从临床随机对照试验的中文文献中，探讨青少女功能失调性子宫出血的中药治疗。 方法：以佛教慈济医疗财团法人图书馆电子资源查询系统5.0为平台，透过「中国知网」（National Knowledge Infrastructure，CNKI）资料库，以「子宫出血」为关键字，学科设定为「中医学」、「中西医结合」，主题限缩在「青春期功能失调性子宫出血」，锁定2013年至2023年6月为发表年份，搜寻相关中文文献，并进行汇整。 结果：共得可下载文章36篇，排除医家经验、文献整理与无对照组之研究共7篇，仅保留随机对照试验29篇，另排除中药合并针灸治疗者5篇，最终选取实验组仅纳入单纯中药治疗或中西医结合治疗共24篇。 结论：中药治疗可分为两类：其一，纯中药治疗，多采分期介入，出血期以止血为首要目标，止血後则采补肾温阳、健脾益气为主；其二，中西医结合治疗，多以单一主方介入，补肾、健脾、益气为主要治则。相较於对照组，仅中药或中西医共同治疗後，可显着提升痊愈率、有效率、排卵率、激素值、血红蛋白值，也可明显降低出血控制时间、出血减少时间、出血完全停止时间、不良反应率和住院时间，虽可证实中药介入的有效性，但各临床研究皆无采取盲法试验（blinded experiment），缺乏更强烈说服力，因此仍需透过进一步大型、严谨且盲性研究加以证实。 【关键词】子宫出血 ； 青春期 ； 中医 ； 月经 ； 崩漏 |
Objective: The aim of this article was to investigate the direction of Chinese medicine in the treatment of dysfunctional uterine bleeding in adolescent girls from the Chinese literature of randomized controlled clinical trials. Methods: We used "uterine bleeding" as the key word and undertook researches, through Electronic Resources Federated Search System 5.0 of Buddhist Tzu Chi Medical Foundation Library, on the National Knowledge Infrastructure(CNKI) database in the category of "Chinese medicine" and "integration of Chinese and Western medicines" from 2013 to June, 2023, and summarized these articles. Results: 36 studies were included in this review. 29 RCTs were admitted, and 3 expert opinions, 2 systemic reviews and 2 studies without control group were excluded. Moreover, literatures on combining Chinese medicine and other treatments were ruled out. Finally, 24 RCTs were adopted, including Western medicine contrasting to Chinese medicine or Western medicine contrasting to combination of both Chinese and Western medicine. Conclusion: The treatment of adolescent dysfunctional uterine bleeding with Chinese medicine can be divided into two categories: first, pure Chinese medicine treatment, which is divided into the bleeding period and the post-hemorrhagic period; second, combined Chinese and western medicines treatment, which is mostly based on the intervention of one single prescription. The results of many studies have shown that the treatment can significantly increase the cure rate, efficiency rate, ovulation rate, hormones, hemoglobin, and also significantly reduce the time to control bleeding, time to reduce bleeding, time to complete bleeding cessation, the rate of adverse reactions, and the length of hospitalization. Although the efficacy of Chinese medicine intervention can be proved, none of the clinical studies we included have adopted blinded experiment, which lacks stronger convincing results, and therefore further large-scale, rigorous and blinded studies are still needed to prove it. 【Keywords】uterine bleeding； puberty； Chinese Medicine； menstruation |
2801.3中药治疗青少女功能失调性子宫出血 之文献回顾
