米非司酮序贯益气化瘀中药治疗子宫肌瘤临床观察

目的探讨米非司酮序贯益气化瘀中药治疗子宫肌瘤的临床疗效。方法将98例子宫肌瘤患者随机分为3组:A组服用益气化瘀中药;B组前一疗程服用米非司酮、后一疗程服用益气化瘀中药,C组单纯服用米非司酮。3个月为1个疗程,连用2个疗程。观察各组治疗前、治疗期间及停药后肌瘤体积大小,检测血清雌二醇(E2)水平,并评价临床症状缓解情况及副作用。结果各组临床症状均较治疗前明显改善(P0.05)。其中,第1疗程B、C两组的有效率均显著高于A组(P0.01),但E2水平较A组明显降低(P0.05),更年期症状评分明显升高(P0.05);第2疗程B、C两组的有效率仍然高于A组(P0.05),但B组E2水平有所提高、更年期症状显著改善,而C组E2水平持续降低、更年期症状进一步加重。停药后3月,C组的复发率明显高于A、B组(P0.05);停药6月,C组的复发率进一步增高,临床症状复发。结论米非司酮联合益气化瘀药物序贯疗法可使子宫肌瘤体积明显缩小,且临床副反应小,停药后复发率低。

Clinical observation on mifepristone and Chinese medicine for the treatment of uterine leiomyoma by sequential therapy

Objective To investigate the clinical efficacy of mifepristone and Chinese medicine in treating uterine leiomyoma by sequential therapy. Methods Ninety-eight cases were radomely divided into three groups： group A was treated with Chinese medicine with qi invirgorting and blood stasis resolving effects; group B was treated with mifepristone for the first course and Chinese medicine for the second course; group C was treated with mifepristone only. Three months as one course, with the treatment of 2 courses. We observed the size of uterine leiomyoma, E2 level, and evaluate remission of clinical symptoms and its side effects before and after treatment. Results The clinical symptoms of each group were significantly improved after treatment （ P 〈 0.05 ）. In the first course of treatment, the effective rates of group B and group C were higher than that of the group A （P 〈 0.01 ）, but the E2 level was lower than that of the group A （ P 〈 0.05 ） , and the menopause symptom score was significantly increased （ P 〈 0.05 ）. In the second course, the effective rates of group B and group C is still higher than that of the group A（P 〈 0.05 ）, but the E2 level of group B was increased, the menopausal symptoms were improved significantly, while the E2 level of group C was reduced continuously and the menopause symptoms were worsen. After drug withdrawal for three months, the recurrence rate of C group was significantly higher than that of the group A and group B （P 〈 0.05）. After drug withdrawal for six months, the recurrence rate of group C was increased and the clinical symptoms were recurred. Conclusion Combined mifepristone and Chinese medicine sequentially can reduce the size of uterine leiomyoma and has less side effects and low recurrence rate.