Objective

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To analyze the clinical characteristics of adolescents with abnormal uterine bleeding （AUB） and anemia， and evaluate the efficacy of the staged treatment with kidney-nourishing and blood-supplementing （KNBS） traditional Chinese medicines （TCMs） for AUB adolescents with kidney-yin deficiency syndrome and internal disturbance of blood-heat syndrome.

Methods

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Medical records of adolescents with AUB and anemia were collected， including general data on menarche age and disease duration， TCM syndrome and symptom data on menstrual volume and color， facial complexion， tongue and pulse patterns， laboratory results such as complete blood count and six sex hormones， and reproductive system ultrasound findings. Clinical characteristics and the TCM syndrome distribution were analyzed. The efficacy of the staged treatment with kidney-invigorating and blood-nourishing TCMs was evaluated in terms of menstrual recovery and anemia improvement for AUB adolescents with kidney-yin deficiency syndrome and internal disturbance of blood-heat syndrome.

Results

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①A total of 96 patients were included， with a median age of onset of 13.5 years old. Symptoms developed in 41.7% of patients within one year after menarche， while 54.2% had a disease duration longer than one year at the time of consultation. Mild anemia was the most common （70.8%）， with 55.2% of patients presenting with microcytic hypochromic anemia. ②Among the 82 patients who underwent six sex hormone level testing， 56 patients （68.3%） showed hormone imbalances， with 20 patients （24.4%） presenting with abnormalities in more than two hormone levels. Elevated testosterone was the most common abnormality （50.0%）. ③A reproductive system ultrasound was performed on 76 patients， with uterine volumes ranging from 5.45 to 58.05 cm³ and ovarian volumes ranging from 2.23 to 14.16 cm³.④The most common TCM syndromes in adolescents with AUB were kidney-yin deficiency syndrome （61.5%） and internal disturbance of blood-heat syndrome （29.2%）. ⑤Eighty-seven patients received the staged KNBS treatment together with iron supplements. However， 9 patients were excluded due to follow-up time of less than three months， leaving 78 patients for efficacy evaluation. The overall effective rate for controlling metrorrhagia and metrostaxis was 98.7%， and the overall effective rate for anemia was 69.2%.

Conclusions

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Adolescents with AUB and anemia predominantly present with kidney-yin deficiency syndrome and internal disturbance of blood-heat syndrome in TCM. The staged KNBS treatment has shown satisfactory therapeutic results clinically.