加味瓜蒌瞿麦汤联合米非司酮治疗子宫肌瘤患者的疗效及对其性激素水平的影响  

Modified Gualou Qumai Decoction Combined with Mifepristone for Treating Hysteromyoma:Therapeutic Effect and Influences on Sex Hormone Levels

作　　者：李小华[1] 陈卓 牛凤鹤 LI Xiao-hua;CHEN Zhuo;NIU Feng-he(Department of Gynecology,Nanyang Second General Hospital,Nanyang Henan 473000)

机构地区：[1]河南省南阳市第二人民医院妇科,河南南阳473000

出　　处：《世界中西医结合杂志》2024年第6期1187-1190,1195,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河南省医学科技攻关计划项目(LHGJ20200898)。

摘　　要：目的探讨加味瓜蒌瞿麦汤联合米非司酮治疗子宫肌瘤患者的疗效及对其性激素水平的影响。方法选取2020年2月—2022年3月期间于河南省南阳市第二人民医院就诊的痰湿瘀结证子宫肌瘤患者120例,按随机数字表法分为对照组和研究组,每组各60例。对照组单纯给予米非司酮治疗,研究组在对照组治疗的基础上联合加味瓜蒌瞿麦汤治疗,两组患者均于月经干净开始服药,经期停药,均治疗3个月。观察比较两组患者临床疗效及不良反应发生率,治疗前后月经质量、子宫肌瘤体积及子宫体积,并检测两组患者血清性激素[雌二醇(Estradial,E_(2))、促卵泡生长激素(Folliclestimulating hormone,FSH)、孕酮(Progesterone,P)、促黄体生成素(Luteinizing hormone,LH)]水平。结果治疗后研究组临床总有效率95.00%(57/60)明显高于对照组80.00%(48/60),差异有统计学意义(P<0.05)。治疗后两组患者视觉模拟量表(Visual analog scale,VAS)评分及月经失血图(Pictorial blood loss assessment chart,PBAC)评分均较治疗前降低,差异有统计学意义(P<0.05);且研究组VAS、PBAC评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者子宫肌瘤、子宫体积均较治疗前降低,差异有统计学意义(P<0.05);且研究组子宫肌瘤、子宫体积均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清性激素LH、P、E_(2)及FSH水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组血清性激素LH、P、E_(2)及FSH水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,研究组不良反应发生率10.00%(6/60)与对照组6.67%(4/60)比较,差异无统计学意义(P>0.05)。结论加味瓜蒌瞿麦汤与米非司酮联用能进一步提高子宫肌瘤的疗效,改善月经质量,缩小肌瘤体积,调节性激素水平,具有良好的安全性。Objective To explore the therapeutic effect of modified Gualou Qumai Decoction combined with mifepristone on hysteromyoma and the influences of this therapy on sex hormone levels.Methods A total of 120 hysteromyoma patients with the syndrome of phlegm-dampness combined with stasis treated in the Nanyang Second General Hospital from February 2020 to March 2022 were selected and assigned with the random number table method into a control group and a study group,with 60 patients in each group.The control group was treated with mifepristone alone,while the study group was treated with modified Gualou Qumai Decoction combined with mifepristone.The patients in both groups started taking medications after their menstrual bleeding stopped and stopped taking medications during the menstrual bleeding.The treatment lasted for three months in both groups.The clinical efficacy and incidence of adverse reactions were compared between the two groups of patients.The menstrual quality,uterine fibroid volume,uterine volume,and the serum levels of sex hormones[estradiol(E_(2)),follicle-stimulating hormone(FSH),progesterone(P),and luteinizing hormone(LH)]were measured for both groups of patients before and after treatment.Results After treatment,the total response rate in the study group was 95.00%(57/60),which was higher than that(80.00%,48/60)in the control group(P<0.05).After treatment,the visual analog scale(VAS)scores and pictorial blood loss assessment chart(PBAC)scores of the two groups decreased(P<0.05),and the VAS score and PBAC score of the study group were lower than those of the control group(P<0.05).After treatment,the uterine fibroid volume and uterine volume decreased in both groups(P<0.05)and they were lower in the study group than in the control group(P<0.05).After treatment,the serum levels of LH,P,E 2,and FSH in the two groups of patients declined(P<0.05),and the serum levels of LH,P,E_(2),and FSH in the study group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the study

关 键 词：加味瓜蒌瞿麦汤 米非司酮 子宫肌瘤 痰湿瘀结证 性激素 

分 类 号：R711.74[医药卫生—妇产科学]