软坚消结调经汤治疗子宫肌瘤的临床疗效及对性激素、子宫血流动力指标的改善作用研究

Clinical Efficacy of Ruanjian Xiaojie Tiaojing Decoction in Treatment of Uterine Fibroids and Its Improvement Effect on Sex Hormone and Uterine Hemodynamic Indexes

目的:探讨软坚消结调经汤治疗子宫肌瘤的临床疗效及对子宫血流动力指标的改善作用研究。方法:选择符合纳入标准的78例子宫肌瘤患者依据随机数字表随机分为观察组和对照组,每组各39例。对照组患者口服米非司酮片治疗,25 mg/次,每日1次;观察组在对照组治疗的基础上加用软坚消结调经汤治疗,每日1剂,水煎后分早晚两次服用;两组均治疗24周。比较两组治疗前后中医症状积分、子宫体积、瘤体大小、性激素(LH、FSH、E_(2)、P)水平和子宫动脉血流速度变化情况,并比较两组的临床疗效。结果:治疗后,观察组总有效率(89.74%,35/39)高于对照组(71.79%,28/39),差异具有统计学意义(P<0.05);两组患者经期长、月经量多、阴道不规则流血、腰酸背痛和面色晦暗等中医症状积分均较治疗前明显降低,且观察组优于对照组(P<0.05);两组患者子宫体积和瘤体大小较治疗前明显降低,且观察组优于对照组(P<0.05);两组患者治疗后LH、FSH、E_(2)、P水平较治疗前明显下降,且观察组优于对照组(P<0.05);两组患者治疗后子宫动脉血流速度PI、RI较治疗前升高,PSV水平较治疗前明显降低,且观察组改善情况优于对照组(P<0.05)。结论:软坚散结调经汤联合米非司酮片可显著改善子宫肌瘤患者的临床症状,降低性激素水平,缩小肌瘤体积,提高子宫动脉血流速度。

Objective:To explore the clinical therapeutic effect of Ruanjian Xiaojie Tiaojing Decoction on uterine fibroids and its improvement effect on uterine hemodynamic indexes.Methods:78 cases of uterine fibroids met the inclusion criteria were randomly divided into the observation group and the control group,with 39 cases in each group.The control group was treated with oral Mifepristone,25 mg/time and 1/d;on which basis,the observation group was also treated with Ruanjian Xiaojie Tiaojing Decoction,1 dose/d and 2 times/day.Both groups were treated for 24 weeks.TCM symptoms score,uterine volume,size of tumors,sex hormones levels of LH,FSH,E_(2)and P,and uterine artery blood flow velocity were compared between before and after the treatment in the two groups.Clinical efficacy was also compared between the two groups.Results:The total effective rate was 89.74%(35/39)in the observation group,which was significantly higher than 71.79%(28/39)in the control group(P<0.05).The score of TCM symptoms,including long menstrual period,heavy menstruation,irregular bleeding of vagina,back pain and dark complexion,was lower in the observation than that in the control group(P<0.05).The uterine volume and the tumor size were significantly decreased after the treatment compared with those before the treatment in the two groups,and the decreases in the observation group were more significant than those in the control group(P<0.05).The levels of LH,FSH,E_(2)and P were decreased after the treatment compared with those before the treatment in the two groups,and the decreases in the observation group were more significant than those in the control group(P<0.05).PI and RI of uterine artery blood flow velocity were higher,the level of PSV was lower after the treatment in the two groups,and the improvements were more significant in the observation group than those in the control group(P<0.05).Conclusion:Ruanjian Sanjie Tiaojing Decoction combined with Mifepristone Tablet can significantly improve clinical symptoms of uterine fibroids,lower levels of sex hormones and fibroid volume,and improve uterine artery blood flow velocity.