世界中医药

目的:观察益肾活血消癥方对子宫肌瘤肾虚血瘀证患者内分泌功能及血液流变学的影响。方法:回顾性分析2015年6月至2016年6月北京中医药大学东直门医院收治的子宫肌瘤肾虚血瘀证患者40例,依据随机数字表法将其分为观察组和对照组,每组20例。对照组给予米非司酮片治疗,观察组在对照组治疗基础上,加服益肾活血消癥方治疗,2组均治疗3个月。比较2组治疗前后肿瘤体积、子宫体积、生殖内分泌激素［孕酮(P)、雌二醇(E2)、黄体生成激素(LH)、卵泡生成激素(FSH)及血清催乳素(PRL)］及血液流变学(高切全血黏度、低切全血黏度、血浆黏度、红细胞压积、红细胞聚集指数、红细胞沉降率及纤维蛋白原)的改善情况,并统计2组临床疗效。结果:治疗后观察组总有效率(90.0%)显著高于对照组(80.0%),2组间差异有统计学意义(P<0.05);治疗前2组子宫体积、肌瘤体积经比较无显著差异(P>0.05),治疗后2组子宫体积和肌瘤体积较治疗前缩小(P<0.05),且观察组缩小程度较对照组更为明显,2组间差异有统计学意义(P<0.05);治疗前2组生殖内分泌激素水平经比较差异无统计学意义(P>0.05),治疗后2组生殖内分泌激素水平均显著降低,且观察组降低程度较对照且组更明显,2组间差异有统计学意义(P<0.05);治疗前2组血液流变学水平经比较差异无统计学意义(P>0.05),治疗后2组高切全血黏度、低切全血黏度、血浆黏度、红细胞聚集指数、红细胞沉降率及纤维蛋白原水平均显著降低,红细胞压积水平均显著升高,观察组改善程度较对照组更明显,且2组间差异有统计学意义(P<0.05)。结论:益肾活血消癥方能够有效改善患者生殖内分泌激素和血液流变学水平,缩小子宫体积和肌瘤体积,提高临床治疗效果,值得临床推广应用。

English Summary:

To observe the influence of Yishen Huoxue Xiaozheng Fang on endocrine function and hemorheology of uterine fibroids kidney deficiency and blood stasis patients. Methods:A retrospective analysis of 40 cases of uterine fibroids kidney deficiency and blood stasis patients from June 2015 to June 2016 in our hospital was conducted. The patients were divided into the observation group and the control group according to the random number table method, with 20 cases in each group. The control group was given mifepristone tablets, and the observation group added to Yishen Huoxue Xiaozheng Fang on the basis of control group. Both groups were treated for 3 months continuously. The tumor volume, uterine volume, reproductive endocrine hormones (Progesterone (P), estradiol (E2), luteinizing hormone (LH), follicle growth hormone (FSH) and serum prolactin (PRL)) and the improve situation of hemorheology (whole blood viscosity, high shear and low shear whole blood viscosity, plasma viscosity, hematocrit, erythrocyte aggregation index, erythrocyte sedimentation rate and fibrinogen) of 2 groups before and after treatment were compared, and the clinical efficacy of 2 groups was statisticsed. Results:The total effective rate of observation group (90.0%) was significantly higher than control group (80.0%) (P<0.05). The volume of uterus and myoma of 2 groups had no significant difference before treatment (P>0.05), and the volume of uterus and volume of myoma of 2 groups reduced than before treatment (P<0.05). The degree of reduction of observation group was more significant than that of the control group, and there was significant difference between 2 groups (P<0.05); the reproductive endocrine hormones levels of 2 groups had no significant difference before treatment (P>0.05), and the reproductive endocrine hormones levels of 2 groups decreased significantly after treatment. The degree of reduction of observation group was more significant than that of the control group, and there was significant difference between 2 groups (P<0.05); the hemorheology levels of 2 groups had no significant difference before treatment (P>0.05), and the whole blood viscosity, high shear and low shear whole blood viscosity, plasma viscosity, erythrocyte aggregation index, erythrocyte sedimentation rate and fibrinogen levels of 2 groups decreased significantly after treatment. The hematocrit increased significantly, and the improvement degree of the observation group was more significant than that of the control group. There was significant difference between 2 groups (P<0.05). Conclusion:Yishen Huoxue Xiaozheng Fang can effectively improve the endocrine function and hemorheology levels of patients, reduce the volume of uterus and myoma, enhance the clinical efficiency, which is worthy of clinical application.

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