米非司酮联合中药治疗子宫肌瘤的疗效观察
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[摘要] 目的 探讨米非司酮联合中药治疗子宫肌瘤的疗效。方法 入院确诊的70例子宫肌瘤患者随机分为治疗组(米非司酮+中药)和对照组(米非司酮)各35例，比较两组治疗的临床疗效及治疗前后血红蛋白、瘤体体积的变化。结果 两组间疗效比较，治疗组的疗效优于对照组(P<0.01)。治疗后两组的血红蛋白均较治疗前明显升高，瘤体体积治疗后均较治疗前明显降低(P<0.01)。两组血红蛋白及瘤体体积比较，治疗组的血红蛋白及瘤体体积较对照组改善更明显，差异有统计学意义(P<0.05)。结论 米非司酮联合中药治疗子宫肌瘤可显著提高临床疗效，能够明显缩小瘤体体积，值得推广和应用。
[关键词]子宫肌瘤；米非司酮；中药；血红蛋白
[中图分类号] R711.74 [文献标识码] B [文章编号]1673-9701(2011)31-73-02
The Efficacy of Mifepristone Combined with Traditional Chinese Medicine in Treatment of Uterine Fibroids
ZHOU Junhong1 WANG Hongyan2
1. Hubei Huangmei Orthopaedic Hospital (Apricot Medical School) ,Huangmei 435500, China; 2.Huangmei County People's Hospital in Hubei Province, Huangmei 435500, China
[Abstract] Objective To investigate the effects of mifepristone combined with traditional Chinese medicine in treatment of uterine fibroids. Methods Seventy cases were randomly divided into treatment group (mifepristone + medicine) and control group (mifepristone)with 35 cases in each in our hospital from February 2009 to February 2010，and the clinical efficacy and the changes of hemoglobin, tumor volume were comparde before and after treatment. Results The two groups were compared, the efficacy of treatment group was significantly higher than control group，and the difference was statistically significant(P<0.01). After treatment, the hemoglobin was significantly higher than that before treatment, tumor volume after treatment was significantly lower than that before treatment(P<0.01) .Two groups hemoglobin and tumor volume was improved more significantly than the control group, the difference was statistically significant(P<0.05). Conclusion Mifepristone and traditional Chinese medicine treatment uterine fibroids can significantly improve the clinical efficacy and reduce the tumor size. It is should be promoted and applied.
[Key words] Uterine fibroids; Mifepristone; Medicine ；Hemoglobin
子宫肌瘤是育龄期妇女的常见病、多发病，近年来，其发病率逐年升高，目前临床治疗子宫肌瘤的方法较多，且疗效报道不一[1]。随着社会进步及人们健康意识的提高，绝大多数子宫肌瘤患者均要求治疗后能够保留子宫，因此药物治疗成为治疗子宫肌瘤的有效治疗手段之一[2]。本研究旨在探讨米非司酮联合中药治疗子宫肌瘤,从而为临床治疗提供进一步的参考。
1 资料与方法
1.1 一般资料
我院2009年2月~2010年2月入院确诊的70例子宫肌瘤患者，年龄25~42岁，患者主诉有月经过多、尿急、尿频、痛经、合并贫血。治疗前未用过任何激素类药物，无肝肾疾患。全部患者随机分为治疗组和对照组各35例，两组患者的年龄、婚史及肌瘤类型等临床资料比较，差异均无显著性(P>0.05)，具有可比性。
1.2 治疗方法及疗效判断
从月经周期第1天开始，对照组予米非司酮12.5mg，每晚睡前口服，连用3个月。治疗组在此基础上予桂枝茯苓丸，药物组成：桂枝15g，茯苓20g，丹皮15g，桃仁10g，赤芍15g，当归10g，白术10g，柴胡10g，三棱10g，莪术10g，香附10g，生牡蛎30g。水煎，每日1剂，分2次服用。3个月为1个疗程，比较两组的疗效及治疗前后血红蛋白、瘤体体积的变化。肌瘤体积(cm3)=0.523×A×B×C(A、B、C分别代表肌瘤的三维径线半径)。疗效标准参考文献[2] 分为痊愈、有效、无效。
1.3 统计学处理
全部数据处理均采用SPSS12.0统计软件进行，其中计量资料以均数±标准差(χ±s)表示，计数资料采用χ2检验，P<0.05为差异有统计学意义。
2 结果
2.1 治疗后两组患者疗效比较
注：两组间疗效比较差异有统计学意义(χ2=8.23，*P<0.01)
2.2 两组患者治疗前后血红蛋白、瘤体体积的变化
注：两组治疗后的血红蛋白均较治疗前明显升高，瘤体体积治疗后均较治疗前明显降低(t值分别为2.56、2.13、2.64、2.34,*P<0.01)，治疗后两组血红蛋白及瘤体体积比较，差异有统计学意义(t值分别为2.34、2.67，#P<0.05)
2.3 不良反应
两组患者服药早期偶有患者出现轻度恶心呕吐 ......
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