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中国医药导刊 ›› 2019, Vol. 21 ›› Issue (10): 583-588.

• 临床医学 • 上一篇    下一篇

血府逐瘀汤联合米非司酮治疗中老年子宫肌瘤的应用疗效及对相关指标的影响

谭忠伦   

  1. 重庆市万州区第一人民医院中医科
  • 收稿日期:2019-11-28 出版日期:2019-10-31 发布日期:2019-10-31

The Effect of Xuefuzhuyu Decoction Combined with Mifepristone on Middle-aged and Elderly Uterine Fibroids and its Influence on Related Indicators

  • Received:2019-11-28 Online:2019-10-31 Published:2019-10-31

摘要: 目的:研究血府逐瘀汤联合米非司酮对中老年子宫肌瘤相关指标及预后的影响。方法:选择2015年9月至2016年6月我院妇科收治的147例中老年子宫肌瘤患者,按随机数字表法将患者分为观察组(72例)和对照组(75例),对照组依病情给予米非司酮治疗,观察组在对照组基础上联合给药血府逐瘀汤治疗,观察两组患者的临床疗效及治疗后激素受体及肿瘤细胞因子等的表达情况,比较患者治疗后生活质量的改善情况、复发率及不良反应等。结果:统计显示,经相应治疗后,观察组患者子宫及肿瘤体积均有缩小,治疗有效率高于对照组(P<0.05),且在有效治疗的患者中,观察组患者临床症状的改善情况也优于对照组(P<0.05)。两组患者经相应治疗,卵泡刺激素(FSH)、促黄体生成素(LH)、雌激素(E2)、孕激素(P)的含量均有下降趋势,雌激素受体(ER)、孕激素受体(PR)等激素受体的表达及增殖细胞核抗原(ki-67)、B淋巴细胞瘤-2基因(bcl-2)、兔抗人单克隆抗体(Bax)、肿瘤抑制基因(p53)的阳性表达率降低,对照组治疗前后FSH、LH的含量差异均无统计学意义(P>0.05),E2、P含量及ER、PR、ki-67、bcl-2、Bax、p53的阳性表达率差异均有统计学意义(P<0.05),观察组患者治疗前后的所有指标差异均有统计学意义(P<0.05),且两组患者观察指标的改善情况差异均有统计学意义(P<0.05)。相应治疗后,对照组患者日常生活及社会行动能力得到改善,与治疗前差异有统计学意义(P<0.05);抑郁及焦虑状态未得到明显改善(P>0.05)。观察组患者日常生活及社会行动能力、抑郁及焦虑状态均得到明显改善(P<0.05)。治疗1年后随访,观察组复发率为4.17%,对照组复发率为29.33%。两组患者比较差异有统计学意义(P<0.05)。结论:血府逐瘀汤联合米非司酮治疗中老年子宫肌瘤能有效降低患者体内FSH、LH、E2、P的含量, ER、PR、bcl-2等因子的阳性表达率降低,患者生活质量得到明显改善,预后效果更佳。

关键词: 血府逐瘀汤, 米非司酮, 中老年子宫肌瘤, 预后影响

Abstract: Objective:To study the effect of xuefuzhuyu decoction combined with mifepristone on middle-aged and elderly uterine fibroids and its influence on related indicators. Methods:From September 2015 to June 2016, 147 middle-aged and elderly patients with uterine fibroids in our hospital were divided into the observation group (72 cases) and the control group (75 cases) according to random number table. The control group patients were treated with mifepristone, and the observation group patients were treated with xuefuzhuyu decoction on the basis of the control group. The clinical curative effect and the expression of hormone receptor and tumor cytokines were observed in the two groups. The improvement of quality of life, recurrence rate and adverse reactions of the two groups were compared.Results:The statistics result showed that after the corresponding treatment, the uterus and tumor of patients in the observation group were significantly reduced, the clinical symptoms improved. In the patients with effective treatment, the improvement of clinical symptoms in the observation group was better than that in the control group (P<0.05). After treatment, the contents of FSH, LH, E2 and P of the two groups of patients decreased, the positive expression of ER, PR, ki-67, bcl-2, Bax and p53 decreased. In the control group, the contents of FSH, LH before and after treatment has no statistical difference (P>0.05), the content of E2, P and the positive expression of ER, PR, ki-67, bcl-2, Bax and p53 before and after treatment has statistical difference ( P<0.05). All the indexes in the observation group before and after treatment has statistical difference (P<0.05), and the improvement of the two groups has statistical difference (P<0.05). After the corresponding treatment, the daily life and social action ability of the control group were improved, and the difference with before treatment has statistical significance (P<0.05), the depression and anxiety status were not improved significantly, and the difference was not statistically significant (P>0.05). The daily life and social action ability, depression and anxiety status of the observation group were significantly improved, and the difference was statistically significant (P<0.05). After one year follow-up, the recurrence rate was 4.17% in the observation group and 29.33% in the control group. There was significant difference between the two groups (P<0.05). Conclusion:Xuefuzhuyu decoction combined with mifepristone can effectively reduce the levels of FSH, LH, E2 and P in the treatment of senile uterine fibroids, and the positive expression rate of ER, PR and bcl-2 is significantly reduced. The quality of life of the patients has been significantly improved, and has better prognosis.

Key words: Xuefuzhuyu decoction, Mifepristone, Middle-aged and elderly uterine fibroids, Prognosis

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