桂枝茯苓丸联合GnRH-a治疗子宫腺肌瘤术后的效果观察

Effect of Guizhi Fuling Pills Combined with GnRH-a in the Treatment of Uterine Adenomyoma after Operation

目的:观察桂枝茯苓丸联合促性腺激素释放激素激动剂(GnRH-a)治疗子宫腺肌瘤术后的效果。方法:选择2017年1月-2018年12月于江西省妇幼保健院治疗的60例子宫腺肌瘤患者,按随机数字表法将其分为两组,各30例。60例患者均行腹腔镜手术治疗,术后对照组采用GnRH-a治疗,观察组采用GnRH-a联合桂枝茯苓丸治疗。术后随访24个月,比较两组痛经评分、月经量、子宫大小、妊娠率及复发率。结果:术后3、12、24个月时,观察组视觉模拟评分法(VAS)评分[(2.49±0.85)分、(1.09±0.42)分、(0.79±0.35)分]、月经失血图评分法(PBAC)评分[(64.95±22.87)分、(45.98±21.04)分、(42.97±18.52)分]、子宫体积[(126.39±24.52)cm^(3)、(110.74±18.49)cm^(3)、(107.62±15.43)cm^(3)]均低于对照组,差异均有统计学意义(P<0.05);观察组妊娠率高于对照组,复发率低于对照组,差异均有统计学意义(P<0.05)。结论:桂枝茯苓丸联合GnRH-a用于子宫腺肌瘤患者术后治疗中效果确切,可缓解痛经情况,促使月经量减少及子宫体积缩小,降低复发率,提高妊娠率。

Objective:To observe the effect of Guizhi Fuling Pills combined with gonadotropin-releasing hormone agonist(GnRH-a)in the treatment of postoperative uterine adenomyoma.Method:A total of 60 patients with uterine adenomyoma who were treated in Jiangxi Maternal and Child Health Hospital from January 2017 to December 2018 were selected and divided into two groups according to the random number table method,with 30 cases in each group.All 60 patients were treated with laparoscopic surgery,the control group was treated with GnRH-a after operation,and the observation group was treated with GnRH-a combined with Guizhi Fuling Pills.After 24 months of follow-up,the dysmenorrhea score,menstrual volume,uterine size,pregnancy rate and recurrence rate were compared between the two groups.Result:After 3,12,24 months of operation,the visual analogue scale(VAS)scores of the observation group were[(2.49±0.85)points,(1.09±0.42)points,(0.79±0.35)points],pictorial blood loss assessment chart(PBAC)scores[(64.95±22.87)points,(45.98±21.04)points,(42.97±18.52)points],uterine volume[(126.39±24.52)cm^(3),(110.74±18.49)cm^(3),(107.62±15.43)cm^(3)]were lower than those in the control group,with statistical differences(P<0.05);the pregnancy rate in the observation group was higher than that in the control group,and the recurrence rate in the observation group was lower than that in the control group,with statistical differences(P<0.05).Conclusion:Guizhi Fuling Pills combined with GnRH-a is effective in postoperative treatment of patients with uterine fibroids.It can relieve dysmenorrhea,reduce menstrual flow and uterine volume,reduce recurrence rate and improve pregnancy rate.