Clinical Observation On Treatment Of Perimenopausal Dysfunction Of Spleen And Kidney Deficiency With Yishen Jianpi Guchong Decoction Combined With Dydrogesterone

Objective:To observe the clinical effect of Yishen Jianpi Guchong Decoction combined with dydrogesterone in the treatment of perimenopausal anovulatory dysfunctional uterine bleeding in the perimenopausal with spleen and kidney deficiency type,and to explore the efficacy of the combination of Chinese and western medicine in treating perimenopausal dysfunction The mechanism and advantages of medical treatment of this disease provide new research methods and ideas for clinical treatment of this disease in gynecology.Methods:select Sixty patients with perimenopausal dysfunctional uterine bleeding admitted to the outpatient and inpatient hospitals ofNanjing Chinese Medicine Hospital Affiliated to Nanjing University of Traditional Chinese Medicine from September 2017 to July 2019 were selected as the research subjects,and were randomly divided into a treatment group and a control group,each group 30 example.All patients had a diagnosis of curettage or endometrial biopsy within 1 week before treatment.The results showed simple endometrial hyperplasia and proliferative endometrium.The treatment group was treated with Yishen Jianpi Guchong Decoction on the first day after the curettage.The drug was not discontinued during the menstrual period.From the 16th day after the curettage,dydrogesterone 10mg q12h was taken orally for 10 days.Take this method on the 16th day of the menstrual cycle for 3 cycles.The control group was given oral dydrogesterone in the same way as the treatment group,with 3 cycles of 1 course.Observe and compare the efficacy of the two groups in recent hemostasis,adjustment of menstrual cycle,and improvement of spleen and kidney deficiency syndromes.Laboratory indicators were measured before and after treatment:hemoglobin(Hb),activated partial prothrombin time(APTT),Prothrombin time(PT)and endometrial thickness,and whether there was recurrence 6 months after follow-up treatment.result:1.In terms of recent hemostatic effect:the total effective rate of Yishen Jianpi Guchong Decoction combined with dydrogesterone is 86.7%,which is significantly higher than the total effective rate of pure dydrogesterone by 80.0%.Significance(P>0.05)2.Comparison of the efficacy of single symptoms of traditional Chinese medicine:The differences in the scores of single symptoms of traditional Chinese medicine before and after treatment were compared.The scores of the treatment group and the control group were significantly different from those before the treatment,and the treatment group was better than the control group.3.In terms of total TCM symptom scores,the total symptom scores of patients in the treatment group and the control group were lower than before treatment,and the reduction was greater in the treatment group.There was a statistically significant difference between the groups(P<0.05);4.Regarding menstrual cycle adjustment:the total effective rate in the control group was 73.3%,and the total effective rate in the treatment group was 93.3%.After the test,the difference between the two groups was statistically significant P(=0.009)<0.05,and the total The effective rate was significantly better than the control group.5.Changes in laboratory indicators:After treatment,the hemoglobin levels of the two groups were significantly higher than before treatment,with significant statistical differences,and the treatment group was better than the control group;after treatment,the PT and APTT values of the two groups were higher than before treatment.There was a significant statistical difference in the decrease(p<0.05);in terms of endometrial thickness changes:there was a significant statistical difference between the treatment group and the control group before and after treatment(p<0.05),and the treatment group had The film thickness was lower than the control group.6.Recurrence rate:After chi-square test,the recurrence rate in the control group was 36.7%,and the recurrence rate in the treatment group was 10.0%.The recurrence of the two groups within 6 months of treatment was statistically significant P(=0.015)<0.05Conclusion:Yishen Jianpi Guchong Decoction combined with dydrogesterone in the treatment of perimenopausal dysfunction in patients with spleen and kidney deficiency type can effectively stop bleeding and correct anemia,and has significant effects in adjusting the effect of menstrual cycle.The clinical recurrence rate is low,and there are no obvious adverse reactions and side effects,which deserves further clinical promotion.