Abstract：【Objective】To study the efficacy of estrogen combined with medroxyprogesterone acetate in the treatment of acute abnormal uterine bleeding. 【Methods】A total of 118 patients with acute abnormal uterine bleeding from April 2019 to February 2022 were selected and divided into the observation group(n=59) and the control group(n=59) by random number table method. The control group was treated with medroxyprogesterone acetate,while the observation group was treated with estrogen in addition to medroxyprogesterone acetate. Patients in both groups received treatment for 3 months. The clinical efficacy,hemostatic effect,incidence of adverse reactions,serum luteinizing hormone(LH),estradiol(E2),follicle-stimulating hormone(FSH),endometrial thickness,and health-promoting lifestyle scale(HPLP-Ⅱ) scores were compared between the two groups before and after treatment.【Results】The total effective rate of the observation group(94.92%) was higher than that of the control group(79.66%)(P<0.05). The duration of complete hemostasis and the time to control bleeding in the observation group were shorter than those in the control group(P<0.05). Compared to before treatment,the serum levels of FSH,E2,and LH in both groups decreased after treatment,and the thickness of the endometrium became thinner(P<0.05). And the changes in the observation group were more obvious(P<0.05). After treatment,the scores of HPLP-Ⅱ in both groups increased(P<0.05),and the score in the observation group was higher than that in the control group(P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05). 【Conclusion】Estrogen combined with medroxyprogesterone acetate is effective in the treatment of patients with acute abnormal uterine bleeding,which can reduce the level of sex hormones and endometrial thickness,improve the quality of life of patients,and is safe and reliable.
[1] BENETTI-PINTO C L,ROSA-E-SILVA A C J S,YELA D A,et al.Abnormal uterine bleeding[J].Rev Bras Ginecol Obstet,2017,39(7):358-368. [2] SIMS J,LUTZ E,WALLACE K,et al.Depo-medroxyprogesterone acetate,weight gain and amenorrhea among obese adolescent and adult women[J].Eur J Contracept Reprod Health Care,2020,25(1):54-59. [3] DIEM S J,GUTHRIE K A,MITCHELL C M,et al.Effects of vaginal estradiol tablets and moisturizer on menopause-specific quality of life and mood in healthy postmenopausal women with vaginal symptoms:a randomized clinical trial[J].Menopause,2018,25(10):1086-1093. [4] 谢辛,孔北华,段涛.妇产科学[M]. 9版.北京:人民卫生出版社,2018:152-153. [5] 中华医学会妇产科学分会内分泌学组,中华医学会妇产科学分会绝经学组. 功能失调性子宫出血临床诊断治疗指南(草案)[J].中华妇产科杂志,2009,44(3):234-236. [6] 曹文君,郭颖,平卫伟,等. HPLP-Ⅱ健康促进生活方式量表中文版的研制及其性能测试[J].中华疾病控制杂志,2016,20(3):286-289. [7] 黄颖,高波,李玲. 两种方法治疗青春期功能失调性子宫出血98例临床疗效分析[J].海军医学杂志,2016,37(2):170-171. [8] 郭小梅,任喜应,刘燕. 黄体酮联合雌激素对子宫异常出血患者月经、血红蛋白和止血效果的影响[J].血栓与止血学,2021,27(6):1023-1024. [9] 费梦,范文. 米非司酮与醋酸甲羟孕酮片对异常子宫出血患者子宫内膜厚度及生殖激素的影响[J].湖南师范大学学报(医学版),2019,16(2):154-157. [10] 张宇靖,辛志泳,郭珊珊. 结合雌激素片联合醋酸甲羟孕酮治疗围绝经期功能失调性子宫出血的疗效观察[J].现代药物与临床,2017,32(8):1512-1515. [11] 陈桂清,李成志. 功能失调性子宫出血的发病机制及治疗进展[J].医学综述,2015(3):390-392. [12] 李红梅. 戊酸雌二醇联合黄体酮序贯疗法对青春期功能性子宫出血患者止血效果观察[J].医药论坛杂志,2020,41(5):126-129. [13] 孔众,张玉媛. 黄体酮胶囊联合戊酸雌二醇片治疗无排卵性功能失调性子宫出血的效果[J].中国妇幼保健,2021,36(21):5003-5005. [14] 李燕,张爱英,臧学利,等. 雌激素联合醋酸甲羟孕酮治疗功能失调性子宫出血患者的临床研究[J].中国临床药理学杂志,2020,36(20):3208-3211.
2023, Vol. 40 
