目的 桂枝茯苓膠囊聯(lián)合左炔諾孕酮宮內(nèi)節(jié)育系統(tǒng)治療子宮腺肌癥的臨床療效。方法 選取2013年12月-2016年8月武漢大學(xué)人民醫(yī)院接受治療的子宮腺肌病患者140例，隨機分為對照組和治療組，每組各70例。對照組患者給予左炔諾孕酮宮內(nèi)節(jié)育系統(tǒng)，于月經(jīng)3 d后置入宮腔內(nèi)。治療組在對照組治療基礎(chǔ)上口服桂枝茯苓膠囊，3粒/次，3次/d。兩組均連續(xù)治療6個月。觀察兩組的臨床療效，同時比較兩組治療前后子宮內(nèi)膜厚度、痛經(jīng)VAS評分及激素水平的變化情況。結(jié)果 治療后，治療組和對照組的總有效率分別為78.57%、91.43%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者子宮內(nèi)膜厚度、痛經(jīng)VAS評分、卵泡生成激素（FSH）、黃體生成激素（LH）水平均顯著降低，但雌二醇（E₂）顯著升高，同組治療前后差異有統(tǒng)計學(xué)意義（P<0.05）；治療后，治療組子宮內(nèi)膜厚度、VAS評分、FSH、LH水平低于對照組，E₂水平高于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 桂枝茯苓膠囊聯(lián)合左炔諾孕酮宮內(nèi)節(jié)育系統(tǒng)治療子宮腺肌癥具有較好的臨床療效，可降低子宮內(nèi)膜厚度和痛經(jīng)VAS評分，同時可改善激素水平，具有一定的臨床推廣應(yīng)用價值。

Objective To explore the clinical efficacy of Guizhi Fuling Capsules combined with Levonorgestrel Intrauterine System in treatment of adenomyosis. Methods Patients (140 cases) with adenomyosis in People's Hospital of Wuhan University from December 2013 to August 2016 were randomly divided into control (70 cases) and treatment (70 cases) groups. Patients in the control group were administered with Levonorgestrel Intrauterine System, and they were put into the uterine cavity after 3 d of menstruation. Patients in the treatment group were po administered with Guizhi Fuling Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacy was evaluated, and the changes of endometrial thickness, VAS score of dysmenorrheal, and hormone levels in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 78.57% and 91.43%, respectively, and there was difference between two groups (P<0.05). After treatment, endometrial thickness, VAS score of dysmenorrheal, FSH, and LH in two groups significantly decreased, but E₂ significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, endometrial thickness, VAS score of dysmenorrheal, FSH, and LH in the treatment group were lower then those in the control group, but E₂ in the treatment group was higher than that in the control group, and there was difference between two groups (P<0.05). Conclusion Guizhi Fuling Capsules combined with Levonorgestrel Intrauterine System has a significant effect in treatment of adenomyosis, and can significantly reduce the endometrial thickness and VAS score of dysmenorrheal, also can significantly improves hormone levels, which has a certain clinical application value.