目的 探討桂枝茯苓膠囊聯(lián)合孕三烯酮治療子宮腺肌癥的臨床效果。方法 選取2012年6月-2016年6月在鶴壁京立醫(yī)院就診的126例子宮腺肌癥患者，隨機(jī)分為對照組和治療組，每組各63例，對照組患者口服孕三烯酮膠囊，月經(jīng)第1天和第5天各1片，以后2次/周，2.5 mg/次，且服藥時(shí)間一致。治療組患者在對照組的基礎(chǔ)上口服桂枝茯苓膠囊，3粒/次，3次/d。兩組患者均持續(xù)治療6個(gè)月。觀察治療后兩組患者的臨床效果，比較分析患者治療前后兩組患者子宮體積、痛經(jīng)評級、月經(jīng)量變化指標(biāo)以及血清CA125和血管內(nèi)皮生長因子（VEGF）水平。結(jié)果 治療后，對照組和治療組的總有效率分別為66.67%、88.89%，兩組患者臨床總有效率比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者痛經(jīng)評級，子宮體積，月經(jīng)量PBAC評分均比治療前顯著下降，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組患者這些指標(biāo)要顯著優(yōu)于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者血清CA125、VEGF水平均顯著下降（P<0.05），且治療后治療組患者血清CA125、VEGF水平顯著低于對照組（P<0.05）。治療過程中，對照組患者不良反應(yīng)發(fā)生率為31.75%，顯著高于治療組的14.29%，兩組不良反應(yīng)發(fā)生情況比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 桂枝茯苓膠囊聯(lián)合孕三烯酮治療子宮腺肌癥臨床效果較好，可明顯改善患者臨床癥狀，降低血清免疫學(xué)參數(shù)，且不良反應(yīng)較少，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Guizhi Fuling Capsules combined with gestrinone in treatment of adenomyosis. Methods Patients (126 cases) with adenomyosis in Hebi Jingli Hospital from June 2012 to June 2016 were randomly divided into control and treatment groups, and each group had 63 cases. Patients in the control group were po administered with Gestrinone Capsules, each tablet on day 1 and 5 of menstruation, then twice every week, 2.5 mg/time, and kept medication time consistent. Patients in the treatment group were po administered with Guizhi Fuling Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacy was evaluated, and the uterine volume, dysmenorrhea grade, menstrual volume, serum CA125 and VEGF level in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 66.67% and 88.89%, respectively, and there was difference between two groups (P < 0.05). After treatment, the dysmenorrhea grade, uterine volume, and menstrual volume PBAC score in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And these indicators in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the CA125 and VEGF level in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). During the treatment, the adverse reaction rate in the control group was 31.75%, which was significantly higher than that (14.29%) in the treatment group, with significant difference between two groups (P < 0.05). Conclusion Guizhi Fuling Capsules combined with gestrinone has good clinical effects in treatment of adenomyosis, can significantly improve the clinical symptoms and decrease serum immunological parameters with less adverse reactions, which has a certain clinical application value.