桂枝茯苓丸联合促性腺激素释放激素激动剂对围绝经期子宫肌瘤合并异常子宫出血患者血清性激素、血管生成素-2水平的影响

The efficacy of Guizhi Fuling Pill combined with GnRH-a on serum sex hormone and Ang-2 level in patients with perimenopausal uterine leiomyoma and abnormal uterine bleeding

目的探讨桂枝茯苓丸联合促性腺激素释放激素激动剂(GnRH-a)对围绝经期子宫肌瘤合并异常子宫出血患者血清性激素、血管生成素-2(Ang-2)水平的影响。方法选取2018年5月至2019年6月青海大学附属医院收治的92例围绝经期子宫肌瘤合并异常子宫出血患者作为研究对象。按照随机数字表法分为治疗组(n=46例)和对照组(n=46例),对照组采用GnRH-a单一治疗,治疗组在对照组基础上联合桂枝茯苓丸治疗。比较两组临床疗效、子宫与子宫肌瘤体积、血清性激素及Ang-2水平。结果治疗后,治疗组总有效率(91.30%)较对照组(76.09%)高,差异具有统计学意义(P<0.05);两组治疗后子宫与子宫肌瘤体积与治疗前比较均缩小,差异具有统计学意义(P<0.05),且治疗组均较对照组小,差异具有统计学意义(P<0.05);两组治疗后血清性激素水平及Ang-2水平与治疗前比较均下降,差异具有统计学意义(P<0.05),且治疗组均较对照组低,差异具有统计学意义(P<0.05)。结论围绝经期子宫肌瘤合并异常子宫出血患者采用桂枝茯苓丸联合GnRH-a治疗的效果显著,其可能与下调血清性激素及Ang-2水平有关。

Objective To investigate the efficacy of Guizhi Fuling Pill combined with gonadotropin releasing hormone-agonist(GnRH-a) in the treatment of perimenopausal uterine leiomyoma with abnormal uterine bleeding and its influences on serum sex hormone and angiopoietin-2(Ang-2) levels. Methods 92 cases of perimenopausal uterine leiomyoma complicated with abnormal uterine bleeding treated in Qinghai University Affiliated Hospital from May 2018 to June 2019 were enrolled, and divided into control group(n=46) and treatment group(n=46) according to random number table method. Control group was treated with GnRH-a, while the treatment group was treated with GnRH-a and Guizhi Fuling Pill. The clinical efficacy, uterine and uterine leiomyoma volumes, serum sex hormones and Ang-2 levels were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 91.30%, which was higher than 76.09% of the control group(P<0.05). The volumes of uterus and uterine leiomyoma in the two groups were smaller than those before treatment(P<0.05), and those in the treatment group were lower than those in the control group(P<0.05). The levels of serum sex hormone and Ang-2 in both groups were lower than those before treatment(P<0.05), and those in the treatment group were lower than those in the control group(P<0.05). Conclusions Guizhi Fuling Pill combined with GnRH-a is effective in treating perimenopausal uterine leiomyoma with abnormal uterine bleeding, which may be related to the decrease of serum sex hormones and Ang-2 levels.