子宫动脉栓塞术联合行气祛瘀汤在弥漫型子宫腺肌病的应用研究

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观察子宫动脉栓塞术(uterine artery embolization,UAE)联合行气祛瘀汤治疗子宫腺肌病(adenomyosis,AD)的临床疗效。回顾性分析2014年1月至2015年9月,南漳县人民医院78例弥漫型AD患者作为研究对象,随机分为观察组(39例)和对照组(39例)。对照组患者仅予UAE治疗,观察组予UAE联合行气祛瘀汤治疗,术后5d口服行气祛瘀汤,连续服用6个月,治疗前后空腹抽血检测雌二醇(E2)、促卵泡刺激素(FHS)、促黄体生成素(LH)、糖类抗原125(CA125),采用阴道彩色多普勒超声测量子宫体积变化情况,采用视觉模拟评分法评价痛经程度,采用月经量评分评价月经量变化情况。采用SPSS19.0软件,计数资料进行χ2检验,计量资料进行t检验,P<0.05为差异有统计学意义。结果显示,观察组和对照组组内及组间治疗前后生殖激素指标差异无统计学意义(P>0.05)。治疗后,观察组子宫体积(165±26)cm3,对照组子宫体积(184±27)cm3,差异有统计学意义(t=3.775,P<0.05);观察组CA125(36.6±10.4)KU/L,对照组CA125(49.8±12.5)KU/L,差异有统计学意义(t=3.701,P<0.05);观察组痛经疼痛评分(2.58±1.13)分,对照组痛经疼痛评分(4.23±1.21)分,差异有统计学意义(t=3.496,P<0.05);观察组月经量评分(48.4±5.2.4)分,对照组月经量评分(71.2±6.4)分,差异有统计学意义(t=4.811,P<0.05)。两组均未出现严重并发症。UAE联合行气祛瘀汤能有效控制弥漫型AD,安全性良好,对卵巢内分泌功能无明显影响。 To observe the clinical efficacy of uterine artery embolization (UAE) combined with Qi Qushi Decoction in the treatment of adenomyosis (AD). Retrospective analysis From January 2014 to September 2015, 78 patients with diffuse AD in Nanzhang County People’s Hospital were randomly divided into observation group (39 cases) and control group (39 cases). The patients in the control group were treated with UAE alone. The patients in the observation group were treated with UAE combined with Qiqiyu Decoction. The patients were treated with Qiqiyu Decoction 5 days after operation and taken continuously for 6 months. Estradiol (E2) was detected in fasting blood before and after treatment. Follicle stimulating hormone (FHS), luteinizing hormone (LH), carbohydrate antigen 125 (CA125), vaginal color Doppler ultrasound measurement of uterine volume changes, visual analogue scale evaluation of dysmenorrhea, menstrual scale evaluation Menstrual changes. Using SPSS19.0 software, count data for χ2 test, measurement data for t test, P <0.05 for the difference was statistically significant. The results showed that the observation group and the control group within and between groups before and after treatment of reproductive hormones showed no significant difference (P> 0.05). After treatment, the uterine volume (165 ± 26) cm3 in the observation group and the uterine volume in the control group (184 ± 27) cm3 were significantly different (t = 3.775, P <0.05) L and control group, the level of CA125 was 49.8 ± 12.5 KU / L, the difference was statistically significant (t = 3.701, P <0.05); the dysmenorrhea pain score (2.58 ± 1.13) in the observation group and the pain score of the control group (4.23 ± 1.21 ), The difference was statistically significant (t = 3.496, P <0.05); the observation group menstrual volume score (48.4 ± 5.2.4) points, the control group menstrual volume score (71.2 ± 6.4) points, the difference was statistically significant t = 4.811, P <0.05). No serious complications occurred in either group. UAE joint qiquyu decoction can effectively control diffuse AD, good safety, no significant effect on the ovarian endocrine function.
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