摘要
目的:分析月经周期阶段性中药方剂在子宫内膜异位(EMs)不孕症患者中的应用效果,为EMs不孕症患者的临床治疗提供参考。方法:选取2014年3月至2016年7月在杭州市中医院诊断且符合纳入标准的74例EMs不孕症患者为研究对象,采用随机数字表法将其分为观察组和对照组。对照组患者采用地屈孕酮片治疗,观察组患者在对照组基础上加用月经周期阶段性中药方剂治疗,比较两组患者的临床疗效、免疫功能、卵巢功能及妊娠结局。结果:观察组患者的临床治疗总有效率显著高于对照组(P<0.05)。治疗前,两组患者的CD~+_3、CD~+_4、CD~+_4/CD~+_8、自然杀伤细胞(NK)、雌二醇(E_2)及抗苗勒管激素(AMH)水平比较均无统计学差异(P>0.05);治疗后,两组患者的CD~+_3、CD~+_4、CD~+_4/CD~+_8、NK、E_2及AMH水平均显著高于治疗前(P<0.05),且观察组高于对照组(P<0.05)。治疗前,两组患者的促黄体生成素(LH)和促卵泡生成激素(FSH)水平比较均无统计学差异(P>0.05);治疗后,两组患者的LH及FSH水平均显著低于治疗前(P<0.05),且观察组低于对照组(P<0.05)。观察组患者的妊娠成功率显著高于对照组(P<0.05)。结论:月经周期阶段性中药方剂可调节EMs不孕患者的免疫功能,改善患者卵巢功能,提高患者妊娠率。
AIM: To investigate the application of menstrual cycle periodic Chinese medicine prescription in endometriosis( EMs) infertility patients,and to provide a reference for the clinical treatment of EMs infertility patients. METHODS: A total of74 infertility patients with EMs from March 2014 to July 2016 who met the inclusion criteria in our hospital were selected,and were randomly divided into observation group( n = 37) and control group( n =37) according to the random number table method.The control group was treated with dydrogesterone tablets,while the observation group was treated with menstrual cycle periodic Chinese medicine prescription based on the control group. The clinical effect,immune function,ovarian function and pregnancy outcome were compared between the two groups.RESULTS: The total effective rate of clinical treatment in observation group was significantly higher than that of control group( P < 0. 05). Before treatment,there were no significantly differences in the level of CD~+_3, CD~+_4, CD~+_4/CD~+_8, natural kille( NK),estradiol 2( E_2) and anti-mullerian hormone( AMH) between the two groups( P > 0. 05).After treatment,the level of CD~+_3,CD~+_4,CD~+_4/CD~+_8,NK E_2 and AMH were significantly better than those of before treatment( P < 0. 05),and the observation group was significantly better than the control group( P < 0. 05). Before treatment,there were no significantly differences in the level of luteinizing hormone( LH) and follicle-stimulating hormone( FSH) between the two groups( P > 0. 05).After treatment,the level of LH and FSH were significantly lower than those of before treatment( P <0. 05),and the observation group was significantly lower than the control group( P < 0. 05). The success rate of pregnancy in observation group was significantly higher than that of control group( P <0. 05). CONCLUSION: The menstrual cycle periodic Chinese medicine prescription can adjust the immune function,improve the ovarian function,and increase the pregnancy rate of the EMs infertile patients.
引文
[1]于月新,李亚里.子宫内膜异位症中转化生长因子-β作用机制及临床意义的研究进展[J].解放军医学院学报,2016,37(11):1197-1199.
[2]刘瑞景,蔡海燕.子宫内膜异位症发病机制及其治疗分类研究[J].中国医学创新,2017,14(6):145-148.
[3]杨如萌,张轶清.子宫内膜异位症的研究进展[J].湖北科技学报(医学版),2016,30(1):89-91.
[4]吴秀芳,陈琛,王迎.子宫内膜异位症生育指数对内异症合并不孕患者术后妊娠的指导价值[J].现代仪器与医疗,2017,23(5):96-97.
[5]孙彦,车艳辞.腹腔镜手术联合药物治疗子宫内膜异位症临床效果的Meta分析[J].现代妇产科进展,2015,24(1):37-39.
[6]张少萍.子宫内膜异位症的中医中药治疗[J].内蒙古中医药,2015,34(1):43-44.
[7]中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症诊断与治疗规范[J].中华妇产科杂志,2007,42(9):645-648.
[8]李萌,夏天,王宝娟.不同治疗方案对子宫内膜异位症合并不孕患者生育影响的研究进展[J].生殖与避孕,2015,35(7):478-483.
[9]蔡婷,姜锐.腹腔镜术后辅以散结镇痛汤治疗子宫内膜异位症合并不孕临床研究[J].中医药信息,2017,34(1):104-106.
[10]马遇春,孙博,丛慧芳.子宫内膜异位症中医内治法研究进展[J].医学综述,2015,21(11):2036-2038.
[11]李杏杏,万贵平.中药治疗子宫内膜异位症作用机制的研究进展[J].现代中西医结合杂志,2015,24(2):210-213.
[12]赵瑞华,唐仪.子宫内膜异位症相关不孕症中医治疗经验[J].北京中医药,2015,34(4):288-290.
[13]陈建梅,刘姣,秦翠梅,等.莪术水煎液、配方颗粒及莪术油抗痛经作用的比较研究[J].中药药理与临床,2016,32(4):60-63.
[14]赵永见,牛凯,唐德志,等.桃仁药理作用研究近况[J].辽宁中医杂志,2015,42(4):888-890.
[15]侯新新,王晓秋,李大金.不同T细胞亚群及与其他免疫细胞协同作用参与子宫内膜异位病灶的形成和发展[J].现代免疫学,2016,36(4):333-336.
[16]李岩.白芍及其化学成分的药理研究进展[J].职业与健康,2015,31(15):2153-2156.
[17]孙秀玲,姜明霞.黄芪药理作用机制的研究进展[J].中医临床研究,2015,7(17):140-141.
[18]孙森凤,张颖颖,褚万春.黄柏药理作用的研究进展[J].山东化工,2017,46(14):99-100.
[19]张晓芳,张宜群.滋阴补阳中药对子宫内膜异位症合并不孕患者血清性激素水平与妊娠结局的影响研究[J].中国性科学,2016,25(4):129-132.
[20]赵文静,王历,王芝兰,等.淫羊藿的药理作用及临床应用研究进展[J].中医药信息,2016,33(2):105-108.
[21]何恩惠.续断的药理分析与中药配伍[J].世界最新医学信息文摘,2015,15(66):251.
