Clinical Observation Of Ruanjian Sanjie Capsule Combined With High Intensity Focused Ultrasound In The Treatment Of Myoma Of Phlegm And Stasis Syndrome

Objective: There are about 65 million patients with uterine fibroids in China.The annual direct medical cost of surgical treatment is 40 billion yuan,and the indirect health and economic burden to the society is up to 100 billion yuan.This leads to the loss of about 1 million quality-adjusted life year each year in our country,So it is imperative to find a better method for the treatment of uterine fibroids.High intensity focused ultrasound thermal ablation(HIFU)is the most nearly non-invasive treatment technology developed currently,which is widely used in the treatment of all kinds of benign and malignant solid tumors such as myoma of uterus,adenomyosis of uterus,liver cancer,kidney cancer and so on.Ruanjian Sanjie capsule made by Shanxi Provincial Hospital of traditional Chinese Medicine has the effect of promoting blood circulation for removing blood stasis and softening the knot,which is used for the treatment of various tumors,sputum,scrofula,nuclear galls and the curative effect is remarkable.The purpose of this study is to observe the curative effect of Ruijian Sanjie capsule combined with high intensity focused ultrasound thermal ablation in the treatment of uterine fibroids,and the improvement of postoperative clinical symptoms,and to provide more effective treatment for the treatment of uterine myoma.Methods: The subject investigated were hysteromyoma patients who were diagnosed in the oncology department from September 2015 to October 2017.The patients are in accordance with the diagnostic criteria of uterine fibroids and standard of syndrome differentiation of phlegm and blood stasis syndrome,and screening the research objects in strict accordance with the inclusion criteria and the exclusion criteria.A total of 80 people were randomly divided into two groups: the treatment group and the control group.A total of 40 patients in the treatment group were treated by Ruijian Sanjie capsule combined with HIFU.The patients in the treatment group began to take the Ruijian Sanjie capsule on the first day after the operation of HIFU,three times a day,4 grains each time,until 3 months after the operation.The other 40 patients in the control group were treated with HIFU.The pelvic enhanced MRI was examined 1 days before operation,1 days after operation,1 months after operation,and 3 months after operation.The volume of uterine fibroids and postoperative fibroids without perfusion volume were measured by magnetic resonance images.Then the ablation rate(postoperative myoma ablation volume / preoperative myoma volume 100%)and the reduction rate of postoperative myoma volume [volume reduction rate =(preoperative myoma volume-postoperative myoma volume)/ preoperative myoma volume x 100% ]were calculated.The Improvement of clinical symptoms such as abnormal menstruation,dysmenorrhea,anemia and other clinical symptoms were recorded.According to the TCM syndrome score and the reduction of myoma,the curative effect was evaluated.Result: 1.Before and after treatment,the volume of uterine myoma in the two groups was significantly reduced,and the difference was statistically significant.The reduction rate of uterine myoma in the treatment group(1 months after operation and 3 months after operation)was significantly higher than the control group,and the difference was statistically significant.2.In terms of TCM syndrome score,there was no significant difference between the two groups before treatment.After three months,the TCM syndrome score of the treatment group was significantly reduced compared with the control group,and the difference between the two groups was statistically significant.3.In patients with clinical symptoms,the main manifestations are abnormal menstruation,dysmenorrhea,anemia.The treatment group and the control group had similar rates of clinical symptoms.After treatment for three months,the clinical symptoms of the treatment group were significantly improved,and the remission rate of clinical symptoms was significantly higher than the control group.The difference was statistically significant.The mechanism is related to the Ruijian Sanjie capsule which has the effect of promoting blood circulation for removing blood stasis and softening the knot.Conclusion:When HIFU is used to treat uterine fibroids,it is not completely ablation of the myoma because of the need to avoid the thin wall of the uterus after the operation.And the remaining part of the myoma still needs adjuvant therapy by drugs.Ruijian Sanjie capsule combined with HIFU has a definite curative effect on phlegm and blood stasis syndrome type of uterine fibroids.Compared with the simple HIFU treatment,it has obvious improvement in reducing the clinical symptoms,promoting postoperative recovery and promoting the liquefaction and absorption of necrotic tissue.It can provide a more effective treatment for the treatment of uterine fibroids.