目的 探讨大黄蛰虫丸联合亮丙瑞林治疗子宫肌瘤的临床疗效。方法 选取2016年6月—2017年6月在保定市第一医院治疗的子宫肌瘤患者96例，随机分为对照组（48例）和治疗组（48例）。对照组在月经第1天腹部皮下注射注射用醋酸亮丙瑞林缓释微球，3.75 mg/次，1次/4周。治疗组在对照组的基础上口服大黄蛰虫丸，3 g/次，3次/d。两组患者均治疗12周。观察两组患者临床疗效，比较治疗前后两组患者子宫体积和子宫肌瘤体积、血清性激素水平以及血清细胞因子水平。结果 治疗后，对照组和治疗组临床总有效率分别为81.25%、95.83%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者子宫体积、子宫肌瘤体积均明显缩小（P<0.05）；且治疗组子宫体积和子宫肌瘤体积比对照组缩小更显著（P<0.05）。治疗后，两组患者血清雌二醇（E₂）、孕酮（P）、促卵泡成熟激素（FSH）水平均明显降低（P<0.05）；且治疗组患者血清性激素水平明显低于对照组（P<0.05）。治疗后，两组患者血清血管内皮生长因子（VEGF）、糖表抗原125（CA125）、胰岛素样生长因子-1（IGF-1）水平均显著降低，IL-2水平明显升高，同组比较差异具有统计学意义（P<0.05）；且治疗组的血清细胞因子水平显著优于对照组（P<0.05）。结论 大黄蛰虫丸联合亮丙瑞林治疗子宫肌瘤可有效缩小子宫肌瘤体积，改善性激素水平，降低血清VEGF、CA125、IGF-I水平。

Objective To investigate the clinical curative effect of Dahuang Zhechong Pills combined with leuprolide in treatment of uterine fibroids. Methods Patients (96 cases) with uterine fibroids in Baoding NO.1 Hospital from June 2016 to June 2017 were randomly divided into control (48 cases) and treatment (48 cases). Patients in the control group were abdominal subcutaneous injection administered with Leuprorelin Acetate Microspheres Sustained Release for injection in the first day of menstrual, 3.75 mg/time, once every four weeks. Patients in the treatment group were po administered with Dahuang Zhechong Pills on the basis of the control group, 3 g/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, the uterine and uterine fibroids volume, the sex hormone, and serum cytokine levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 81.25% and 95.83% respectively, and there were differences between two groups (P < 0.05). After treatment, the uterine and uterine fibroids volume in two groups was significantly decreased (P < 0.05), and the volume in the treatment group was significantly smaller than that in the control group (P < 0.05). After treatment, the E₂, P and FSH levels in two groups were significantly decreased (P < 0.05). And the sex hormone indexes level in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the VEGF, CA125 and IGF-I level in two groups was significantly decreased, but IL-2 level was significantly increased, and there were differences in the same group (P < 0.05). And these serum cytokine levels in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Dahuang Zhechong Pills combined with leuprolide in treatment of uterine fibroids can effectively reduce the uterine fibroids volume, improving the sex hormones level and reduce the serum VEGF, CA125, and IGF-I level.

保定市科技局项目（12ZF015）