目的 桂枝茯苓胶囊联合左炔诺孕酮宫内节育系统治疗子宫腺肌症的临床疗效。方法 选取2013年12月-2016年8月武汉大学人民医院接受治疗的子宫腺肌病患者140例，随机分为对照组和治疗组，每组各70例。对照组患者给予左炔诺孕酮宫内节育系统，于月经3 d后置入宫腔内。治疗组在对照组治疗基础上口服桂枝茯苓胶囊，3粒/次，3次/d。两组均连续治疗6个月。观察两组的临床疗效，同时比较两组治疗前后子宫内膜厚度、痛经VAS评分及激素水平的变化情况。结果 治疗后，治疗组和对照组的总有效率分别为78.57%、91.43%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者子宫内膜厚度、痛经VAS评分、卵泡生成激素（FSH）、黄体生成激素（LH）水平均显著降低，但雌二醇（E₂）显著升高，同组治疗前后差异有统计学意义（P<0.05）；治疗后，治疗组子宫内膜厚度、VAS评分、FSH、LH水平低于对照组，E₂水平高于对照组，两组比较差异有统计学意义（P<0.05）。结论 桂枝茯苓胶囊联合左炔诺孕酮宫内节育系统治疗子宫腺肌症具有较好的临床疗效，可降低子宫内膜厚度和痛经VAS评分，同时可改善激素水平，具有一定的临床推广应用价值。

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.