固冲汤加减治疗崩漏气不摄血证疗效观察及对凝血功能的影响

Observation on the Efficacy of Modified Guchong Decoction for Metrorrhagia and Metrostaxis with Syndrome of Qi Failing to Control Blood and Its Effect on Coagulation Function

摘要:

目的：观察固冲汤加减治疗崩漏气不摄血证的临床疗效及对凝血功能的影响。方法：纳入2022年1月—2024年1月玉环市中医院收治的80例崩漏患者，按随机数字表法分为西药组与中药组各40例。西药组采用地屈孕酮治疗，中药组采用固冲汤加减治疗。比较2组临床疗效、中医证候评分、出血情况、凝血功能［活化部分凝血酶原时间（APTT）、凝血酶原时间（PT） ］ 和不良反应发生率。结果： 中药组总有效率为97.50%（39/40），西药组为82.50%（33/40），2组比较，差异有统计学意义（P＜0.05）。治疗后，2组经血量、淋漓不尽、色淡质稀等中医证候评分均较治疗前降低（P＜0.05），且中药组各项评分均低于对照组（P＜0.05）。治疗后，西药组出血控制时间、完全止血时间均短于中药组，差异有统计学意义（P＜0.05）。治疗后，2组APTT、PT水平均较治疗前降低（P＜0.05），且中药组2项指标水平均低于对照组（P＜0.05）。治疗期间，西药组不良反应发生率为15.00%（6/40），中药组未出现相关不良反应，2组不良反应发生率比较，差异有统计学意义（P＜0.05）。结论：固冲汤加减治疗崩漏气不摄血证能够提高临床疗效，有效改善中医证候，增强凝血功能，降低不良反应发生率，但其控制出血和完全止血效果不及地屈孕酮。

Abstract:

Abstract： Objective： To observe the clinical efficacy of modified Guchong Decoction in the treatment of metrorrhagia and metrostaxis with syndrome of qi failing to control blood， and to analyze its effect on coagulation function. Methods：A total of 80 patients with metrorrhagia and metrostaxis admitted to Yuhuan Hospital of Traditional Chinese Medicine from January 2022 to January 2024 were enrolled and divided into the western medicine group and the Chinese medicine group using the random number table method， with 40 cases in each group. The western medicine group was treated with Dydrogesterone， while the Chinese medicine group was treated with modified Guchong Decoction. The clinical efficacy， traditional Chinese medicine syndrome scores， bleeding， coagulation function [activated partial thromboplastin time （APTT）， prothrombin time （PT）]， and incidence of adverse reactions were compared between the two groups. Results：The total effective rate was 97.50%（ 39/40） in the Chinese medicine group and 82.50% （33/40） in the western medicine group， with statistically significant differences （P＜0.05）. After treatment，the traditional Chinese medicine syndrome scores such as menstrual blood volume，dribbling menstruation， and light-colored thin menstrual blood in both groups decreased compared with those before treatment （P＜0.05），and the scores in the Chinese medicine group were lower than those in the western medicine group （P＜0.05）. After treatment， the bleeding control time and complete hemostasis time in the western medicine group were shorter than those in the Chinese medicine group， with statistically significant differences （P＜0.05）. After treatment， the APTT and PT in both groups decreased compared with those before treatment （P＜0.05）， and the values of these two indicators in the Chinese medicine group were shorter than those in the western medicine group （P＜0.05）. During treatment，the incidence of adverse reactions was 15.00% （6/40） in the western medicine group，while no medicinerelated adverse reactions occurred in the Chinese medicine group. The difference in the incidence of adverse reactions between the two groups was statistically significant （P＜0.05）. Conclusion： Modified Guchong Decoction in the treatment of metrorrhagia and metrostaxis with syndrome of qi failing to control blood can improve clinical efficacy， effectively alleviate traditional Chinese medicine syndromes，enhance coagulation function，and reduce the incidence of adverse reactions. However， its effects on bleeding control and complete hemostasis are not as rapid as those of Dydrogesterone.