Objective To investigate the efficacy of mifepristone with or without tamoxifen in the treatment of leiomyomas. Methods 173 symptomatic patients with leiomyomas were divided into 2 groups randomly. Group A (88cases) received mifepristone 25mg per day;Group B(85 cases) received mifepristone per day combined with tamoxifen l0mg twice a day from the first day of menstrul cycle for three months. Leiomyoma and uterine size were measured by B ultrasound, the changes of endometrium were examined pathologically. Estrogen and progesterone levels, hemoglobin and liver renal function were all measured, meanwhile, adverse effects of drugs were assessed. Results All the patients in the 2 groups were amenorrhea with increased hemoglobin, the level of estrogen and progesterone remained in the early stage of proliferation phase. The uterus and leiomyoma sizes in two groups both reduced, but those in group B reduced less significantly(P＜0.01). Adverse effects showed similarity and needed no special control. Conclusions Both mifepristone and mifepristone combined with tamoxifen show good efficacy in the treatment of leiomyoma, but mifepristone combined with tamoxifen is more suitable.%目的探讨米非司酮配伍或不配伍三苯氧胺治疗子宫肌瘤的临床效果。方法将绝经前有症状的子宫肌瘤患者173例随机分成两组，A组：米非司酮组，88例，每天口服米非司酮25mg；B组：米非司酮配伍三苯氧胺组，85例，每天口服米非司酮25mg，同时口服三苯氧胺10mg，每日两次，从月经周期第一天开始，连服3个月。在治疗前后B超测量子宫体积、肌瘤体积；行子宫内膜病检观察子宫内膜变化；检测雌、孕激素水平，血红蛋白，肝肾功能，观察服药后的副反应。结果两组患者治疗期间均闭经，子宫内膜及雌孕激素水平维持于增殖早期，血红蛋白上升。两组治疗后子宫体积、最大肌瘤的平均体积缩小。治疗后两组之间差异有显著性(P＜0.01)，B组子宫和最大肌瘤的体积缩小较小。两组副反应类似且无需特殊处理。结论米非司酮配伍或不配伍三苯氧胺治疗子宫肌瘤均有较好的临床效果，米非司酮配伍三苯氧胺是更合理的方法。
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