探讨子宫动脉栓塞(UAE)联合药物(宫瘤消胶囊)治疗子宫肌瘤(UM)的临床疗效。

选择2012年3月至2013年4月于内蒙古自治区赤峰市医院诊断为UM的40例患者为研究对象。按照UM患者接受的治疗方式，将其分为研究组(n＝20，UAE联合宫瘤消胶囊治疗)与对照组(n＝20，单纯UAE治疗)。观察两组患者治疗后不良反应发生情况，以及治疗前与治疗后3、6、12个月时的月经情况(月经周期、月经期)及UM体积，并对上述指标进行统计学分析。两组患者年龄、体重、产次、孕次及治疗前月经周期、月经期、UM体积等一般临床资料比较，差异均无统计学意义(P>0.05)。

①不良反应率比较：治疗后，研究组患者下腹部疼痛率为5.0%(1/20)，显著低于对照组的35.0%(7/20)，并且差异有统计学意义(χ²＝5.625，P＝0.018)；两组患者发热、恶心呕吐、肢体乏力及阴道不规则出血等不良反应率比较，差异均无统计学意义(P>0.05)。②月经周期比较：两组患者月经周期的组间×时间因素比较，无交互效应，差异无统计学意义(F_{组间×时间}＝0.593，P＝0.555)，而且治疗前、后，月经周期的时间与组间因素分别比较，差异亦均无统计学意义(F_时间＝0.103，P＝0.902；F_组间＝0.057，P＝0.813)。月经期比较：两组患者月经期的组间×时间因素比较，存在交互效应，差异有统计学意义(F_{组间×时间}＝3.982，P＝0.022)，而且治疗前、后，月经期的时间与组间因素分别比较，差异亦均有统计学意义(F_时间＝138.216，P＝0.000；F_组间＝4.179，P＝0.048)；两组治疗后3、6及12个月时，组内分别与治疗前比较，均显著缩短，并且差异均有统计学意义(研究组：t＝4.155，P＝0.001；t＝7.559，P＝0.000；t＝8.340，P＝0.000；对照组：t＝3.075，P＝0.006；t＝6.155，P＝0.000；t＝6.373，P＝0.000)；治疗前及治疗后3个月时，两组组间比较，差异均无统计学意义(t＝0.285，P＝0.777；t＝1.874，P＝0.069)；而治疗后6及12个月时，研究组较对照组均缩短，差异均有统计学意义(t＝3.079，P＝0.004；t＝2.539，P＝0.015)，并且随着时间增加，研究组缩短程度高于对照组。③UM体积比较：两组患者UM体积的组间×时间因素比较，存在交互效应，差异有统计学意义(F_{组间×时间}＝7.853，P＝0.001)，而且治疗前、后，UM体积的时间与组间因素分别比较，差异均有统计学意义(F_时间＝494.861，P＝0.000；F_组间＝6.971，P＝0.012)；治疗前两组比较，差异无统计学意义(t＝0.032，P＝0.975)；治疗后3、6及12个月时，研究组均显著小于对照组，差异均有统计学意义(t＝2.780，P＝0.008；t＝5.627，P＝0.000；t＝2.900，P＝0.006)；治疗后3、6及12个月时，两组均分别较治疗前显著缩小，差异均有统计学意义(研究组：t＝7.982，P＝0.000；t＝13.617，P＝0.000；t＝17.889，P＝0.000；对照组：t＝4.962，P＝0.000；t＝8.482，P＝0.000；t＝15.178，P＝0.000)。

UAE联合宫瘤消胶囊治疗UM，可改善UM患者月经情况，使UM体积显著缩小，并可有效缓解UAE治疗导致的下腹部疼痛，提高UAE治疗UM的疗效。因本研究纳入样本量较小，UAE联合宫瘤消胶囊治疗UM的疗效，仍有待大样本、多中心随机对照试验研究证实。

To explore the therapeutic effects of uterine artery embolization (UAE) combined with drug therapy in treatment of uterus myoma (UM).

From March 2012 to April 2013, a total of 40 cases of patients who were diagnosed as UM in Inner Mongolia Autonomous Region Chifeng Municipal Hospital and received treatments were selected into this study as research subjects. According to the treatment methods UM patients received, they were divided into study group (n=20, received UAE combined with uterine tumor eliminator capsule treatment) and control group (n=20, received UAE treatment alone). Adverse reactions after treatment and menstruation (menstrual cycle and period) and UM volume before treatment and 3, 6, 12 months after treatment of two groups were observed and were analyzed by statistical methods. There were no statistical differences between two groups among age, body weight, parity, gravidity, menstrual cycle and menstrual period and UM volume before treatment and so on (P>0.05).

①After treatment, the incidence of hypogastrium pain in study group was 5.0% (1/20) which was significantly lower than 35.0% (7/20) in control group, and the difference was statistically significant (χ²=5.625, P=0.018). While there were no statistical differences between two groups among the incidences of fever, nausea and vomiting, limb weakness and irregular vaginal bleeding (P>0.05). ②There was no interaction effect between group and time factor in menstrual cycles, and the difference was not statistically significant (F_group×time=0.593, P=0.555). There were no statistical differences among the menstrual cycles before and after treatment at different times (F_time=0.103, P=0.902) and between two groups (F_group=0.057, P=0.813). There was interaction effect between group and time factor in menstrual period, and the difference was statistically significant (F_group×time=3.982, P=0.022). There were statistical differences among the menstrual periods before and after treatment at different times (F_time=138.216, P=0.000) and between two groups (F_group=4.179, P=0.048). And 3, 6, and 12 months after treatment, the menstrual periods in two groups all were shorter than before treatment, and all the differences were statistically significant (study group: t=4.155, P=0.001; t=7.559, P=0.000; t=8.340, P=0.000; control group: t=3.075, P=0.006; t=6.155, P=0.000; t=6.373, P=0.000). Before treatment and 3 months after treatment, there were no statistical differences between two groups in menstrual periods (t=0.285, P=0.777; t=1.874, P=0.069), but 6 and 12 months after treatment, the menstrual periods in study group both were shorter than those in control group, and both the differences were statistically significant (t=3.079, P=0.004; t=2.539, P=0.015). As time increased, the menstrual period in study group shortened even higher than that in control group. ③There was interaction effect between group and time factor in UM volume, and the difference was statistically significant (F_group×time=7.853, P=0.001). There were statistical differences among the UM volume before and after treatment at different times (F_time=494.861, P=0.000) and between two groups (F_group=6.971, P=0.012). Before treatment, there was no statistical difference between two groups in UM volume (t=0.032, P=0.975), while 3, 6 and 12 months after treatment, the UM volumes in study group all were smaller than those in control group, and all the differences were statistically significant (t=2.780, P=0.008; t=5.627, P=0.000; t=2.900, P=0.006). And 3, 6, and 12 months after treatment, the UM volumes in two groups all were smaller than before treatment, and all the differences were statistically significant (study group: t=7.982, P=0.000; t=13.617, P=0.000; t=17.889, P=0.000; control group: t=4.962, P=0.000; t=8.482, P=0.000; t=15.178, P=0.000).

UAE combined with uterine tumor eliminator capsule in treatment of UM can improve the menstruation of UM patients and reduce the volume of UM, and can effectively relieve hypogastrium pain caused by UAE, and then strengthen the therapeutic effects of UAE in treatment of UM. As the sample size in this study is small, the therapeutic effects of UAE combined with uterine tumor eliminator capsule in treatment of UM still remains to be confirmed by multicenter, large sample randomized controlled trials.