桂枝茯苓胶囊联合左炔诺孕酮宫内释放系统治疗子宫腺肌病临床研究

Clinical study on Guizhifuling capsule in combined with levonorgestrel releasing intrauterine system in the treatment of adenomyosis

目的：探讨桂枝茯苓胶囊联合左炔诺孕酮宫内释放系统（LNG-IUS）治疗子宫腺肌病（AM）临床疗效。方法：分析本院2015年2月～2016年2月收治的80例AM患者临床资料,随机分为研究组与对照组;两组均于月经后7d内放置LNG-IUS,研究组同时口服桂枝茯苓胶囊3粒/次,3次/d,经期停止服用,两组疗程均为6个月;采用PBAC法评估治疗前后月经量情况,慢性疼痛分级问卷法进行痛经程度评级,于月经后3d内行阴道B超测定子宫体积,检测治疗前后性激素血清雌二醇（E_2）、卵泡刺激素（FSH）、黄体生成素（LH）及血清CA125水平。结果：治疗后两组月经量、痛经程度及子宫体积均降低,与治疗前比较有统计学意义（P〈0.05）,痛经程度、子宫体积研究组优于对照组,有统计学意义（P〈0.05）;治疗后两组E_2、FSH、LH水平无明显变化,两组比较无统计学意义（P〉0.05）;治疗后两组CA125水平均较治疗前降低,与治疗前比较有统计学意义（P〈0.05）,研究组优于对照组,有统计学意义（P〈0.05）。结论：桂枝茯苓胶囊联合LNG-IUS治疗AM临床效果满意,可明显改善患者临床症状,有效降低CA125水平,且对性激素水平无明显影响,值临床推广。

Objective： To explore the clinical efficacy of Guizhifuling capsule in combined with levonorgestrel releasing intrauterine system （LNG-IUS） in the treatment of adenomyosis （AM）. Methods： A total of 80 patients with AM who were admitted in our hospital from February, 2015 to February, 2016 were included in the study and randomized into the study group and the control group. LNG-IUS was placed in patients in the two groups 7d after menstruation. The patients in the stud- y group were given additional Guizhifuling capsule, 3 capsules/time, 3 times/d, and the drug was withdrawn in the menstrual period. Six-month treatment was regarded as one course. PBAC was used to evaluate the menstrual blood volume before and af- ter treatment. The chronic pain grading questionnaire method was used for dysmenorrhea degree rating. The vaginal B ultra- sound 3d after menstruation was performed to detect the uterine volume. E2, FSH, LH, and serum CA125 level before and af- ter treatment were detected. Results： The menstrual blood volume, dysmenorrhea degree, and uterine volume after treatment in the two groups were significantly reduced when compared with before treatment （P〈0.05）, and the reduced degree of dys-menorrhea degree and uterine volume in the study group was significantly superior to that in the control group （P〈0.05）. Af- ter treatment, E2, FSH, and LH levels in the two groups were not significantly changed, and the comparison between the two groups was not statistically significant （P〉0.05）. After treatment, CA125 level in the two groups was significantly reduced when compared with before treatment （P〈0.05）, and the reduced degree in the study group was significantly superior to that in the control group （P〈0.05）. Conclusions： Guizhifuling capsule in combined with LNG-IUS in the treatment of AM can sig- nificantly improve the clinical symptoms, effectively reduce CA125 level, and has no obvious effect on the sex hormone levels with a satisfactory clinical efficacy, therefore, it deserves to be widely recommended in the clinic.