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目的探讨桂枝茯苓胶囊联合米非司酮治疗子宫肌瘤疗效及对血清血管内皮生长因子(VEGF)、雌激素受体(ER)和孕激素受体(PR)水平变化的影响。方法选取2013年11月至2016年3月间西南医科大学附属中医院收治的72例子宫肌瘤患者,采用随机数表法分为观察组与对照组,每组36例。观察组患者采用桂枝茯苓胶囊联合米非司酮治疗,对照组患者仅采用米非司酮治疗,两组均持续治疗3个月。疗程结束后统计并比较两组患者的临床疗效、不良反应发生率、入院时及疗程结束后子宫体积与子宫肌瘤体积及血清VEGF、ER和PR水平变化情况。结果治疗后,两组患者的子宫肌瘤体积与子宫体积较治疗前缩小,且观察组小于对照组,差异有统计学意义(P<0.05)。观察组患者临床总有效率为94.4%,高于对照组患者的69.4%,差异有统计学意义(P<0.05)。治疗后两组患者血清VEGF、ER和PR水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组患者血压降低、头痛头晕、腹泻和呕吐恶心的发生情况分别为2例(5.6%)、1例(2.8%)、1例(2.8%)和2例(5.6%),与对照组患者的1例(2.8%)、3例(8.3%)、2例(5.6%)和1例(2.8%)比较,差异均无统计学意义(均P>0.05)。结论桂枝茯苓胶囊联合米非司酮治疗子宫肌瘤患者效果显著,可有效降低血清VEGF、ER和PR水平,缩小子宫与子宫肌瘤体积,提高治疗效果,且具有安全性,值得推广。
Objective To investigate the curative effect of Guizhi Fuling capsule combined with mifepristone on the changes of serum vascular endothelial growth factor (VEGF), estrogen receptor (ER) and progesterone receptor (PR). Methods Totally 72 patients with uterine leiomyoma admitted to the Affiliated Chinese Medicine Hospital of Southwest Medical University from November 2013 to March 2016 were randomly divided into observation group and control group with 36 cases in each group. Patients in the observation group were treated with Guizhi Fuling capsule combined with mifepristone, and patients in the control group were treated with mifepristone only. Both groups were treated for 3 months. After treatment, the clinical curative effect, the incidence of adverse reactions, the volume of uterine fibroids and uterine leiomyoma and the levels of serum VEGF, ER and PR after admission and at the end of treatment were compared and compared between the two groups. Results After treatment, the volume of uterine fibroids and uterine volume of both groups narrowed before treatment, and the observation group was smaller than the control group, the difference was statistically significant (P <0.05). The total clinical effective rate in the observation group was 94.4%, which was higher than that in the control group (69.4%), the difference was statistically significant (P <0.05). After treatment, the levels of serum VEGF, ER and PR in the two groups were lower than those before treatment, and the difference was statistically significant (P <0.05). Patients in the observation group had 2 cases (5.6%), 1 case (2.8%), 1 case (2.8%) and 2 cases (5.6%) with decreased blood pressure, headache and dizziness, diarrhea and vomiting. (P> 0.05) in 1 case (2.8%), 3 cases (8.3%), 2 cases (5.6%) and 1 case (2.8%). Conclusion Guizhi Fuling capsule combined with mifepristone treatment of patients with uterine fibroids significant effect, can effectively reduce the serum levels of VEGF, ER and PR, reduce the volume of uterine and uterine fibroids and improve the treatment effect, and is safe, it is worth promoting.