祛湿化瘀散结汤联合桂枝茯苓胶囊治疗痰湿瘀结证子宫肌瘤临床研究
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R737.33;R273

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Clinical Study on Qushi Huayu Sanjie Decoction Combined with Guizhi Fuling Cap⁃ sules for Uterine Fibroids with Static Accumulation of Phlegm-Damp Syndrome
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    摘要:

    目的:观察祛湿化瘀散结汤联合桂枝茯苓胶囊治疗痰湿瘀结证子宫肌瘤的临床疗效。方法:选取 106 例痰湿瘀结证子宫肌瘤患者为研究对象,按随机数字表法分为联合组与对照组各53 例。对照组接受桂枝 茯苓胶囊治疗,联合组在对照组基础上联合祛湿化瘀散结汤治疗,共治疗12 周。比较2 组临床疗效及不良反 应,比较2 组治疗前后性激素[雌二醇(E2)、卵泡刺激素(FSH)、孕酮(P)、黄体生成素(LH)]、血流动力 学指标[收缩期峰值血流速度(PSV)、阻力指数(RI)、搏动指数(PI)]、肿瘤标志物[糖抗原125(CA125)、 人附睾蛋白4(HE4)]、血清血管内皮生长因子(VEGF)、心肌素、核因子-κB p65(NF-κB p65) 水平及月 经周期,子宫、肌瘤体积。结果:治疗12 周后,联合组治疗总有效率92.45%,高于对照组77.36% (P< 0.05)。治疗后,2 组血清E2、FSH、P、LH 水平均降低(P<0.05),且联合组低于对照组(P<0.05)。治疗 后,2 组血清VEGF、NF-κB p65 水平均下降(P<0.05),心肌素水平均升高(P<0.05),且联合组血清 VEGF、NF-κB p65 水平低于对照组(P<0.05),心肌素水平高于对照组(P<0.05)。治疗后,2 组子宫、肌瘤 体积均变小(P<0.05),月经周期均缩短(P<0.05),且联合组子宫、肌瘤体积均小于对照组(P<0.05),月 经周期短于对照组(P<0.05)。治疗后,2 组PSV 下降(P<0.05),RI、PI 升高(P<0.05),且联合组PSV 低 于对照组(P<0.05),RI、PI 高于对照组(P<0.05)。治疗后,2 组CA125、HE4 水平均下降(P<0.05),且 联合组低于对照组(P<0.05)。2 组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:祛湿化瘀散 结汤联合桂枝茯苓胶囊用于痰湿瘀结证子宫肌瘤疗效好,安全性高,且能明显改善患者性激素和血流动力学水 平,降低致癌风险。

    Abstract:

    Abstract: Objective: To observe the clinical effect of Qushi Huayu Sanjie Decoction combined with Guizhi Fuling Capsules for uterine fibroids with static accumulation of phlegm-damp syndrome. Methods:A total of 106 patients with uterine fibroids with static accumulation of phlegm- damp syndrome were selected as the research subjects and divided into the combination group and the control group according to the random number table method,with 53 cases in each group. The control group was treated with Guizhi Fuling Capsules,and the combination group was treated with Qushi Huayu Sanjie Decoction on the basis of the treatment of the control group. Both groups were treated for 12 weeks. The clinical effects and adverse reactions were compared between two groups. The levels of sex hormones [estradiol (E2), follicle stimulating hormone (FSH), progesterone (P), and luteinizing hormone (LH)], hemodynamic indicators [peak systolic blood flow velocity (PSV), resistance index (RI), and pulsatile index (PI)], tumor markers [carbohydrate antigen 125 (CA125), and human epididymal protein 4 (HE4)], serum vascular endothelial growth factor (VEGF), myocardin, nuclear factor- κB p65 (NF- κB p65), as well as menstrual cycle, uterine and fibroid volume were compared between the two groups before and after treatment. Results: After 12 weeks of treatment,the total effective rate was 92.45% in the combination group,higher than that of 77.36% in the control group (P<0.05). After treatment,the levels of E2,FSH,P,and LH in serum in the two groups were decreased (P<0.05), and the levels in the combination group were lower than those in the control group (P<0.05). After treatment,the levels of VEGF and NF- κB p65 in serum in the two groups were decreased (P<0.05),and the levels of myocardin were increased (P<0.05);the levels of VEGF and NF- κB p65 in serum in the combination group were lower than those in the control group (P< 0.05),and the level of myocardin was higher than that in the control group (P<0.05). After treatment,the uterine and fibroid volume in the two groups were decreased (P<0.05), and the menstrual cycle was shortened (P<0.05); the uterine and fibroid volume in the combination group was smaller than that in the control group (P<0.05),and the menstrual cycle was shorter than that in the control group (P<0.05). After treatment,the PSV in the two groups were decreased (P<0.05),and RI and PI were increased (P< 0.05);the PSV in the combination group was lower than that in the control group (P<0.05),and RI and PI were higher than those in the control group (P<0.05). After treatment the levels of CA125 and HE4 were decreased (P<0.05),and the levels in the combination group were lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion:The combination of Qushi Huayu Sanjie Decoction and Guizhi Fuling Capsules has a good curative effect and high safety in treating uterine fibroids with static accumulation of phlegm- damp syndrome,and can significantly improve the levels of sex hormones and hemodynamics in patients,and reduce the risk of cancer.

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刘会玲,徐泽霞,李颖.祛湿化瘀散结汤联合桂枝茯苓胶囊治疗痰湿瘀结证子宫肌瘤临床研究[J].新中医,2023,55(23):130-135

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  • 在线发布日期: 2023-12-13
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