散结镇痛胶囊辅助腹腔镜手术治疗子宫内膜异位症合并的疗效及对妊娠结局的影响
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摘要
目的:探究散结镇痛胶囊辅助腹腔镜手术治疗子宫内膜异位症(EMS)合并不孕的疗效及对妊娠结局的影响。方法:选取2016年1月至2018年12月六安市人民医院收治的EMS合并不育患者72例作为研究对象,随机分为对照组与观察组,每组36例。所有患者均给予腹腔镜保守性手术以及常规米非司酮治疗,观察组则在此基础上加用散结镇痛胶囊,2组患者均于术后连续治疗90 d。随访1年。观测并比较2组患者的血清癌抗原125(CA_(125))、血管内皮生长因子(VEGF)和前列腺素F2α(PGF_(2α))水平、血常规指标、血流动力学指标以及妊娠率。结果:治疗前,2组患者的血清癌抗原125(CA_(125))、VEGF、PGF_(2α)、红细胞计数(RBC)、血红蛋白(Hb)、血小板计数(PLT)、搏动指数(PI)和阻力指数(RI)水平差异均无统计学意义(P> 0. 05);治疗后,2组患者的CA_(125)、VEGF、PGF_(2α)水平以及左右侧PI、RI水平均降低,且观察组的CA_(125)、VEGF、PGF_(2α)水平以及左右侧PI、RI水平均低于对照组(P <0. 05)。治疗后,2组患者的RBC、Hb、PLT水平均增加,且观察组的RBC、Hb、PLT水平均高于对照组,差异有统计学意义(P <0. 05)。观察组患者在治疗结束后3个月、12个月的妊娠率均高于对照组,差异有统计学意义(P <0. 05)。结论:结镇痛胶囊辅助腹腔镜手术治疗EMS合并不孕患者具有良好的临床疗效,可显著降低其CA_(125)、VEGF和PGF_(2α)水平,改善患者的血流动力学,提高妊娠率。
Objective: To explore the effects of Sanjie Zhentong capsule assisted laparoscopic surgery for in the treatment of endometriosis( EMS) complicated with infertility and its impact on pregnancy outcome. Methods: A total of 72 patients with EMS complicated with infertility who were treated in gynecology department of Lu'an People's Hospital from January 2016 to December 2018 were randomly divided into the control group( 36 cases) and the observation group( 36 cases). All patients were given laparoscopic conservative surgery and conventional mifepristone treatment. On this basis,the observation group was given Sanjie Zhentong capsule. Both groups were treated continuously for 90 days after operation. The follow-up period was 1 year. The levels of serum cancer antigen 125( CA125),VEGF and prostaglandin F2 alpha( PGF2),blood conventional parameters,hemodynamic parameters and pregnancy rate were observed and compared between the 2 groups. Results: Before treatment,the levels of serum CA125,VEGF,PGF2,erythrocyte count( RBC),hemoglobin( Hb),platelet( PLT),motility index( PI) and resistance index( RI) were not significantly different between the 2 groups( P > 0. 05). After treatment,the levels of CA125,VEGF,PGF2 and PI and RI in both groups decreased. The levels of CA125,VEGF,PGF2,PI and RI in the observation group were lower than those in the control group( P <0. 05). After treatment,the levels of RBC,Hb and PLT increased in both groups,and the levels of RBC,Hb and PLT in the observation group were higher than those in the control group( P < 0. 05). The pregnancy rate in the observation group was higher than that in the control group at 3 months and 12 months after treatment( P < 0. 05). Conclusion: Sanjie Zhentong capsule assisted laparoscopic surgery has good clinical efficacy in treating EMS patients complicated with infertility. It can significantly reduce the levels of CA125,VEGF and PGF2,improve the hemodynamics of patients,and increase the pregnancy rate. It is worthy of clinical promotion and application.
Objective: To explore the effects of Sanjie Zhentong capsule assisted laparoscopic surgery for in the treatment of endometriosis( EMS) complicated with infertility and its impact on pregnancy outcome. Methods: A total of 72 patients with EMS complicated with infertility who were treated in gynecology department of Lu'an People's Hospital from January 2016 to December 2018 were randomly divided into the control group( 36 cases) and the observation group( 36 cases). All patients were given laparoscopic conservative surgery and conventional mifepristone treatment. On this basis,the observation group was given Sanjie Zhentong capsule. Both groups were treated continuously for 90 days after operation. The follow-up period was 1 year. The levels of serum cancer antigen 125( CA125),VEGF and prostaglandin F2 alpha( PGF2),blood conventional parameters,hemodynamic parameters and pregnancy rate were observed and compared between the 2 groups. Results: Before treatment,the levels of serum CA125,VEGF,PGF2,erythrocyte count( RBC),hemoglobin( Hb),platelet( PLT),motility index( PI) and resistance index( RI) were not significantly different between the 2 groups( P > 0. 05). After treatment,the levels of CA125,VEGF,PGF2 and PI and RI in both groups decreased. The levels of CA125,VEGF,PGF2,PI and RI in the observation group were lower than those in the control group( P <0. 05). After treatment,the levels of RBC,Hb and PLT increased in both groups,and the levels of RBC,Hb and PLT in the observation group were higher than those in the control group( P < 0. 05). The pregnancy rate in the observation group was higher than that in the control group at 3 months and 12 months after treatment( P < 0. 05). Conclusion: Sanjie Zhentong capsule assisted laparoscopic surgery has good clinical efficacy in treating EMS patients complicated with infertility. It can significantly reduce the levels of CA125,VEGF and PGF2,improve the hemodynamics of patients,and increase the pregnancy rate. It is worthy of clinical promotion and application.
引文
[1]Gordts S,Koninckx P,Brosens I. Pathogenesis of deep endometriosis[J]. Fertil Steril,2017,108(6):872-885.
[2]Ahn SH,Singh V,Tayade C. Biomarkers in endometriosis:challenges and opportunities[J]. Fertil Steril,2017,107(3):523-532.
[3]梁钧梅,陈燕妮,冉青珍.散结镇痛胶囊治疗气滞血瘀型慢性盆腔疼痛临床观察[J].河北中医,2017,39(12):1797-1800.
[4]张振武,温延丽.子宫内膜异位症合并不孕患者术后妊娠的影响因素分析[J].中国医药导报,2015,12(5):28-31.
[5]许琳,庄雨龙,金哲.子宫内膜异位症(慢性盆腔痛)患者生存质量及影响因素分析[J].天津中医药,2018,35(3):167-169.
[6]卢红,卢蓉,陆月梅,等.腹腔镜下子宫内膜异位症生育指数的生育能力评估的作用[J].湖南师范大学学报:医学版,2015,12(1):45-48.
[7]方明珠,郭华峰,郭宝芝,等.宫腹腔镜治疗子宫内膜异位症合并不孕患者的效果[J].中国妇幼保健,2014,29(19):3106-3108.
[8]张庆霞,李喜英,张蕴霞,等.重度子宫内膜异位症术后使用GnRH-a与孕三烯酮的临床观察[J].实用妇产科杂志,2015,31(2):153-155.
[9]李婧,吕娟,王宇娟,等.腹腔镜下卵巢子宫内膜异位症囊肿剥除术不同止血方法对卵巢储备功能影响的系统评价[J].中国循证医学杂志,2015,15(7):833-839.
[10]徐漾漾,梁惠霞.散结镇痛胶囊联合米非司酮治疗50例子宫内膜异位症[J].药物流行病学杂志,2014,23(10):599-601.
[11]高巍,张莉,翟丽丽,等.散结镇痛胶囊对子宫内膜异位症患者术后血清PGF2α、CA125及子宫动脉血流动力学的影响[J].宁夏医科大学学报,2016,38(7):832-835.
[12]陈晓莉.散结镇痛胶囊联合米非司酮治疗子宫内膜异位症[J].长春中医药大学学报,2016,32(1):141-143.
[13]Dowlut-McElroy T,Strickland JL. Endometriosis in adolescents[J].Curr Opin Obstet Gynecol,2017,29(5):306-309.
[14]杨志琴,白红艳.消癥止痛汤治疗子宫内膜异位症所致痛经56例临床疗效观察[J].四川中医,2018,36(1):149-151.
[15]练鹏颖,刘枚芳,徐景利.桂枝茯苓胶囊联合米非司酮治疗子宫内膜异位症随机对照试验的Meta分析[J].中药新药与临床药理,2016,27(4):564-570.
[2]Ahn SH,Singh V,Tayade C. Biomarkers in endometriosis:challenges and opportunities[J]. Fertil Steril,2017,107(3):523-532.
[3]梁钧梅,陈燕妮,冉青珍.散结镇痛胶囊治疗气滞血瘀型慢性盆腔疼痛临床观察[J].河北中医,2017,39(12):1797-1800.
[4]张振武,温延丽.子宫内膜异位症合并不孕患者术后妊娠的影响因素分析[J].中国医药导报,2015,12(5):28-31.
[5]许琳,庄雨龙,金哲.子宫内膜异位症(慢性盆腔痛)患者生存质量及影响因素分析[J].天津中医药,2018,35(3):167-169.
[6]卢红,卢蓉,陆月梅,等.腹腔镜下子宫内膜异位症生育指数的生育能力评估的作用[J].湖南师范大学学报:医学版,2015,12(1):45-48.
[7]方明珠,郭华峰,郭宝芝,等.宫腹腔镜治疗子宫内膜异位症合并不孕患者的效果[J].中国妇幼保健,2014,29(19):3106-3108.
[8]张庆霞,李喜英,张蕴霞,等.重度子宫内膜异位症术后使用GnRH-a与孕三烯酮的临床观察[J].实用妇产科杂志,2015,31(2):153-155.
[9]李婧,吕娟,王宇娟,等.腹腔镜下卵巢子宫内膜异位症囊肿剥除术不同止血方法对卵巢储备功能影响的系统评价[J].中国循证医学杂志,2015,15(7):833-839.
[10]徐漾漾,梁惠霞.散结镇痛胶囊联合米非司酮治疗50例子宫内膜异位症[J].药物流行病学杂志,2014,23(10):599-601.
[11]高巍,张莉,翟丽丽,等.散结镇痛胶囊对子宫内膜异位症患者术后血清PGF2α、CA125及子宫动脉血流动力学的影响[J].宁夏医科大学学报,2016,38(7):832-835.
[12]陈晓莉.散结镇痛胶囊联合米非司酮治疗子宫内膜异位症[J].长春中医药大学学报,2016,32(1):141-143.
[13]Dowlut-McElroy T,Strickland JL. Endometriosis in adolescents[J].Curr Opin Obstet Gynecol,2017,29(5):306-309.
[14]杨志琴,白红艳.消癥止痛汤治疗子宫内膜异位症所致痛经56例临床疗效观察[J].四川中医,2018,36(1):149-151.
[15]练鹏颖,刘枚芳,徐景利.桂枝茯苓胶囊联合米非司酮治疗子宫内膜异位症随机对照试验的Meta分析[J].中药新药与临床药理,2016,27(4):564-570.