從臨床隨機對照試驗的中文文獻中，探討青少女功能失調性子宮出血的中藥治療。 方法：以佛教慈濟醫療財團法人圖書館電子資源查詢系統5.0為平台，透過「中國知網」（National Knowledge Infrastructure，CNKI）資料庫，以「子宮出血」為關鍵字，學科設定為「中醫學」、「中西醫結合」，主題限縮在「青春期功能失調性子宮出血」，鎖定2013年至2023年6月為發表年份，搜尋相關中文文獻，並進行彙整。 結果：共得可下載文章36篇，排除醫家經驗、文獻整理與無對照組之研究共7篇，僅保留隨機對照試驗29篇，另排除中藥合併針灸治療者5篇，最終選取實驗組僅納入單純中藥治療或中西醫結合治療共24篇。 結論：中藥治療可分為兩類：其一，純中藥治療，多採分期介入，出血期以止血為首要目標，止血後則採補腎溫陽、健脾益氣為主；其二，中西醫結合治療，多以單一主方介入，補腎、健脾、益氣為主要治則。相較於對照組，僅中藥或中西醫共同治療後，可顯著提升痊癒率、有效率、排卵率、激素值、血紅蛋白值，也可明顯降低出血控制時間、出血減少時間、出血完全停止時間、不良反應率和住院時間，雖可證實中藥介入的有效性，但各臨床研究皆無採取盲法試驗（blinded experiment），缺乏更強烈說服力，因此仍需透過進一步大型、嚴謹且盲性研究加以證實。 【關鍵詞】子宮出血 ； 青春期 ； 中醫 ； 月經 ； 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中藥治療青少女功能失調性子宮出血 之文獻回顧
