher than that of the control group (P < 0.05). Compared with the control group, PBAC score, uterine volume and endometrial thickness were decreased in the study group after treatment (P < 0.05). Compared with the control group, the levels of FSH, LH, E2 and P in the study group were decreased after treatment (P < 0.05). Compared with the control group, the serum levels of IL-1β, IL-6, TNF-α and NO were decreased in the study group after treatment, and the levels of VEGF and bFGF were increased (P < 0.05). The recurrence rate and complication rate of the study group at 6 months and 9 months after treatment were lower than those of the control group (P < 0.05). There was no significant difference in adverse reactions between the two groups (P > 0.05). Conclusion Modified Wengjing Tang combined with MPA is effective in the treatment of AUBP patients, which can effectively control bleeding symptoms, reduce uterine volume, inhibit endometrial hyperplasia, improve sex hormone levels, alleviate inflammation, promote new angiogenesis, prevent disease recurrence and reduce complications, and has certain safety. |
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