自凝刀配合益气化瘀中药治疗子宫肌瘤的临床分析-clinical analysis of self - setting knife combined with yiqi huayu traditional chinese medicine in treating hysteromyoma.docxVIP

成都中医药大学硕士学位论文 成都中医药大学硕士学位论文 PAGE PAGE 5 中文摘要 子宫肌瘤是女性生殖器中最常见的良性肿瘤，自凝刀射频微创技术（以下简称自 凝刀）是近年来在临床上逐步推广的治疗子宫肌瘤的一种新兴技术，但因自凝刀手术 的局限性导致了肌瘤的不完全消融及术后诸多并发症。本试验通过对自凝刀配合益气 化瘀中药治疗子宫肌瘤的临床观察，客观评价其治疗的临床疗效及安全性，探索自凝 刀术后配合中药保守治疗子宫肌瘤的临床优化方案。本试验将符合自凝刀手术治疗子 宫肌瘤纳入标准的 68 例患者，随机分为自凝刀组（35 例）与自凝刀加中药组（33 例）两组。中药疗程为 3 个月。观察各组治疗前后子宫体积、肌瘤体积、证候积分、 血清雌激素和孕激素水平、NK 细胞、血液流变学的变化。结果提示：1. 自凝刀治疗 子宫肌瘤可缩小子宫和肌瘤体积，改善患者症状，增加患者的 NK 细胞。2. 自凝刀加 中药组可促进子宫和肌瘤体积的缩小，提高证候疗效，加快改善患者腰骶酸痛、小腹 肛门坠胀疼痛、神疲乏力、头晕心悸、经期延长、经质异常等症状，减轻自凝刀术后 阴道流血溢液等并发症，且能进一步增加患者的 NK 细胞。3. 与自凝刀组相比, 自凝刀 加中药组有改善患者血液的凝、粘、聚状态的趋势。4. 自凝刀组和自凝刀加中药组血 清雌激素和孕激素水平的变化均不显著。5. 自凝刀新技术配合益气化瘀中药治疗子宫 肌瘤安全、无毒副作用，值得进一步研究和推广应用。 关键词：子宫肌瘤，自凝刀，益气化瘀，中药 ABSTRACT Myoma uteri is the most common benign tumor in the female genital organs. Radio-frequency ablation(RFA) is a new technology of treating myoma uteri in recent years,which gradually spreaded in clinical practice.However, the limitation of RFA leads to inadequacy of ablation and many complication after the operation.The experiment is to evaluate the clinical effect and safety objectively,and explore a new clinical optimization scheme of treating myoma uteri conservatively with traditional Chinese medicine(TCM) after RFA.The experiment divides sixty eight patients who meet the criterion of treating myoma uteri by RFA into two groups at random,thirty five patients treated by RFA,thirty three patients treated by TCM after RFA’s therapy.The course of the TCM therapy is three months.The uterine volume,hysteromyoma’s cubage,syndrome’s integral,level of estrogen and progesterone in blood,level of natural killer cell(NK) and hemorheology of two groups were observed both before and after treatment.Results suggest: 1 The treatment of RFA on hysteromyoma can reduce the uterus volume and hysteromyoma’s cubage,and improve patient’s symptoms，and enhance the level of NK. 2 Using TCM which can tonify qi and remove blood stasis after RFA surgery can accelerate the absorption of tumor and the reduction of uterus,increase the effect of syndrome