益母逐瘀生新方辅助米非司酮治疗子宫肌瘤肾虚血瘀证疗效观察

Observation on the curative effect of Yimu Zhuyu Shengxin Decoction supported with mifepristone on uterine fibroids with syndrome of kidney deficiency and blood stasis

目的观察益母逐瘀生新方辅助米非司酮治疗子宫肌瘤肾虚血瘀证患者的疗效。方法将2016年1月—2018年12月就诊于空军军医大学第一附属医院的108例子宫肌瘤肾虚血瘀证患者按照随机数字表法分组,对照组54例单用米非司酮治疗,研究组54例采用益母逐瘀生新方辅助米非司酮治疗,2组均连续治疗3个月经周期。评估2组疗效、用药安全性,观察治疗后主要症状评分、瘤体情况、生殖内分泌激素水平、血液流变学的变化情况。结果研究组治疗总有效率为92.6%(50/54),对照组为77.8%(42/54),研究组明显高于对照组(P<0.05)。治疗后2组各症状(腰膝酸软、下腹部触痛、下腹坠胀、下腹包块、经血黏稠、月经过多、乳房胀痛)评分、单个瘤体最大直径、单个瘤体最大体积及血清雌二醇(E2)、孕酮(P)、黄体生成激素(LH)、垂体泌乳素(PRL)、卵泡生成激素(FSH)、血浆黏度、全血黏度高切、全血黏度低切水平均显著降低(P均<0.05),且治疗后研究组上述指标变化幅度明显高于对照组(P均<0.05)。研究组不良反应发生率与对照组比较差异无统计学意义(P>0.05)。结论益母逐瘀生新方辅助米非司酮治疗子宫肌瘤肾虚血瘀证患者疗效更高,可显著缩小肌瘤体积,缓解临床症状,调节生殖内分泌激素水平,改善血液流变学,且未明显增加不良反应,优势显著。

Objective It is to observe the curative effect of Yimu Zhuyu Shengxin Decoction supported with mifepristone in the treatment of uterine fibroids with syndrome of kidney deficiency and blood stasis.Methods 108 cases of patients with uterine fibroids with syndrome of kidney deficiency and blood stasis treated in The First Affiliated Hospital of Air Force Medical University from January 2016 to December 2018 were divided into 2 groups according to the random number table.54 cases in the control group were treated with mifepristone alone,and 54 cases in the study group were treated with Yimu Zhuyu Shengxin Decoction combined with mifepristone,both groups were treated for 3 consecutive menstrual cycles.The efficacy and safety of medication in the two groups were evaluated,the changes in the main symptom scores,tumor status,reproductive endocrine hormone levels,and hemorheology after treatment were observed.Results The total effective rate of treatment in the study group was 92.6%(50/54),and that in the control group was 77.8%(42/54),the study group was significantly higher than the control group(P<0.05).After treatment,the scores of each symptom(soreness and weakness of waist and knees,lower abdomen tenderness,lower abdomen bulging,lower abdomen mass,thick menstrual blood,menorrhagia,breast tenderness),maximum diameter of a single tumor,maximum volume of a single tumor,and the levels of serum estradiol(E2),progesterone(P),luteinizing hormone(LH),pituitary prolactin(PRL),follicle-forming hormone(FSH),plasma viscosity,whole blood viscosity high cut,whole blood viscosity low cut were significantly decreased in the two groups(P<0.05),and the change range of the above indicators in the study group was significantly higher than that in the control group after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the study group and the control group(P>0.05).Conclusion Yimu Zhuyu Shengxin Decoction supported with mifepristone is more effective in the treatment of patients with uterine fibroids with syndrome of kidney deficiency and blood stasis.It can significantly reduce the size of fibroids,relieve clinical symptoms,regulate the level of reproductive endocrine hormones,and improve blood rheology without significant increase of adverse reactions,its advantages are significant.