【摘要】 目的分析284例异常子宫出血患者的中医证候、病因及病理情况,为探讨本病的中医证候及防治提供临床依据。方法选取2018年12月—2020年12月我科住院的284例异常子宫出血患者,入院时即依据四诊合参,判定中医证候,统计分析中医证候的分布情况;采用宫腔镜检查+诊刮术,结合病史、体征、辅助检查,对异常子宫出血(abnormal uterine bleeding,AUB)进行病因分类,并统计分析各病因、病理的中医证候分布情况。结果 284例异常子宫出血的中医证候以实证最多,虚实夹杂次之,虚证最少。实证以血瘀、气滞血瘀、血瘀化热为主,虚实夹杂以气虚血瘀、肾虚血瘀、气血两虚夹瘀为主,虚证以气血两虚、肾虚、脾肾两虚为主。病因累计频数以AUB-O、AUB-P、AUB-L占比最多,各种病因的中医证候分布绝大多数与血瘀相关(占比96.78%)。病理分类以良性为主,差异有统计学意义(P<0.01),各种病理的中医证候分布,差异无统计学意义(P> 0.05),均以血瘀最多见。结论 284例异常子宫出血的中医证候以实证为主。病因累计频数以AUB-O、AUB-P、AUB-L占比最多,各种病因的中医证候分布绝大多数与血瘀相关。各种证候的病理分类均以良性为主,以其它证候组占比最多。病理为不典型增生、恶性的中医证候以血瘀占比最多。更多还原

【Abstract】 Objective To analyze the TCM syndromes, etiology and pathology of 284 patients with abnormal uterine bleeding, and to provide clinical basis for the discussion of TCM syndromes and prevention and treatment of this disease. Methods 284 cases of patients with abnormal uterine bleeding hospitalized in our department from December 2018 to December 2020 were selected. Upon admission, TCM syndroms were determined according to the four diagnostic parameters, and the distribution of TCM syndroms was statistically analyzed. By using hysteroscopy + curettage, combined with the history, physical signs and auxiliary examination, the etiology of abnormal uterine bleeding(AUB) was classified, and the distribution of TCM syndrome of each etiology and pathology was statistically analyzed. Results In 284 cases of abnormal uterine bleeding, most of TCM syndromes were evidence-based, followed by deficiency and excess, and deficiency syndromes were least. The main symptoms of deficiency and deficiency were blood stasis, qi stagnation and blood stasis. The mixture of deficiency and deficiency was mainly qi deficiency and blood stasis, kidney deficiency and blood stasis, and qi and blood deficiency and blood stasis. Deficiency syndrome was mainly qi and blood deficiency, kidney deficiency and spleen and kidney deficiency. AUB-O, AUB-P and AUB-L accounted for the most in the cumulative frequency of etiology, and most of the TCM syndromes of various etiologies were related to blood stasis(96.78%). Pathological classification was mainly benign(P < 0.01), and there was no difference in the distribution of TCM syndromes of various pathologies(P > 0.05), and blood stasis was most common in all of them. Conclusion 284 cases of abnormal uterine bleeding were mainly evidenced by TCM syndromes.AUB-O, AUB-P and AUB-L accounted for the most in the cumulative frequency of etiology, and most of the TCM syndromes of various etiologies were related to blood stasis. The pathological classification of various syndromes was mainly benign, and other syndromes accounted for the most. Pathologically atypical hyperplasia and malignancy of traditional Chinese medicine syndrome blood stasis accounted for the most.更多还原