化瘤方、桂枝茯苓胶囊与米非司酮治疗子宫肌瘤的效果分析

Analysis of the effects of Hualiu formula,Guizhi Fuling capsule and mifepristone in the treatment of uterine fibroid

目的探究子宫肌瘤患者实施化瘤方、米非司酮(RU486)、桂枝茯苓胶囊治疗的效果。方法选择96例子宫肌瘤患者作为研究组,采用抽签法分为A组、B组和C组,每组32例。A组行化瘤方治疗,B组行桂枝茯苓胶囊治疗,C组行米非司酮治疗。选择同期32例正常体检女性作为比照组。比较研究组各亚组肌瘤体积、子宫体积,肌瘤体积、子宫体积缩小情况,治疗效果、不良反应发生情况;研究组各亚组、比照组激素水平[雌二醇(E_(2))、孕酮(P)];研究组、比照组炎症指标[肿瘤坏死因子-α(TNF-α)、可溶性白细胞介素2受体(sIL-2R)]。结果治疗后,A组、B组、C组肌瘤体积、子宫体积均比本组治疗前缩小(P<0.05)。A组肌瘤体积缩小率>40%的占比为40.63%,明显高于B组的12.50%和C组的15.63%(P<0.05)。治疗后,A组、B组的P、E_(2)与本组治疗前及比照组比较均无差异(P>0.05);治疗后,C组的P、E_(2)水平分别为(6.17±4.93)nmol/L、(214.34±30.96)pmol/L,均低于本组治疗前的(14.03±7.15)nmol/L、(315.55±22.61)pmol/L及比照组的(12.88±6.12)nmol/L、(304.23±30.75)pmol/L(P<0.05)。治疗后,研究组TNF-α(1.21±0.32)ng/ml、sIL-2R(265.73±13.14)U/ml低于本组治疗前的(7.75±1.03)ng/ml、(320.69±30.81)U/ml,且sIL-2R低于比照组的(296.23±21.05)U/ml(P<0.05);研究组TNF-α水平与比照组比较无差异(P>0.05)。A组总有效率为96.88%,高于B组的81.25%和C组的75.00%(P<0.05);B组、C组总有效率比较无差异(P>0.05)。A组不良反应发生率为6.25%。低于B组的31.25%、C组的34.38%(P<0.05);B组、C组不良反应发生率比较无差异(P>0.05)。结论化瘤方、桂枝茯苓胶囊、米非司酮均能缓解子宫肌瘤患者的炎症反应,但米非司酮对激素水平的影响较大,且在治疗效果、不良反应方面化瘤方优势更为明显,能优化肌瘤体积缩小效果,其价值更为显著。

Objective To explore the effects of Hualiu formula,Guizhi Fuling capsule and mifepristone(RU486)in the treatment of uterine fibroid.Methods 96 patients with uterine fibroids were selected for study and divided into group A,group B,and group C by lottery method,with 32 cases in each group.Group A received Hualiu formula treatment,group B received Guizhi Fuling capsule treatment,and group C received mifepristone treatment.Additionally,32 females with health check ups during the same period were included in the comparison group.Comparison of fibroid volume and uterine volume,range reduction of fibroid volume and uterine volume,therapeutic effect,and the occurrence of adverse reactions in each subgroup of the study group;comparison of hormone levels[estradiol(E_(2)),progesterone(P)]in each subgroup of the study group and the comparison group;comparison of inflammation indicators[tumor necrosis factor-α(TNF-α),soluble interleukin-2 receptor(sIL-2R)]in the study group and the comparison group.Results After treatment,the fibroid volume and uterine volume in group A,group B and group C were all smaller than those before treatment(P<0.05).The percentage of uterine volume reduction>40%was 40.63%in group A,which was significantly higher than 12.50%in group B and 15.63%in group C(P<0.05).After treatment,there was no difference in P and E_(2) of group A and group B compared with that of this group before treatment and the comparison group(P>0.05).After treatment,P and E_(2) levels in group C were(6.17±4.93)nmol/L and(214.34±30.96)pmol/L,which were lower than those in this group before treatment[(14.03±7.15)nmol/L and(315.55±22.61)pmol/L]and those in the comparison group[(12.88±6.12)nmol/L and(304.23±30.75)pmol/L](P<0.05).After treatment,the study group had TNF-αof(1.21±0.32)ng/ml and sIL-2R of(265.73±13.14)U/ml,which were lower than(7.75±1.03)ng/ml and(320.69±30.81)U/ml in this group before treatment,and sIL-2R was lower than(296.23±21.05)U/ml in the comparison group(P<0.05).There was no difference in TNF-αlevels between the study group and the comparison group(P>0.05).The total effective rate of group A was 96.88%,which was higher than 81.25%in group B and 75.00%in group C(P<0.05).There was no difference in the comparison of total effective rate between group B and group C(P>0.05).The incidence rate of adverse reactions was 6.25%in group A,which was lower than 31.25%in group B and 34.38%in group C(P<0.05).There was no difference in the comparison of the incidence of adverse reactions between group B and group C(P>0.05).Conclusion Hualiu formula,Guizhi Fuling capsule and mifepristone can all alleviate the inflammatory response of patients with uterine fibroids,but mifepristone has a greater effect on hormone levels,and the advantages of Hualiu formula are more pronounced in terms of therapeutic efficacy and adverse reactions,and can optimize the effect of leiomyosarcoma volume reduction,which is of more significant value.