少腹逐瘀颗粒联合甲羟孕酮治疗子宫内膜异位症的临床研究
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摘要
目的探讨少腹逐瘀颗粒联合醋酸甲羟孕酮片治疗子宫内膜异位症的临床效果。方法选取2015年2月—2016年6月绵阳市中心医院收治的子宫内膜异位症患者98例作为研究对象,所有患者随机分为对照组和治疗组,每组各49例。对照组患者口服醋酸甲羟孕酮片,1片/次,1次/d。治疗组在对照组治疗的基础上口服少腹逐瘀颗粒,1袋/次,3次/d。两组均连续治疗6个月。评估两组患者的临床疗效,同时比较两组患者的盆腔包块大小、VAS评分、糖类抗原125(CA125)、雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)、超敏C反应蛋白(hs-CRP)白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、复发率和痛觉发生情况。结果治疗后,治疗组的总有效率为93.9%,显著高于对照组的73.5%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者盆腔包块大小、VAS评分和CA125均较治疗前均显著下降,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组盆腔包块大小、VAS评分和CA125显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者E2水平较治疗前均显著下降,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组E2水平明显低于对照组,两组间比较差异具有统计学意义(P<0.05)。治疗后,两组患者hs-CRP、IL-6和TNF-α水平较治疗前均显著下降,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组炎症指标水平明显低于对照组,两组比较差异具有统计学意义(P<0.05)。随访1年后,治疗组患者复发率明显低于对照组(P<0.05),且痛觉人数明显少于对照组(P<0.05)。结论少腹逐瘀颗粒联合醋酸甲羟孕酮片治疗子宫内膜异位症具有较好的临床疗效,有助于缓解患者临床症状、降低机体炎症反应、降低复发率,且安全性高,具有一定的临床推广价值。
Objective To investigate the clinical effect of Shaofu Zhuyu Granules combined with Medroxyprogesterone Acetate Tablets in treatment of endometriosis. Methods Patients(98 cases) with endometriosis in Mianyang Central Hospital from February 2015 to June 2016 were randomly divided into control and treatment groups, and each group had 49 cases. Patients in the control group were po administered with Medroxyprogesterone Acetate Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Shaofu Zhuyu Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 6 month. After treatment, the clinical efficacies were evaluated, and the pelvic mass size, VAS, CA125, E2, FSH, LH, hs-CRP, IL-6, TNF-α, recurrence rate, and the occurrence of pain in two groups were compared. Results After treatment, the clinical efficacy in the treatment group was 93.9%, which was significantly higher than 73.5% in the control group, and there were differences between two groups(P < 0.05). After treatment, the pelvic mass size, VAS, and CA125 in two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, the pelvic mass size, VAS scores, and CA125 levels in the treatment group were lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, the E2 level in two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, the E2 levels in the treatment group were lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, the levels of hs-CRP, IL-6, and TNF-α in two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, the serum Inflammatory index levels in the treatment group were lower than those in the control group, and there were differences between two groups(P < 0.05). After 1 year of follow-up, the recurrence rate in the treatment group was significantly lower than that in the control group(P < 0.05), and the numbers of pain was significantly less than that in the control group(P < 0.05). Conclusion Shaofu Zhuyu Granules combined with Medroxyprogesterone Acetate Tablets has significant clinical effect in treatment of endometriosis, can alleviate the clinical symptoms of patients, reduce inflammation reaction, and reduce recurrence rate, with high safety, which has a certain clinical application value.
Objective To investigate the clinical effect of Shaofu Zhuyu Granules combined with Medroxyprogesterone Acetate Tablets in treatment of endometriosis. Methods Patients(98 cases) with endometriosis in Mianyang Central Hospital from February 2015 to June 2016 were randomly divided into control and treatment groups, and each group had 49 cases. Patients in the control group were po administered with Medroxyprogesterone Acetate Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Shaofu Zhuyu Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 6 month. After treatment, the clinical efficacies were evaluated, and the pelvic mass size, VAS, CA125, E2, FSH, LH, hs-CRP, IL-6, TNF-α, recurrence rate, and the occurrence of pain in two groups were compared. Results After treatment, the clinical efficacy in the treatment group was 93.9%, which was significantly higher than 73.5% in the control group, and there were differences between two groups(P < 0.05). After treatment, the pelvic mass size, VAS, and CA125 in two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, the pelvic mass size, VAS scores, and CA125 levels in the treatment group were lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, the E2 level in two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, the E2 levels in the treatment group were lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, the levels of hs-CRP, IL-6, and TNF-α in two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, the serum Inflammatory index levels in the treatment group were lower than those in the control group, and there were differences between two groups(P < 0.05). After 1 year of follow-up, the recurrence rate in the treatment group was significantly lower than that in the control group(P < 0.05), and the numbers of pain was significantly less than that in the control group(P < 0.05). Conclusion Shaofu Zhuyu Granules combined with Medroxyprogesterone Acetate Tablets has significant clinical effect in treatment of endometriosis, can alleviate the clinical symptoms of patients, reduce inflammation reaction, and reduce recurrence rate, with high safety, which has a certain clinical application value.
引文
[1]李雅男,王丹波,陈英汉,等.不同类型子宫内膜异位症临床特点及意义分析[J].实用妇产科杂志,2015,31(1):34-36.
[2]陈惠君.浅谈少腹逐瘀颗粒在妇科疾病治疗中的应用[J].新疆中医药,2014,32(2):58-59.
[3]袁立明,周纤纤,杨梦洁,等.少腹逐瘀汤对原发性痛经大鼠作用[J].医药导报,2017,36(12):1350-1354.
[4]乔蕾.醋酸甲羟孕酮治疗巧克力囊肿临床效果观察[J].当代医学,2018,24(5):57-59.
[5]Carr B,Dmowski W P,O'Brien C,et al.Elagolix,an oral GnRHantagonist,versus subcutaneous depot medroxyprogesterone acetate for the treatment of endometriosis:effects on bone mineral density[J].Reprod Sci,2014,21(11):1341-1351.
[6]中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症的诊治指南[J].中华妇产科杂志,2015,50(3):161-169.
[7]王曼.子宫内膜异位症的中西医结合研究和诊疗标准[J].浙江中西医结合杂志,2002,12(5):265-267.
[8]严广斌.视觉模拟评分法[J].中华关节外科杂志:电子版,2014,8(2):34.
[9]宁丽,陈萱,庄如锦,等.子宫内膜异位症发病机制的研究进展[J].现代生物医学进展,2016,16(3):593-596,556.
[10]成臣,万贵平.血清免疫相关性炎性因子在子宫内膜异位症中表达的研究进展[J].医学综述,2014,20(5):797-799.
[11]范长法.VEGF、IL-6、TNF-α及CA125表达在子宫内膜异位症患者检测中的价值[J].实用妇科内分泌杂志:电子版,2017,4(24):134,136.
[12]王晓辉,覃颖,徐波.子宫内膜异位症患者血清和腹腔液中VEGF、IL-6和CA125的表达及临床意义[J].中国妇幼保健,2018,33(20):4573-4575.
[13]曲军英,欧湘红,林经安,等.子宫内膜异位症局部雌激素代谢酶的表达及意义[J].实用妇产科杂志,2011,27(5):350-354.
[14]印慧琴.腹腔镜下卵巢子宫内膜异位囊肿剥除术联合GnRH-a对子宫内膜异位囊肿患者FSH、LH、E2的影响[J].中国妇幼保健,2017,32(18):4589-4591.
[15]聂伟,马迎萍.子宫内膜异位症与免疫不孕的相关性研究[J].中国妇幼保健,2017,32(17):4212-4214.
[2]陈惠君.浅谈少腹逐瘀颗粒在妇科疾病治疗中的应用[J].新疆中医药,2014,32(2):58-59.
[3]袁立明,周纤纤,杨梦洁,等.少腹逐瘀汤对原发性痛经大鼠作用[J].医药导报,2017,36(12):1350-1354.
[4]乔蕾.醋酸甲羟孕酮治疗巧克力囊肿临床效果观察[J].当代医学,2018,24(5):57-59.
[5]Carr B,Dmowski W P,O'Brien C,et al.Elagolix,an oral GnRHantagonist,versus subcutaneous depot medroxyprogesterone acetate for the treatment of endometriosis:effects on bone mineral density[J].Reprod Sci,2014,21(11):1341-1351.
[6]中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症的诊治指南[J].中华妇产科杂志,2015,50(3):161-169.
[7]王曼.子宫内膜异位症的中西医结合研究和诊疗标准[J].浙江中西医结合杂志,2002,12(5):265-267.
[8]严广斌.视觉模拟评分法[J].中华关节外科杂志:电子版,2014,8(2):34.
[9]宁丽,陈萱,庄如锦,等.子宫内膜异位症发病机制的研究进展[J].现代生物医学进展,2016,16(3):593-596,556.
[10]成臣,万贵平.血清免疫相关性炎性因子在子宫内膜异位症中表达的研究进展[J].医学综述,2014,20(5):797-799.
[11]范长法.VEGF、IL-6、TNF-α及CA125表达在子宫内膜异位症患者检测中的价值[J].实用妇科内分泌杂志:电子版,2017,4(24):134,136.
[12]王晓辉,覃颖,徐波.子宫内膜异位症患者血清和腹腔液中VEGF、IL-6和CA125的表达及临床意义[J].中国妇幼保健,2018,33(20):4573-4575.
[13]曲军英,欧湘红,林经安,等.子宫内膜异位症局部雌激素代谢酶的表达及意义[J].实用妇产科杂志,2011,27(5):350-354.
[14]印慧琴.腹腔镜下卵巢子宫内膜异位囊肿剥除术联合GnRH-a对子宫内膜异位囊肿患者FSH、LH、E2的影响[J].中国妇幼保健,2017,32(18):4589-4591.
[15]聂伟,马迎萍.子宫内膜异位症与免疫不孕的相关性研究[J].中国妇幼保健,2017,32(17):4212-4214.