目的 探讨散结灵胶囊联合亮丙瑞林治疗子宫肌瘤的临床疗效。方法 选择2018年1月-2020年12月天津市宁河区医院收治的102例子宫肌瘤患者,按照随机数字表法分为对照组和治疗组,每组各51例。对照组患者皮下注射注射用醋酸亮丙瑞林微球,月经周期第1天给药,1支/次,每28天1次,共治疗3次;在对照组治疗的基础上,治疗组餐前2 h口服散结灵胶囊,3粒/次,3次/d。所有患者治疗12周。观察两组患者临床疗效,比较治疗前后两组患者月经量、子宫体积、瘤体体积、性激素水平,及血清血管内皮生长因子(VEGF)和环氧合酶-2(COX-2)水平。结果 治疗后,治疗组的总有效率明显高于对照组(P<0.05)。治疗后,两组月经量、子宫体积及瘤体体积均明显减小(P<0.05),且治疗组明显比对照组小(P<0.05)。治疗后,两组性激素黄体生成素(LH)、促卵泡激素(FSH)、雌二醇(E₂)和孕酮(P)水平,及血清VEGF和COX-2水平均明显降低(P<0.05),且治疗组明显比对照组低(P<0.05)。结论 散结灵胶囊联合亮丙瑞林治疗子宫肌瘤的临床疗效较好,能够明显缩小子宫体积和肌瘤体积,改善性激素水平,且安全性较好。

Objective To investigate the clinical efficacy of Sanjieling Capsules combined with leuprorelin in treatment of uterine leiomyoma. Methods Patients (102 cases) with uterine leiomyoma in Ninghe District Hospital from January 2018 to December 2020 were divided into control and treatment group by the random number table method, and each group had 51 cases. Patients in the control group were subcutaneous injection administered with Leuprorelin Acetate Microspheres For injection, from the first day of menstrual cycle, one injection at a time, once every 28 d, totally administered for three times. Patients in the treatment group were po administered with Sanjieling Capsules on the basis of the control group 2 h before meals, 3 grains/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical evaluation was evaluated, the volume of menstrual, uterine, tumor, hormone levels, the levels of serum VEGF and COX-2 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (P < 0.05). After treatment, the menstrual volume, uterine volume and tumor volume in two groups were significantly decreased (P < 0.05), and these indexes in the treatment group were significantly smaller than those in the control group (P < 0.05). After treatment, the levels of LH, FSH, E₂ and P, and the levels of serum VEGF and COX-2 were significantly decreased in two groups (P < 0.05), and the levels of these factors in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Sanjieling Capsules combined with leuprorelin has good clinical efficacy in treatment of uterine leiomyoma, which can significantly reduce the volume of uterus and leiomyoma, improve the level of sex hormone, and has good safety.

R984

国家自然科学基金资助项目（81330088）