教案妇科临床医学论文 子宫肌瘤临床论文.docVIP

妇科临床医学论文子宫肌瘤临床论文 米非司酮联合桂枝茯苓加减丸治疗子宫肌瘤的临床观察 　　【摘要】 目的 对比米非司酮与桂枝茯苓加减丸联合用药或单独用药治疗子宫肌瘤的疗效。方法 回顾性分析98例子宫肌瘤患者治疗方案及疗效。31例患者口服米非司酮片(米非司酮组)；33例患者口服桂枝茯苓加减丸(桂枝茯苓丸加减丸组)；34例患者同时服用两种药物(联合用药组)，均连续用药3个月。检测子宫肌瘤体积以及血清卵泡刺激素(FSH)、黄体生成素(LH)、雌激素(E2)及孕酮(P)的浓度。结果 联系用药3个月之后，3组患者月经量、经期时间、痛经以及腰部酸胀等症状较治疗前明显改善，其中联合用药组月经量较其他两组减少更为明显。米非司酮组、桂枝茯苓加减丸组、联合用药组治疗后子宫肌瘤体积较治疗前分别缩小了49.6%、44.1%以及71.2%，血清FSH、LH、E2、P的浓度较治疗前均明显降低(P0.05)，随访1年发现桂枝茯苓加减丸组及联合用药组无反弹。结论 米非司酮与桂枝茯苓加减丸联合用药治疗子宫肌瘤疗效明显优于单独用药，值得临床推广应用。　　【关键词】米非司酮；桂枝茯苓加减丸；子宫肌瘤　　　　Clinical effects of combined administration of Mifepristone and guizhi fuling wan(GFW)onhysteromyoma　　WANG Yuan ,SHI Xiao-yan. department of gynecology, Affiliated Hospital of Yan’an University, Yan’an 716000, China　　【Abstract】 Objective To compare the clinical effects of drug combination of Mifepristone and GFW on hysteromyoma to that of Mifepristone or GFW alone. Methods Ninety-eight patients with hysteromyoma consecutively received administration of Mifepristone and(or)GFW for 3 month. Moreover, the volume of hysteromyoma and serum concentrations of follicle stimulating hormone(FSH), luteinizing hormone(LH), estrogen(E2)and pregnendione(P)were detected pre-and post-treatment. Results Menstrual blood volum(MBV), bradymenorrhea, menalgia, discomfort in hypogastrium were generally ameliorated after 3 month treatment compared with that of pre-treatment, especially in patients received drug combination as for MBV. Furthermore, administration of Mifepristone and/or GFW significantly decreased the serum concentrations of FSH, LH, E2 and P(P0.05). Follow-up visit showed no rebound in patients received GFW. Conclusion Drug combination of Mifepristone and GFW shows the optimal effects on hystermyoma in our study, and is worth of clinical application.　　【Key words】Mifepristone;Guizhi fuling wan(GFW); Hysteromyoma　　子宫肌瘤是30~50岁育龄期女性常见的良性肿瘤，临床患病率高达20%以上［1］，常导致患者继发性贫血、不孕甚至流产等，严重影响患者生活质量。对于瘤体体积小，临床症状轻微患者可采取保守治疗，但治疗方案不一，疗效差别较大。米非司酮用于子宫肌瘤治疗已有报道，但最佳用药剂量及时间尚需进一步研究［2］，桂枝茯苓加减丸根据患者病情随症相加减治疗