目的 探討桂枝茯苓丸聯(lián)合炔雌醇環(huán)丙孕酮片治療子宮腺肌病的臨床療效。方法 選取2021年6月—2023年3月在河北北方學(xué)院附屬第一醫(yī)院就診的94例子宮腺肌病患者，根據(jù)隨機(jī)數(shù)字表法分為對(duì)照組（47例）和治療組（47例）。對(duì)照組同一時(shí)間點(diǎn)口服炔雌醇環(huán)丙孕酮片，1片/次，1次/d，連續(xù)治療21 d；以1個(gè)月為1個(gè)療程，連續(xù)治療6個(gè)月。治療組在對(duì)照組基礎(chǔ)上口服桂枝茯苓丸，1丸/次，1次/d，連續(xù)治療6個(gè)月。比較兩組的臨床療效、痛經(jīng)程度、超聲指標(biāo)、凝血指標(biāo)和血清因子水平。結(jié)果 治療后，治療組的總有效率為95.74%，明顯高于對(duì)照組的總有效率82.98%，組間比較差異顯著（P＜0.05）。治療后，兩組的VAS評(píng)分、子宮體積、子宮內(nèi)膜厚度均比治療前小（P＜0.05），治療組VAS評(píng)分、子宮體積、子宮內(nèi)膜厚度比對(duì)照組更小（P＜0.05）。治療后，兩組的纖維蛋白原（FIB）、國(guó)際標(biāo)準(zhǔn)化比值（INR）、凝血酶原時(shí)間（PT）以及血清胰島素樣生長(zhǎng)因子1（IGF-1）、人趨化因子配體12（CXCL-12）、抗子宮內(nèi)膜抗體（EMAb）水平顯著降低（P＜0.05），治療組的FIB、INR、PT以及血清IGF-1、CXCL-12、EMAb水平比對(duì)照組更低（P＜0.05）。結(jié)論 桂枝茯苓丸聯(lián)合炔雌醇環(huán)丙孕酮片可提高子宮腺肌病的療效，減輕痛經(jīng)程度，減少子宮體積，改善凝血功能，降低血清因子水平。

Objective To investigate the clinical effect of Guizhi Fuling Pills combined with Ethinylestradiol and Cyproterone Acetate Tablets in treatment of adenomyopathy. Methods Women (94 cases) with adenomyopathy in the First Affiliated Hospital of Hebei North University from June 2021 to March 2023 were divided into control and treatment groups according to the random number table method, and each group had 47 cases. Women in the control group were po administered with Ethinylestradiol and Cyproterone Acetate Tablets, 1 tablet/time, once daily, continuous treatment for 21 d, taking one month as one course of treatment, and continuously treated for six months. Women in the treatment group were po administered with Guizhi Fuling Pills on the basis of the control group, 1 pill/time, once daily, continuously treated for six months. After treatment, the clinical efficacies, dysmenorrhea degree, ultrasound index, coagulation index, and serum factor level in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.74%, which was significantly higher than that of the control group (82.98%), and the difference between groups was significant (P < 0.05). After treatment, VAS score, uterine volume, and endometrial thickness of two groups were lower than those before treatment (P < 0.05), and VAS score, uterine volume, and endometrial thickness of the treatment group were smaller than those of the control group (P < 0.05). After treatment, FIB, INR, PT, and serum levels of IGF-1, CXCL-12, and EMAb in two groups were lower than those before treatment (P < 0.05), and FIB, INR, PT, and serum levels of IGF-1, CXCL-12, and EMAb in the treatment group were lower than those in the control group (P < 0.05).Conclusion Guizhi Fuling Pills combined with Ethinylestradiol and Cyproterone Acetate Tablets can improve the efficacy of adenomyopathy, reduce the dysmenorrhea degree, reduce uterine volume, improve coagulation function, and reduce serum factor level.

R984

河北省衛(wèi)生健康委科研基金項(xiàng)目（20180851）