| Objective: This study observes and compares the clinical efficacy of non-ovulatory abnormal uterine bleeding(AUB)of kidney deficiency and blood fever in perimenopausal women,hoping to provide new ideas for the treatment of this disease by traditional Chinese medicine.Method: A total of 66 patients with perimenopausal anovulation abnormal uterine bleeding of kidney deficiency and blood heat type were randomly divided into observation group(33 cases,oral Qingre gujing decoction plus or minus + dydrogesterone)and control group(33 cases,oral dydrogesterone).The hemostatic effect,menstrual regulation effect and TCM syndrome score changes of the two groups were observed.The changes of hemoglobin content and serum sex hormone before treatment and after 3 courses of treatment,the changes of endometrial thickness before treatment and after 3 courses of treatment were detected respectively,and the changes of endometrial thickness during menstruation were followed up to understand and compare the menstrual regulation 3months after drug withdrawal,so as to study the clinical effect of Qingre gujing decoction plus or minus on patients with this disease.Results:1.A total of 66 patients were enrolled in this study,of which 65 cases were completed.In the control group,1 patient was detached,with a detachment rate of 1.51%.The age,course of disease,duration of vaginal bleeding,TCM syndrome score,sex hormone level,hemoglobin volume and endometrial thickness of the two groups were compared before treatment,and there were no significant differences between the two groups(p > 0.05),indicating that the two groups were comparable.2.In terms of hemostatic effect,the hemostatic effective rate of the observation group was 90.9%,and that of the control group was 78.1%.The hemostatic effect of the observation group was better than that of the control group.3.In terms of adjusting menstrual cycle,menstrual volume and menstrual length during treatment,there was no significant difference in TCM syndrome scores between the observation group and the control group(p > 0.05),indicating that the two groups had similar efficacy in adjusting menstrual cycle,menstrual volume and menstrual cycle during treatment.4.There were significant differences in TCM syndrome scores between the two groups(P<0.01)in regulating and improving the symptoms of waist and knee soreness,vertigo and tinnitus,restless night sleep,irritability,hot flash and night sweat,dry throat and thirst.The TCM syndrome scores of each symptom in the observation group were lower than those in the control group,indicating that the observation group was better than the control group in improving and regulating the symptoms of kidney deficiency and blood heat.5.In terms of regulating and improving sex hormone levels,there were significant differences in LH and FSH between the two groups after treatment(P<0.01),but no significant difference in E2 between the two groups after treatment(p > 0.05).The decrease of LH and FSH in the observation group was better than that in the control group,indicating that the improvement effect of LH and FSH in the observation group was better than that in the control group.6.In terms of endometrial thickness regulation,there was no significant difference between the two groups after treatment(p > 0.05),indicating that the two groups had similar efficacy in endometrial thickness regulation.7.In terms of the effect of menstrual regulation 3 months after drug withdrawal,the two groups were compared.The effective rate of menstrual regulation in the observation group and the control group was 93.9% and 68.75%,and the effect of menstrual regulation in the observation group was higher than that in the control group.Conclusion: The hemostatic effect of the observation group is better than that of the control group.The hemostatic efficiency of Qingre gujing decoction plus or minus combined with dydrogesterone in the treatment of this disease is higher than that of dydrogesterone alone.Qingre gujing decoction plus or minus has good hemostatic effect.Qingre gujing decoction plus or minus can adjust and improve the curative effect of traditional Chinese medicine syndrome,can adjust and improve the pain and weakness of waist and knee,vertigo and tinnitus,restless night sleep,irritability,hot flusher and night sweat,dry throat and thirst,kidney deficiency and blood heat type clinical symptoms;Qingre gujing decoction plus or minus has the effect of regulating serum sex hormones,and has better effect than the simple application of dydrogesterone in regulating the levels of sex hormones LH and FSH.Qingre gujing decoction plus or minus has the effect of increasing hemoglobin content and improving anemia status effectively.After 3 months of discontinuation of the drug,the effect of Qingre gujing decoction plus or minus on regulating menstruation and establishing a more regular cycle was more obvious than that of dydrogesterone alone.The hemostatic effect of Qingre gujing decoction plus or minus,the improvement of TCM syndromes and the curative effect of menstrual regulation may be realized by strengthening uterine contraction and improving ovarian function.Qingre gujing decoction plus or minus is an effective prescription for treating abnormal perimenopausal uterine bleeding of kidney deficiency and blood heat type. |
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