四君子汤联合桂枝茯苓丸加减治疗子宫肌瘤

Sijunzi Decoction Combined with Modified Guizhi Fuling Pill in the Treatment of Uterine Myoma

目的:探讨四君子汤联合桂枝茯苓丸加减对子宫肌瘤(uterine myoma,UM)患者子宫动脉血流指数及血清糖链抗原125(carbohydrate antigen 125,CA125)、癌胚抗原(carcino-embryonic antigen,CEA)、甲胎蛋白(α-fetoprotein,AFP)水平的影响。方法:将102例UM患者按照随机数字表法分为观察组与对照组各51例。对照组给予常规西医治疗,观察组给予四君子汤联合桂枝茯苓丸加减治疗,均治疗3个疗程。比较两组患者临床疗效、不良反应发生率,并比较治疗前后子宫动脉血流指数[搏动指数(pulsatility index,PI)、阻力指数(resistance index,RI)、收缩期峰值流速/舒张期峰值流速(peak systolic velocity/diastolic peak velocity,S/D)]、血清肿瘤标志物(CA125、CEA、AFP)水平及SF-36生存质量评分。结果:两组临床疗效经Ridit分析,观察组优于对照组,差异有统计学意义(P<0.05);治疗后,观察组PI、RI及S/D均高于对照组,差异有统计学意义(P<0.05);治疗后,观察组CA125、CEA、AFP均低于对照组,差异有统计学意义(P<0.05);治疗期间观察组不良反应发生率(3.92%)低于对照组(17.65%),差异有统计学意义(P<0.05);治疗后,观察组生存质量评分高于对照组,差异有统计学意义(P<0.05)。结论:四君子汤联合桂枝茯苓丸加减治疗UM,临床疗效显著,可有效改善患者子宫动脉血流指数,降低血清CA125、CEA、AFP水平,且具有较高安全性,有利于改善患者生存质量。

Objective: To explore the effect of Sijunzi decoction combined with modified Guizhi Fuling Pill on uterine artery blood flow index,serum Carbohydrate antigen 125( CA125),carcino-embryonic antigen( CEA) andα-fetoprotein( AFP) levels in patients with Uterine myoma( UM). Methods: 102 UM patients were divided into observation group and control group according to random number table method,51 cases each. The control group was treated with conventional western medicine,while the observation group was treated with Sijunzi Decoction combined with modified Guizhi Fuling Pill for three courses. The clinical efficacy and incidence of adverse reactions of the two groups were counted,and the uterine artery blood flow index[Pulsatility index( PI),Resistance index( RI),Peak systolic velocity/Diastolic peak velocity( S/D) ],serum tumor markers( CA125,CEA,AFP) levels and SF-36 life quality score were compared before and after treatment. Results: After Ridit analysis,the clinical efficacy of the two groups was better than that of the control group,and the difference was statistically significant( P < 0. 05);after treatment,PI,RI and S/D of the observation group were higher than those of the control group,and the difference was statistically significant( P <0. 05);after treatment,CA125,CEA and AFP of the observation group were lower than those of the control group,and the difference was statistically significant( P < 0. 05);during the treatment,the incidence of adverse reactions in the observation group was3. 92% lower than 17. 65% in the control group( P < 0. 05),and the difference was statistically significant( P < 0. 05);aftertreatment,the quality of life score in the observation group was higher than that in the control group,and the difference was statistically significant( P < 0. 05). Conclusion: Sijunzi Decoction combined with modified Guizhi Fuling Pill in the treatment of UM has significant clinical effect. It can effectively improve the uterine artery blood flow index of patients,reduce the levels of serum CA125,CEA and AFP,and has high safety,which is conducive to improving the quality of life of patients.