新疆医科大学学报

目的 探讨榆栀止血颗粒治疗异常子宫出血(Abnormal uterine bleeding, AUB)的疗效，并分析其安全性。方法 选取湘南学院附属医院2023年5月至2024年8月临床诊断为子宫内膜局部异常性异常子宫出血(AUB-endometrial, AUB-E)及排卵障碍性异常子宫出血(AUB-ovulatory dysfunction, AUB-O)患者270例，随机分为对照1组、对照2组、研究组，各90例，对照1组采用安络血片治疗、对照2组采用安络血片+宫血宁胶囊治疗、研究组采用安络血片+榆栀止血颗粒治疗。比较3组患者PBAC评分出血持续时间、凝血活酶时间(Activated partial thromboplastin time, APTT)、血浆凝血酶原时间(Prothrombin time, PT)、血清血管内皮生成因子(Vascular endothelial growth factor, VEGF)和血管生成素(Angiopoietin-2,Ang-2)水平、临床治疗效果及不良反应情况。结果 与对照1组相比，对照2组和研究组(Pictorial blood loss assessment chart, PBAC)评分均较低，出血持续时间均较短(P<0.05),且研究组PBAC评分低于对照2组，出血持续时间低于对照2组(P<0.05);与治疗前比较，对照1组、对照2组、研究组治疗后APTT、PT均降低(P<0.05),且研究组APTT、PT低于对照2组、对照1组(P<0.05);与治疗前比较，对照1组、对照2组、研究组治疗后VEGF、Ang-2水平均降低(P<0.05),且研究组VEGF、Ang-2水平低于对照2组、对照1组(P<0.05);研究组临床治疗总有效率高于对照1组、对照2组(P<0.05);对照1组、对照2组、研究组3组患者总不良反应发生率比较，差异无统计学意义(P>0.05)。结论 榆栀止血颗粒联合安络血片能有效减少AUB患者的出血症状，改善患者凝血功能，临床疗效优于单一安络血片治疗和安络血片+宫血宁胶囊治疗。

Objective To investigate the efficacy and safety of elm gardenia haemostatic granules in the treatment of abnormal uterine bleeding(AUB). Methods 270 patients with the clinical diagnosis of AUB-endometrial(AUB-E) and AUB-ovulatory dysfunction(AUB-O) were selected from May 2023 to August 2024, randomly assigned to 3 groups, each with 90 cases. Group A received Anluoxue Tablets, Group B received Anluoxue Tablets+Gongxuening Capsule, Group C received Anluoxue tablets+elm gardenia haemostatic granules. The following parameters were compared among the groups: maximum daily blood loss, total blood loss during the bleeding period, bleeding duration, activated partial thromboplast in time(APTT), prothrombin time(PT), serum vascular endothelial-generating factor(VEGF), angiopoietin(ang-2) levels, overall clinical efficacy, and adverse reactions. Results Compared with Group A, both Group B and Group C had lower PBAC scores and shorter bleeding duration(P<0.05), and group C had lower PBAC scores and shorter bleeding duration than group B(P<0.05). After treatment, APTT and PT were decreased significantly in all 3 groups compared to pre-treatment levels(P<0.05), with the Group C showing significantly lower levels of APTT and PT than Group B and Group A(P<0.05). Similarly, the levels of VEGF and ang-2 were significantly reduced post-treatment in all groups(P<0.05), and the reductions were more pronounced in Group C compared to Group B and Group A(P<0.05). The overall clinical efficacy was significantly higher in Group C than in Group A and Group B(P<0.05). No statistically significant difference was observed in the incidence of adverse reactions among the three groups(P>0.05). Conclusion The combination of elm gardenia haemostatic granules and Anluoxue Tablets is effective in reducing bleeding symptoms and improving coagulation function in patients with AUB. This combination therapy demonstrates superior clinical efficacy compared to Anluoxue Tablets alone or combined with Gongxuening Capsules.