基于子宫肌瘤核心病机消癥方辨治子宫肌瘤40例临床分析

Clinical Analysis of Xiaozheng Decoction Based on Core Pathogenesis Uterine Fibroids in Uterine Fibroids Treatment 40 Cases

目的:观察消癥方辨治子宫肌瘤的临床疗效及对血清血管内皮生长因子(VEGF)的影响。方法:80例子宫肌瘤按照就诊先后顺序分为对照组和观察组各40例。对照组采用桂枝茯苓丸,6 g/次,2次/d。观察组给予消癥方辨治加减治疗,1剂/d。两组疗程均为12周。测定治疗前后肌瘤体积;记录主要症状、体征评分;检测性激素水平及血清VEGF水平。结果:观察组综合疗效总有效率为92.5%优于对照组的72.5%(P<0.05);治疗后观察组子宫体积和肌瘤面积均小于对照组(P<0.05);治疗后两组雌二醇(E2)、孕激素(P)水平变化不明显,观察组催乳素(PRL)低于对照组(P<0.01);观察组主要症状、体征积分低于对照组(P<0.01);治疗后观察组血清VEGF水平低于对照组(P<0.01)。结论:基于子宫肌瘤核心病机创设的消癥方,临床辨证加减治疗能降低主要症状、体征积分,缩小子宫体积和肌瘤面积,临床疗效显著,其作用机制可能与降低患者血清VEGF和PRL有关。

Objective：The purpose is to observe the clinical curative effect of Xiaozheng decoction in uterine fibroids treatment and the influence of serum vascular endothelial growth factor （VEGF）.Method：Eighty cases of patients were randomly divided into control group （40 cases） and observation group （40 cases） according to the doctor order.Patients in the control group took Guizhi Fuling pill,6 g/time,2 times/day.Patients in the observation group took Xiaozheng decoction add and subtract treatment,1 does/day.The treatment course of two groups was twelve weeks.Measure the fibroid volume before and after treatment.Record main symptoms and body score.Detect the sex hormone levels and serum VEGF level.Result：The comprehensive total effective rate of observation group was 92.5％,which was superior to control group （72.5％） （P ＜0.05）.after treatment,the volume of uterus and the area of myoma of observation the group were lower than the control group （P ＜ 0.05）,there were no significant difference on the level of estradiol （E2） and progesterone （P）,the prolactin （PRL） of observation group was lower than the control group （P ＜0.01）,after treatment,the main symptom and sign integral of observation group were lower than the control group （P ＜ 0.01）,the level of serum （VEGF） of observation group was lower than the control group （P ＜ 0.01）.Conclusion：The creation of Xiaozheng decoction is based on the center pathogenesis of uterine fibroid,the add and subtract treatment with clinical discrimination can relieve main clinical symptoms,symptoms score and reduce volume of uterus and area of myoma.There is a significant clinical effect and the mechanism may be related to relieving serum VEGF and PRL of patients.