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曲普瑞林联合鳖甲煎丸治疗子宫腺肌病的临床观察
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| 篇名： | 曲普瑞林联合鳖甲煎丸治疗子宫腺肌病的临床观察 |
| TITLE： | Clinical observation of triptorelin combined with Biejiajian pill in the treatment of adenomyosis |
| 摘要： | 目的 探讨曲普瑞林联合鳖甲煎丸治疗子宫腺肌病（AM）患者的临床效果。方法选择2022年1月至2024年10月南阳市第一人民医院收治的186例AM患者，按照随机数字表法分为对照组（93例）和观察组（93例）。对照组患者于脐周皮下注射醋酸曲普瑞林；观察组患者在对照组治疗的基础上口服鳖甲煎丸。两组患者均治疗12周，治疗后随访6个月。比较两组患者的临床疗效、复发、不良反应情况，以及治疗前后的中医证候积分、子宫内膜容受性（子宫内膜厚度、子宫体积、子宫内膜阻力指数和子宫内膜血管指数）、实验室检查指标（黄体生成素、卵泡刺激素、雌二醇、糖类抗原125、胰岛素样生长因子1、基质金属蛋白酶9）水平。结果共有164例患者完成治疗和随访，其中对照组有80例，观察组有84例。观察组患者的总有效率显著高于对照组，低雌激素发生率、复发率均显著低于对照组（P＜0.05）；两组患者恶心、肝肾功能异常的发生率比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者的疼痛视觉模拟评分、月经失血图评分、中医证候积分、子宫内膜厚度、子宫体积、子宫内膜阻力指数、实验室检查指标均显著低于同组治疗前（P＜0.05），且观察组显著低于对照组（卵泡刺激素除外）（P＜0.05）；子宫内膜血管指数显著高于同组治疗前，且观察组显著高于对照组（P＜0.05）。结论曲普瑞林联合鳖甲煎丸治疗AM的疗效显著，可有效改善患者的痛经程度、月经量和子宫内膜容受性，降低复发率，且安全性良好。 |
| ABSTRACT： | OBJECTIVE To investigate the clinical effectiveness of triptorelin combined with Biejiajian pill in the treatment of adenomyosis （AM）. METHODS Totally 186 patients with AM admitted to Nanyang First People’s Hospital from January 2022 to October 2024 were selected as subjects and randomized into control group （n＝93） and observation group （n＝93） using the random number table method. Patients in the control group received subcutaneous injections of triptorelin acetate around the umbilicus. In addition to the treatment of control group， patients in the observation group orally administered Biejiajian pill. Both groups underwent treatment for 12 weeks and were followed up for 6 months post-treatment. The clinical efficacy， recurrence and the occurrence of adverse drug reactions were compared between the two groups. Traditional Chinese medicine （TCM） symptoms， endometrial receptivity indicators （endometrial thickness， uterine volume， endometrial resistance index and vascular index）， laboratory indexes （serum luteinizing hormone， follicle stimulating hormone， estradiol， carbohydrate antigen 125， insulin-like growth factor-1， and matrix metalloproteinase 9） were compared between the two groups before and after treatment. RESULTS A total of 164 patients completed the treatment and follow-up， among whom 80 cases were in control group and 84 cases in the observation group. The overall effective rate in the observation group was significantly higher than that in the control group， while the incidence of low estrogen levels and recurrence rate were significantly lower in the observation group compared to the control group （P＜0.05）. There were no statistically significant differences in the incidence of nausea or abnormal liver and kidney function between the two groups （P＞0.05）. After treatment， the pain Visual Analogue Scale scores， Pictorial Blood Loss Assessment Chart， TCM symptoms scores， endometrial thickness， uterine volume， endometrial resistance index， and laboratory indicators in both groups were significantly lower than those before treatment within the same group （P＜0.05）. Moreover， these values were significantly lower in the observation group compared to the control group （except for follicle stimulating hormone） （P＜0.05）. The endometrial vascular index of the two groups was significantly higher than that in the same group before treatment， and the observation group was significantly higher than the control group （P＜0.05）. CONCLUSIONS Triptorelin combined with Biejiajian pill has a definite therapeutic effect on AM， which can effectively improve the degree of dysmenorrhea and menstrual flow， improve endometrial receptivity， lower the recurrence rate in patients， and demonstrate good safety. |
| 期刊： | 2026年第37卷第03期 |
| 作者： | 王秀萍；乔献伟；徐冰 |
| AUTHORS： | WANG Xiuping，QIAO Xianwei，XU Bing |
| 关键字： | 子宫腺肌病；曲普瑞林；鳖甲煎丸；疗效；子宫内膜容受性；复发 |
| KEYWORDS： | adenomyosis； triptorelin； Biejiajian pill； therapeutic effect； endometrial receptivity； recurrence |
| 阅读数： | 6 次 |
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