目的 探讨桂枝茯苓丸联合炔雌醇环丙孕酮片治疗子宫腺肌病的临床疗效。方法 选取2021年6月—2023年3月在河北北方学院附属第一医院就诊的94例子宫腺肌病患者，根据随机数字表法分为对照组（47例）和治疗组（47例）。对照组同一时间点口服炔雌醇环丙孕酮片，1片/次，1次/d，连续治疗21 d；以1个月为1个疗程，连续治疗6个月。治疗组在对照组基础上口服桂枝茯苓丸，1丸/次，1次/d，连续治疗6个月。比较两组的临床疗效、痛经程度、超声指标、凝血指标和血清因子水平。结果 治疗后，治疗组的总有效率为95.74%，明显高于对照组的总有效率82.98%，组间比较差异显著（P＜0.05）。治疗后，两组的VAS评分、子宫体积、子宫内膜厚度均比治疗前小（P＜0.05），治疗组VAS评分、子宫体积、子宫内膜厚度比对照组更小（P＜0.05）。治疗后，两组的纤维蛋白原（FIB）、国际标准化比值（INR）、凝血酶原时间（PT）以及血清胰岛素样生长因子1（IGF-1）、人趋化因子配体12（CXCL-12）、抗子宫内膜抗体（EMAb）水平显著降低（P＜0.05），治疗组的FIB、INR、PT以及血清IGF-1、CXCL-12、EMAb水平比对照组更低（P＜0.05）。结论 桂枝茯苓丸联合炔雌醇环丙孕酮片可提高子宫腺肌病的疗效，减轻痛经程度，减少子宫体积，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

河北省卫生健康委科研基金项目（20180851）