桂枝茯苓汤联合米非司酮治疗子宫肌瘤疗效观察

Effects on uterine fibroids treated with guizhi fuling tang and mifepristone

目的观察桂枝茯苓汤联合米非司酮治疗子宫肌瘤的疗效,并探讨对雌激素、孕激素、胰岛素样生长因子-1(IGF-1)表达的影响。方法选取我院收治的子宫肌瘤患者122例作为研究对象,按照随机数字表法分为治疗组和对照组各61例,两组均给予饮食指导、健康教育等基础干预,在此基础上对照组给予米非司酮治疗,治疗组在对照组基础上联合桂枝茯苓汤治疗。观察两组中医证候积分、子宫和肌瘤体积、临床疗效、卵泡生成素(FSH)、雌二醇(E_2)、黄体生成素(LH)以及孕酮(P)、IGF-1水平。结果治疗后两组中医证候积分、子宫体积、肌瘤体积、FSH、E_2、LH、P、IGF-1水平显著低于治疗前(P<0.05),且治疗组显著低于对照组(P<0.05);治疗组总有效率91.80%显著高于对照组77.05%,差异有统计学意义(P<0.05)。结论桂枝茯苓汤联合米非司酮能够有效改善子宫肌瘤临床症状,缩小子宫和肌瘤体积,降低雌激素和孕激素水平,提高临床疗效。

Objective To observe the effects on uterine fibroids treated with guizhi fuling tang and mifepristone and explore the impacts on the expressions of estrogen,progestin and IGF-1. Methods A total of 122 patients of uterine fibroids were collected as the subjects. According to the random number table,they were divided into a treatment group and a control group,61 cases in each one. The basic intervention,such as diet,physical exercise and health education was given in the two groups. Additionally,mifepristone was used in the control group. In the treatment group,on the base of the treatment as the control group,guizhi fuling tang was given. TCM symptom score,the size of uterus and fibroid,clinical effects,FSH,E_2,LH,P and IGF-1 were observed in the two groups. Results After treatment,the TCM symptom score,the size of uterus and fibroid,and the levels of FSH,E_2,LH,P and IGF-1 were lower significantly as compared with those before treatment in the two groups（ P〈0. 05）. The results in the treatment group were lower significantly than the control group（ P〈0. 05）. The total effective rate was 91. 80% in the treatment group,higher significantly than 77. 05% in the control group,indicating the significant difference（ P〈0. 05）. Conclusion The combined therapy with guizhi fuling tang and mifepristone effectively relieves the clinical symptoms of uterine fibroids,shortens the size of uterine and fibroid,reduces the levels of estrogen and progestin and improves the therapeutic effects.