小剂量米非司酮配合中药治疗子宫腺肌病的临床观察

Clinical observation of small dose mifepristone combined with traditional Chinese medicine in the treatment of uterine gland disease

目的 观察小剂量米非司酮配合中药治疗子宫腺肌病的临床疗效.方法 选取浙江省人民医院2015年1月至2016年1月收治的76例子宫腺肌病患者,运用随机数字表法分为观察组（38例）和对照组（38例）,对照组给予小剂量米非司酮治疗,观察组采用小剂量米非司酮配合中药治疗,探讨两组临床疗效.结果 治疗后,观察组患者的疼痛程度（21.30±6.70）分、影响活动程度（17.30±12.00）分、活动能力丧失点（1.80±0.70）点、痛经分级（0.60±0.20）级,均低于对照组,差异具有统计学意义（t=5.645、7.023、4.932、3.994,均P〈0.05）,治疗后,观察组患者的子宫体积（56.20±2.00） mm3、CA125水平（32.1 ±2.1） U/mL低于对照组（t =4.024、4.413,均P〈0.05）.观察组患者用药不良反应发生率7.89％,明显低于对照组,差异有统计学意义（χ^2=14.757,P〈0.05）.随访8个月,观察组复发率5.26％,低于对照组的26.32％,差异有统计学意义（χ^2=16.678,P=0.000）.观察组停药≤3个月月经恢复比例为81.58％,显著高于对照组的63.16％,差异有统计学意义（χ^2 =8.484,P=0.003）.结论 小剂量米非司酮配合中药治疗,有利于缓解子宫腺肌病临床症状,减轻疼痛,缩小子宫体积,不良反应少,安全可靠,值得临床推广应用.

Objective To observe the clinical effect of small dose mifepristone combined with traditional Chinese medicine in the treatment of uterine gland disease.Methods 76 patients with uterine gland disease were selected,they were divided into the observation group（n =38） and control group（n =38） by using random number table method.The control group was treated with small dose of mifepristone,while the observation group was treated with small dose of mifepristone combined with traditional Chinese medicine.The clinical curative effects of the two groups were compared.Results After treatment,in the observation group,the pain degree of patients [（21.30 ± 6.70） points],influence activity level [（17.30 ± 12.00） points],activity loss [（1.80 ± 0.70） spots] and grades of dysmenorrheal [（0.60 ± 0.20） stages] were lower than those in the control group,the differences were statistically significant （t =5.645,7.023,4.932,3.994,all P 〈 0.05）.After treatment,in the observation group,the uterine volume [（56.20 ± 2.00） mm3],CA125 level [（32.10 ± 2.10） U/mL] were lower than those of the control group （t =4.024,4.413,all P 〈 0.05）.The incidence rate of adverse reaction of the observation group was 7.89%,which was significandy lower than that of the control group,the difference was statistically significant （χ^2 =14.757,P 〈 0.05）.The patients were followed up for 8 months,the recurrence rate of the observation group was 5.26%,which was lower than 26.32% of the control group,the difference was statistically significant （χ^2 =16.678,P =0.000）.The menstrual recovery ratio less than or equal to three months of the control group was 81.58%,which was signifi candy higher than 63.16% of the control group,the difference was statistically significant （χ^2 =8.484,P =0.003）.Conclusion In the treatment process of adenomyosis,the small dose of mifepristone combined with traditional Chinese medicine can alleviate the clinical symptoms,reduce the pain and reduce the volume of uterus,and it has less adverse reaction,safe and reliable,it is worth of clinical application.