高强度聚焦超声消融治疗（HIFU术）联合补肾活血方治疗子宫腺肌病的临床研究

摘要 目的：探讨高强度聚焦超声消融治疗（HIFU术）联合补肾活血方治疗子宫腺肌病的临床疗效。方法：选取我院2020年3月到2023年3月收治的100例子宫腺肌病患者作为研究对象，应用随机数字表法将其分为观察组与对照组，每组50例。对照组患者采取HIFU术治疗，观察组患者采取HIFU术联合补肾活血方治疗，对比两组患者临床疗效，治疗前后中医证候积分，对比手术前、手术后3个月、6个月的糖类抗原CA125及血红蛋白水平变化，并在治疗3个月后和治疗6个月应用子宫体积、痛经评分、经量评分评价患者远期预后情况。结果：两组临床疗效比较无差异（P>0.05）；治疗前两组患者腰膝酸软、经期腰骶痛、经期腹痛相关中医证候积分对比无明显差异（P＞0.05），治疗后两组患者腰膝酸软、经期腰骶痛、经期腹痛相关中医证候积分均降低，且观察组低于对照组（P＜0.05）；手术两组患者糖类抗原CA125、Hb水平对比无明显差异（P＞0.05），术后3个月、6个月两组患者糖类抗原CA125水平降低，观察组低于对照组，Hb水平升高，观察组高于对照组（P＜0.05）；观察组治疗后3个月的子宫体积、痛经评分、经量评分明显低于对照组（P＜0.05），且治疗6个月后两组患者子宫体积、痛经评分、经量评分均降低，观察组低于对照组（P＜0.05）。结论：对子宫腺肌病患者应用高强度聚焦超声消融术联合补肾活血方治疗可提升其临床治疗效果，减轻患者临床症状，改善患者糖类抗原CA125表达水平，减轻贫血情况，且远期疗效较好，能够进一步改善患者子宫体积、疼痛程度和月经量，值得临床应用推广。

Clinical Study on High Intensity Focused Ultrasound Ablation Therapy (HIFU) Combined with Kidney Tonifying and Blood Activating Formula for the Treatment of Adenomyosis

ABSTRACT Objective: To explore the clinical efficacy of high intensity focused ultrasound ablation (HIFU) combined with kidney tonifying and blood activating formula in the treatment of adenomyosis. Methods: 100 patients with adenomyosis admitted to our hospital from March 2020 to March 2023 were selected as study subjects, and they were divided into observation group and control group by applying the random number table method, with 50 cases in each group. Patients in the control group were treated with HIFU surgery, and patients in the observation group were treated with HIFU surgery combined with the formula of tonifying kidney and activating blood, and the clinical efficacy of patients in both groups were compared, and the Chinese medicine evidence score was compared before and after treatment, and the changes of glycogen antigen CA125 and hemoglobin level were compared before surgery, 3 months and 6 months after surgery, and the lesion volume, dysmenorrhea score, and uterine volume score were applied after 3 months and 6 months of treatment to evaluate patients'' Long-term prognosis. Results: There was no difference in clinical efficacy between the two groups (P>0.05); Pretherapy, there was no significant difference in the scores of traditional Chinese medicine syndromes related to low back and knee soreness, menstrual lumbosacral pain, and menstrual abdominal pain between the two groups of patients (P>0.05). Post-treatment, the scores of traditional Chinese medicine syndromes related to low back and knee soreness, menstrual lumbosacral pain, and menstrual abdominal pain decreased in both groups of patients, and the observation group was lower than the control group (P<0.05); There was no significant difference in the comparison of glycoantigen CA125 and Hb levels among the two groups of patients before surgery(P>0.05). 3 months and 6 months after surgery, the level of glycoantigen CA125 decreased in the two groups and was lower in the observation group than in the control group, and the level of Hb increased in the observation group than in the control group(P<0.05); The long-term prognosis of the two groups of patients was determined by uterine volume, dysmenorrhea score, and menstrual volume score. The uterine volume, dysmenorrhea score and menstrual volume score of the observation group were significantly lower than those of the control group 3 months after treatment(P<0.05), and the uterine volume, dysmenorrhea score and menstrual volume score of both groups decreased after 6 months of treatment, with the observation group being lower than the control group(P<0.05). Conclusion: The application of high-intensity focused ultrasound ablation combined with the formula of tonifying the kidney and activating the blood in patients with adenomyosis can improve their clinical treatment effect, reduce their clinical symptoms, improve the expression level of glycoantigen CA125, reduce anemia, and have better long-term efficacy, which can further improve the uterine volume, pain level and menstrual flow of patients, and is worthy of clinical application and promotion.