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OBJECTIVE@#To compare the clinical efficacy between acupuncture artificial menstrual cycle method and medication artificial menstrual cycle method for abnormal uterine bleeding-ovulatory (AUB-O) dysfunction (spleen deficiency syndrome).@*METHODS@#Sixty patients were randomly assigned into an observation group and a control group, 30 cases in each one. 3 cases dropped out in the observation group and 27 cases were included into analysis; 2 cases dropped out in the control group and 28 cases were included into analysis. The patients in the observation group were treated with acupuncture artificial menstrual cycle method. The acupoints were selected according to different stages of menstrual cycle. The acupuncture was given for 30 min per treatment, once every other day; no treatment was given during menstrual period. Xuehai (SP 10), Sanyinjiao (SP 6), Taixi (KI 3), Guanyuan (CV 4), Qihai (CV 6), Zusanli (ST 36) and Zhangmen (LR 13) were selected after menstrual period. Taichong (LR 3), Hegu (LI 4), Yaoyangguan (GV 3), Geshu (BL 17), Ganshu (BL 18), Sanyinjiao (SP 6), Pishu (BL 20) were selected in ovulaton periods. Baihui (GV 20), Shenshu (BL 23), Yaoyangguan (GV 3), Geshu (BL 17), Sanyinjiao (SP 6), Zusanli (ST 36), Gongsun (SP 4) were selected before menstrual period. The patients in the control group were treated with medication artificial menstrual cycle method. Femoston (estradiol tablets/estradiol dydrogesterone tablets) was taken orally. The white tablets were estradiol (1 mg), while the gray tablets were estradiol (1 mg) and dydrogesterone (10 mg). The Femoston was taken once a day, white tablets for the first 14 days, then gray tablets for the last 14 days. The 28-day treatment was taken as one session, and one cycle menstrual was taken as one treatment course, and totally 3 courses were given in the two groups. The clinical symptom score was observed before and after treatment as well as in follow-up visit (3 months after treatment). The clinical efficacy was evaluated based on the total effective rate, the marked effective rate of main symptoms (including menstrual cycle, menstrual period, menstrual volume) and basal body temperature (BBT).@*RESULTS@#① Compared before treatment, the clinical symptom score in the two groups was decreased after treatment and in the follow-up visit (0.05). Compared with the control group, the clinical symptom score in the follow-up visit as well as the difference of that between pre-treatment and follow-up visit had significant difference in the observation group (0.05). ③ After treatment, the marked effective rate of menstrual cycle, menstrual period, menstrual volume had no significant difference between the two groups (>0.05); during the follow-up visit, the marked effective rate of menstrual cycle in the observation group was superior to that in the control group (0.05). ④ After treatment, the diphasic curve rate of BBT had no significant difference between the two groups (>0.05); during the follow-up visit, the diphasic curve rate of BBT in the observation group was higher than that in the control group (<0.05).@*CONCLUSION@#Acupuncture artificial menstrual cycle method has superior efficacy for AUB-O dysfunction (spleen deficiency syndrome), which has similar efficacy with medication artificial menstrual cycle method. Moreover, acupuncture has advantages in regulating menstrual cycle and improving ovulation, and has a longer curative effect.
Subject(s)
Female , Humans , Acupuncture Therapy , Menstrual Cycle , Treatment Outcome , Uterine Hemorrhage , TherapeuticsABSTRACT
[Objective]To research professor ZHANG's clinical experience in treatment of metrorrhagia. [Methods] By following professor ZHANG diagnosis long time, it summarizes ZHANG's experience of Chinese medicine treatment on uterine bleeding and academics from the etiology and pathogenesis.[Results] ZHANG thinks that the pathogenesis of metrorrhagia, both cold and heat, will cause Chong Ren imbalance, so the method to reconstruct the menstrual cycle as the fundamental purpose, comprehensive use of TCM and western medicine adjuvant hormonal therapy. In the acute hemorrhage, the use of clearing heat and bleeding, liver-spleen -harmonizing remission with artificial cycle therapy according to syndrome differentiation and treatment of hemorrhage, clarifying the source and rectifying the primary on the basis of syndrome making a better clinical effect during the remission. [Conclusion] Professor ZHANG's treatment of uterine bleeding experience, unique, has a strong clinical significance, with learning and promotion of application value.
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Objective To investigate the effect of Fukeqianjin tablets combined with progesterone on serum immunoglobulin,serum IL-2 and soluble receptor levels in patients with functional uterine bleeding,and to explore the optimal regimen for patients with functional uterine bleeding.Methods A total of 98 patients with functional uterine bleeding diagnosed in our hospital from June,2015 to June,2016 were randomLy divided into observation group and control group(n=49).The patients in the control group were treated with oral progesterone and the observation group.The control group was treated on the basis of the combination of gynecological Qianjin Tablet,compared the two groups of patients before and after treatment of menstrual conditions,serum IgM,IgA,serum IL-2 and soluble receptor levels.Results In the first month,the second month and the third month after treatment,the menstrual volume in the observation group were(103.5±21.5)mL,(93.5±14.7)mL,(81.4± 12.2)(7.68±0.92)d,(6.81±0.87)d and(6.14±0.78)d respectively in the observation group were significantly shorter than those in the control group(P<0.05).After treatment,the menstrual period The serum levels of IgA and IgM were(3.6±0.8),(2.6±0.8),(1.8±0.3)and(2.9±0.5),(2.2±0.3),(1.1±0.2)in the first month,the second month and the third month respectively,Significantly lower than the control group,the difference was statistically significant; the first month after treatment,the first two months,the first three months,observation group of patients with serum IL-2 and soluble receptor levels significantly Lower than the control group.Conclusion Fukeqianjin tablets combined with progesterone can improve the immune function of patients with functional uterine bleeding,reduce the level of inflammation and soluble receptor levels,compared with single progesterone treatment better,the program better.
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Objective]Observe the clinical effects of acupuncture treatment of athletes uterine bleeding. [Method]This study included 90 patients with uterine bleeding, randomly divided into three groups, treatment group 30 cases treated by acupuncture. The western medicine control group 30 cases treated with western medicine. Chinese medicine control group 30 cases were treated by traditional Chinese medicinal broth. One treatment course(after 30d) observation curative effect.[Results]The western medicine control group 15 cases cured, 6 cases were markedly effective, 6 cases better, 3 had no effect, the total effective rate was 90%. Traditional Chinese medicine control group 21 cases cured, 6 cases had marked effect, improvement in 3 cases, the total effective rate was 100%. Treatment group: 24 cases were cured, 3 cases had marked effect, improvement in 3 cases, the total effective rate was 100%.[Conclusions]Three treatments had curative effect, but the side effects of western medicine stopped taking the drug repeatedly; for the special athletes, the acupuncture treatment is worthy of popularization and application.
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Objective To explore the efficacy and safety of three types of progesterone dosage forms in treatment of functional uterine bleeding, and compare their cost-effectiveness. Methods 180 cases with functional uterine bleeding were radomly divided into A,B,C three groups,each had 60 cases. On the basis of oral estradiol valerate,A,B and C group were given progesterone capsules,progesterone suppository and progesterone vaginal gel, respectively. The efficacy and cost-effectiveness were observed and compared. Results The efficacy rate of A,B and C group were 71.67%,86.67%and 93.33%,respectively. The adverse reaction ratio of A,B and C group were 5.00%,3.33% and 6.67%,respectively. The cost-effectiveness ratios were 336.26,98.80 and 1501.60,respectively. The increment of cost-effectiveness of A group and C group were-1035.80 and 19751.57.Conclusion Progesterone suppository(B group)has best effect in treatment of functional uterine bleeding.
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Objective To observe the clinical efficacy and adverse reactions of desogestrel ethinylestradiol in the treatment of dysfunctional uterine bleeding ( adolescent Dub ) .Methods 86 cases with adolescent functional bleeding were divided into the treatment group and control group ,43 cases in each group .The control group received conjugated estrogen(Premarin) treatment,the treatment group was given desogestrel ethinylestradiol treatment .The hemostatic effect and drug adverse reaction of the two groups were observed .Results The cure rate of the treatment group was 65.1%,that in the control group was 23.3%,there was significant difference between the two groups (χ2 =15.28,P0.05).Conclusion Desogestrel ethinylestradiol in the treatment of ado-lescent functional bleeding has exact curative effect ,it has low incidence of adverse reactions and better acceptance .
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ObjectiveTo investigate long-term effect on radiofrequency heat-coagulation (RF)endometrial ablation in treatment of anovulatory dysfunctional uterine bleeding (DUB). MethodsFrom Jul.2001 to Nov. 2009, 1 196 patients with DUB who were failed by medical treatment( including 127 patients with dysmenorrheal) were enrolled into this study in Jinan Millitary General HospitaL Those patients were divided into two groups according to age:427 patients at age of or more than 45 years (average age 48 years) in Group A who were treated by RF procedure for amenorrhea;769 patients at age of less than 45 years old (average 37 years) in group B were treated by RF for controlling excessive menstrual bleeding. All the patients had the results of menstrual score (pictorial blood loss assessment chart, PBAC), hemoglobin (Hb) ,endometrial curettage pathology and hysteroscopy examination immediately after RF procedure; Some patients still had another endometrial curettage pathology and clinical results in 6 months after RF. The mean follow-up time was 72 months ( range:6 to 100 months). The evaluation criterion for RF treatment was to use optimal and significant effect measurements. For group A, the optimal treatment effect (cure) was defined as bleeding cessation and achieving amenorrhea that continued for more than 12 months after treatment. For group B, the optimal treatment effect (cure) was also defined as bleeding cessation and resuming normal menstruation which continued for more than 12 months after treatment. Significant treatment effect was defined as irregular, minor bleeding, but PBAC score less than 100 within 12 months. If patient symptoms and PBAC scores did not change compared with those before treatment, the treatment was defined as failure. For dysmenorrhea, the optimal treatment effect was disappearance for more than 12 months, the significant treatment effect was remission, and treatment failure was not changed from the pre-treatment baseline. The effective rate was the sum of that of the optimal and significant effect. One hundred and twentyfive patients with DUB treated by agents at the same time were chosen as control group. Results( 1 ) The recent and long-term effective rates for bleeding cessation by RF: the total recent effective rates within 1 months were 94. 82％ ( 1134/1196), including 96. 5％ (412/427) in group A and 93.9％ (722/769) in group B. The total curative rates for dysmenorrheal were 82. 7％ ( 105/127 ), including 86. 4％ ( 38/44 ) in group A and 80. 7％ ( 67/83 ) in group B. Pathology examination after hysteroscopy immediately after RF showed a completely and whole destroyed endometrium in group A, and a little rested endometrium in group B. The long-term effect rates for bleeding cessation by RF after 12, 24 and 36 months were 92. 55％ (969/1047), 93.9％ (866/922) and 93.7％ (609/650), respectively. PBAC and Hb in group A and group B within 12, 24, 36 and more than 36 months were improved significantly ( P ＜ 0. 05 ). (2) Complications : the major complication was irregular minor bleeding in 1 to 2 months after treatment, the rate was 8.03％ (96/ 1196). The second one was menorrhea in 3 months after RF, the rate was 5. 18％ (62/1 196 ). This condition was corrected by the second RF. No hysterectomy was performed on those patients. Conclusion RF is the safe, efficient and minimal invasive procedure in treatment for DUB. The mechanism of keeping longterm curative effect and preventing recurrence is due to endonetrium inactivation and fibrosis by thermocoagulation.
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The patient is a 48-year-old woman.She came to our hospital because o f consistent colporrhagia for one month.Her first menstrual came when she was 17 ye ars old,her last menstrual period(LMP)was on March 23,2005.When she came to our hospital,she looked weak and anemic.Temperature(T):36.6 ℃;pulse(P):80 counts per minute;respire(R):19 counts per minute;blood pressure(BP):130/90 mm Hg(1 mm Hg=0.133 kPa).Physical examination showed t hat her vagina was smooth,there was some lifeblood in it;the cervical was hypertrophy;the womb was anteposition;there was no pressure pain;the two side adjuncts were normal.The laboratory examination showed that the white blood cell(WBC)was 3.40?109/L,the red blood cell(RB C)3.14?1012/L,the hemoglobin(HGB)88.0 g/L,and the platelet(PLT)206 ?109/L。B ultra sound sh owed that the womb was uniformity aggrandizement.The pathology showed that the endo metrium was glandular hyperplasia.The final diagnosis was dysfunction womb hemeo rrhage.After the uterine curettage and hormonal regulation,there remained some hemorrhage.The ovarine arterial embolization(OAE)was operated on June 30,200 5.The angiography showed the two side internal lliac arteries had no uterine arte ry.The two side ovarian arteries were stout.The balance stage showed that th e womb's blood supply came from ovarian artery.The consistent colporrhagia stopped after the OAE with gelatin sponge through 3.0F SP microcatheter.After 18-months' follow-up survey,the woman's menstrual halted,and she was satisfied wit h it.