目的 探讨大黄䗪虫丸联合桂枝茯苓胶囊治疗子宫肌瘤的临床疗效。方法 纳入2023年2月—2025年9月保定市第二中心医院收治的146例子宫肌瘤患者，采用随机数字表法分为对照组和治疗组，每组各73例。对照组口服桂枝茯苓胶囊，3粒/次，3次/d。在此基础上，治疗组口服大黄䗪虫丸，1丸/次，2次/d，经期暂停服药，待结束后继续服用，两药服用间隔1 h以上。疗程12周。比较两组临床疗效，以及治疗前后肌瘤体积、月经失血评估图表（PBAC）评分、痛经程度视觉模拟评分法（VAS）评分、中医症状评分、健康相关生活质量问卷（HRQL）评分、症状自评量表（SCL-90）评分和血清性激素[雌二醇（E₂）、孕酮（P）]、白细胞介素-6（IL-6）、血小板衍生因子（PDGF）、胰岛素样生长因子-1（IGF-1）水平。结果 治疗后，治疗组总有效率（93.15%）较对照组（82.19%）更高（P＜0.05）。治疗后，两组肌瘤体积缩小，月经量PBAC评分和痛经程度VAS评分降低（P＜0.05）；治疗组肌瘤体积、月经量PBAC评分和痛经程度VAS评分均优于对照组（P＜0.05）。治疗后，两组中医症状评分和SCL-90评分降低（P＜0.05），HRQL评分增加（P＜0.05）；治疗组中医症状评分及HRQL、SCL-90评分均优于对照组（P＜0.05）。治疗后，两组血清性激素（E₂、P）及IL-6、PDGF、IGF-1水平均降低（P＜0.05）；治疗组上述指标均低于对照组（P＜0.05）。结论 大黄䗪虫丸联合桂枝茯苓胶囊治疗子宫肌瘤，能有效促进患者症状缓解，减少月经出血量和痛经程度，并能进一步调节性激素水平、抑制炎症刺激和肌瘤增殖，促进肌瘤缩小及患者生活质量和心理状态改善。

Objective To explore the clinical efficacy of Dahuang Zhechong Pills combined with Guizhi Fuling Capsules in treatment of uterine leiomyomas. Methods A total of 146 patients with uterine leiomyomas admitted to Baoding Second Central Hospital from February 2023 to September 2025 were enrolled and divided into a control group and a treatment group by the random number table method, with 73 patients in each group. Patients in the control group were po administered with Guizhi Fuling Capsules, 3 capsules/time, three times daily. On this basis, patients in the treatment group were po administered with Dahuang Zhechong Pills, 1 pill each time, twice a day. Medication was suspended during menstruation and resumed after menstruation ended, with an interval of more than 1 hour between the two drugs. The treatment course lasted 12 weeks. The two groups were compared in terms of clinical efficacy, fibroid volume, Pictorial Blood Loss Assessment Chart (PBAC) score for menstrual blood loss, Visual Analogue Scale (VAS) score for dysmenorrhea severity, traditional Chinese medicine (TCM) symptom score, Health-Related Quality of Life (HRQL) score, Symptom Checklist 90 (SCL-90) score before and after treatment, as well as serum levels of sex hormones [estradiol (E₂), progesterone (P)], interleukin-6 (IL-6), platelet-derived growth factor (PDGF) and insulin-like growth factor-1 (IGF-1). Results After treatment, the total effective rate of the treatment group (93.15%) was significantly higher than that of the control group (82.19%) (P < 0.05). Fibroid volume was reduced, and PBAC scores for menstrual volume and VAS scores of dysmenorrhea were decreased in both groups after treatment (P < 0.05); the treatment group achieved better outcomes in fibroid volume, PBAC score and dysmenorrhea VAS score compared with the control group (P < 0.05). After treatment, TCM symptom scores and SCL-90 were decreased (P < 0.05), while HRQL scores were increased in both groups (P < 0.05). The treatment group showed superior results in TCM symptom score, HRQL score and SCL-90 score relative to the control group (P < 0.05). Serum levels of sex hormones (E₂, P), IL-6, PDGF and IGF-1 were markedly decreased in both groups post-treatment (P < 0.05), and all above indicators in the treatment group were lower than those in the control group (P < 0.05). Conclusion The combination of Dahuang Zhechong Pills and Guizhi Fuling Capsules can effectively relieve clinical symptoms of patients with uterine leiomyomas, reduce menstrual blood volume and alleviate dysmenorrhea. Moreover, this combined regimen can regulate sex hormone levels, inhibit inflammatory stimulation and fibroid proliferation, shrink fibroids, and improve patients’ quality of life and psychological status.

R984

保定市科技计划项目（2041ZF222）