硝蛎丸联合米非司酮治疗子宫肌瘤的药物疗效和不良反应观察

The curative effect and adverse reactions of Xiaoliwan combined mifepristone in uterine fibroids

目的研究探讨硝蛎丸联合米非司酮对子宫肌瘤患者的药物治疗效果和药物不良反应的影响。方法选取2014年9月-2015年9月期间我院确诊治疗的子宫肌瘤患者136例,依据随机分配原则分为硝蛎米非组（n=68）和米非组（n=68）,所有患者均给予（25mg/d）米非司酮治疗,硝蛎米非组患者在此基础上给予30g/d的硝蛎丸治疗,其中依据米非司酮使用剂量分为常规亚组（25mg/d）和小量亚组（12.5mg/d）,治疗前后给予B超测量子宫体积和子宫内膜病检,统计分析所有患者疗效、不良反应发生情况,并采用放射免疫法检测患者血清中雌孕激素和血红蛋白水平。结果硝蛎米非组患者治疗总有效率为92.65%,米非组患者治疗总有效率为79.41%,前者明显高于后者,差异有统计学意义（P〈0.05）;在血清中雌孕激素和血红蛋白水平方面,常规亚组和小量亚组对比,差异无统计学意义（P〉0.05）,但均明显优于米非组,差异有统计学意义（P〈0.05）;米非组患者不良反应发生率（30.88%）最高,常规亚组患者不良反应发生率（20.59%）次之,小量亚组患者不良反应发生率（11.76%）最低,差异有统计学意义（P〈0.05）。结论硝蛎丸联合米非司酮治疗可有效提高对子宫肌瘤患者的疗效,改善患者内分泌功能,采用小剂量米非司酮治疗可降低患者不良反应的发生,值得临床作进一步推广。

Objective To investigate the curative effect and adverse reactions of Xiaoliwan combined mifepristone in uterine fibroids. Methods 136 patients with uterine fibroids in our hospital from September 2012 to November 2014 were selected and divided into a Xiaoli-mifepristone（OOM） group（n=68） and a mifepristone group（n=68） according to the random distribution method.All patients were given mifepristone（25mg/d）,besides, OOM group were further given 30g/d Xiaoliwan.According to the dosage mifepristone OOM was divided into a normal subgroup（25mg/d） and a small dose subgroup（12.5mg/d）.Type-B ultrasonic was applied in measurement of volume of uterus and endometrial before and after treatment.Curative effect and adverse reactions were analyzed.Serum progesterone and hemoglobin level were detected by radioimmunoassay. Results Total effective rate of OOM group was 92.65%,which was significantly higher than the 79.41% of mifepristone group（P〈0.05）.Estrogen and progestational hormone and serum hemoglobin levels of the normal subgroup and small dose subgroup had no significant difference（P〈0.05）,and both of above items of the normal subgroup and small dose subgroup were better than that in the mifepristone group（P〈0.05）.Adverse reactions rates of mifepristone group（30.88%） was higher than that in the normal subgroup（20.59%） and small dose subgroup（11.76%）,and the adverse reactions rates of normal group was higher than that of the small dose subgroup（P〈0.05）. Conclusion Xiaoliwan combined with mifepristone therapy can effectively improve the curative effect and endocrine function of patients with uterine fibroids.Low-dose mifepristone treatment can decrease the occurrence of adverse reactions, is worth of further clinical promotion.