补肾化瘀方合宫瘤消胶囊治疗子宫内膜异位症疗效及对MMPs、促血管生成因子水平的影响
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摘要
目的:研究补肾化瘀方联合宫瘤消胶囊治疗子宫内膜异位症(Endometriosis,EMS)的疗效及对血管内皮生长因子(vascular endothelial growth factor,VEGF)和基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)的影响。方法:EMS患者130例,用随机数表法分为对照组和观察组,每组各65例,对照组患者给予宫瘤消胶囊口服,观察组患者在对照组的基础上加用补肾化瘀方。比较两组患者的临床疗效、痛经VAS评分和血清性激素、MMP-9、VEGF等水平。结果:观察组患者痊愈28例(43.08%),显效19例(29.23%),有效14例(21.54%),总有效率为93.85%,高于对照组80.00%的总有效率(P<0.05)。治疗前两组患者的血清性激素水平相近(P>0.05),治疗后患者的性激素水平明显下降,观察组的E_2、LH和FSH水平更低(P<0.05)。治疗前两组患者的CA125、MMP-9、VEGF和TNF-α水平相近(P>0.05),治疗后两组患者的以上指标均明显下降,观察组患者的CA125、MMP-9、VEGF和TNF-α水平明显低于对照组(P<0.05)。治疗前两组患者的痛经VAS评分相近(P>0.05),治疗后患者的痛经VAS评分明显下降,观察组的痛经VAS评分更低(P<0.05)。结论:补肾化瘀方联合宫瘤消胶囊可以明显提高子宫内膜异位症患者的临床疗效,降低患者的血清性激素和促血管生成因子水平,改善痛经情况,值得在临床推广应用。
Objective:To study the effect of Bushen Huayu Recipe combined with Gongliuxiao Capsule in the treatment of endometriosis and its effect on the levels of MMPs and VEGF. Methods:Totally 130 EMS patients were divided into control group and observation group using a random number table method, 65 cases in each group. The control group were treated with Gongliuxiao Capsule orally and the patients in the observation group were treated by Bushen Huayu Decoction on the basis of the control group. We compared the clinical efficacy, VAS score of dysmenorrhea, serum sex hormone, MMP-9 and VEGF between the two groups. Results:In the observation group, 28 cases(43.08%) were cured, 19 cases(29.23%) were markedly effective, 14 cases(21.54%) were effective and the total effective rate was 93.85%, which was higher than that of the control group's 80%(P<0.05). Before treatment, the serum sex hormone levels in the two groups were similar(P>0.05). After treatment, the levels of sex hormones in the observation group decreased significantly, and the levels of E_2, LH and FSH in the observation group were lower(P<0.05). Before treatment, the levels of CA125, MMP-9, VEGF and TNF-α in the two groups were similar(P>0.05). After treatment, the above indexes of the two groups were significantly decreased, and the levels of CA125, MMP-9, VEGF and TNF-α in the observation group were significantly lower than those in the control group(P<0.05). Before treatment, the VAS score of dysmenorrhea in the two groups was similar(P>0.05). After treatment, the VAS score of dysmenorrhea in patients was significantly decreased, and the dysmenorrhea VAS score in the observation group was lower(P<0.05). Conclusion:Bushen Huayu Decoction combined with Gongliuxiao Capsule can significantly improve the clinical efficacy of endometriosis, reduce serum sex hormones and angiogenesis factorsand improve dysmenorrhea, which is worthy of clinical application.
Objective:To study the effect of Bushen Huayu Recipe combined with Gongliuxiao Capsule in the treatment of endometriosis and its effect on the levels of MMPs and VEGF. Methods:Totally 130 EMS patients were divided into control group and observation group using a random number table method, 65 cases in each group. The control group were treated with Gongliuxiao Capsule orally and the patients in the observation group were treated by Bushen Huayu Decoction on the basis of the control group. We compared the clinical efficacy, VAS score of dysmenorrhea, serum sex hormone, MMP-9 and VEGF between the two groups. Results:In the observation group, 28 cases(43.08%) were cured, 19 cases(29.23%) were markedly effective, 14 cases(21.54%) were effective and the total effective rate was 93.85%, which was higher than that of the control group's 80%(P<0.05). Before treatment, the serum sex hormone levels in the two groups were similar(P>0.05). After treatment, the levels of sex hormones in the observation group decreased significantly, and the levels of E_2, LH and FSH in the observation group were lower(P<0.05). Before treatment, the levels of CA125, MMP-9, VEGF and TNF-α in the two groups were similar(P>0.05). After treatment, the above indexes of the two groups were significantly decreased, and the levels of CA125, MMP-9, VEGF and TNF-α in the observation group were significantly lower than those in the control group(P<0.05). Before treatment, the VAS score of dysmenorrhea in the two groups was similar(P>0.05). After treatment, the VAS score of dysmenorrhea in patients was significantly decreased, and the dysmenorrhea VAS score in the observation group was lower(P<0.05). Conclusion:Bushen Huayu Decoction combined with Gongliuxiao Capsule can significantly improve the clinical efficacy of endometriosis, reduce serum sex hormones and angiogenesis factorsand improve dysmenorrhea, which is worthy of clinical application.
引文
[1] 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.
[2] 周琴,吴燕虹.“消异汤”治疗子宫内膜异位症保守性术后30例临床研究[J].江苏中医药,2016,48(7):49-50.
[3] 张媛,刘筱茂,霍艳宁,等.中药口服联合保留灌肠治疗子宫内膜异位症生存质量及疗效评价[J].环球中医药,2017,10(7):712-715.
[4] 叶青,孙立兰,何双.活血化瘀补肾中药治疗联合腹腔镜手术治疗子宫内膜异位症不孕患者临床研究[J].中国性科学,2016,25(6):139-143.
[5] 周艳,刘明珠.宫瘤消胶囊对子宫内膜异位症气滞血瘀证血管生成机制的影响[J].中国实验方剂学杂志,2017,23(21):200-205.
[6] 陈能,康佳丽,刘晓俊,等.促性腺激素释放激素激动剂联合加味桂枝茯苓汤对子宫内膜异位症不孕患者血清细胞因子的影响[J].中国药业,2017,26(15):27-29.
[7] 谢琼.中药周期疗法治疗子宫内膜异位症术后30例临床观察[J].江苏中医药,2014,46(1):40-41.
[8] 裴芳利,黎玲.曾诚论治子宫内膜异位症的中医思路[J].广州中医药大学学报,2016,33(6):892-896.
[9] 马迎红,黎烈荣.益气化瘀方预防子宫内膜异位症术后复发的临床研究[J].南京中医药大学学报,2015,31(3):291-294.
[10] 肖新春,彭光霞.宫瘤消胶囊对子宫内膜异位症模型大鼠异位病灶体积及血清E2、P含量的影响[J].中医药导报,2017,23(14):27-30.
[11] 费春香,吴江平,吴瑛,等.宫瘤消胶囊联合散结镇痛胶囊对子宫腺肌病患者月经量、痛经的影响[J].现代中西医结合杂志,2015,24(35):3929-3931.
[12] 费春香,吴江平,吴瑛,等.宫瘤消胶囊联合散结镇痛胶囊对子宫腺肌病患者月经量及痛经的影响[J].河北中医,2016,38(6):924-926.
[13] 杨慧君,赵鲜.藏红花加温胆汤对子宫内膜异位症患者外周血基质金属蛋白酶9水平的影响[J].中国生化药物杂志,2016,36(9):104-107.
[14] 魏郁清,王淼,杨艳琳,等.补肾序贯结合活血化瘀法治疗子宫内膜异位症所致痛经40例临床观察[J].江苏中医药,2015,47(1):44-45.
[15] 朱锋,彭启松,居蓉.VEGF、MMP-2和MMP-9检测在子宫内膜异位症诊断中的应用价值[J].海南医学,2016,27(6):880-882.
[16] 韩晶,吴文英.桂枝茯苓丸对子宫内膜异位症患者血清MAPK、ERK和VEGF水平影响研究[J].中国生化药物杂志,2015,35(12):125-127.
[17] 万莉,卢艳丽,谢群,等.补肾温阳化瘀法对子宫内膜异位症患者子宫内膜腺上皮细胞OPN与MMP-9的影响[J].现代生物医学进展,2017,17(18):3520-3523,3527.
[18] 桂玉然,马迎红.益气化瘀方治疗保守性手术后复发子宫内膜异位症的临床研究[J].湖北中医药大学学报,2017,19(4):84-87.
[19] 张玉虹,刘晓娟,孙喜斌,等.腹腔镜联合地诺孕素和中药治疗子宫内膜异位症的临床观察[J].中国药房,2015,26(35):4960-4962.
[20] 唐晓琳,石璇.中药治疗子宫内膜异位症的临床效果[J].西部中医药,2017,30(1):66-68.
[21] 孟俊玲,林燕,汤莉.益肾化瘀汤联合中药外敷治疗子宫内膜异位症50例临床观察[J].河北中医,2014,36(9):1294-1296.
[2] 周琴,吴燕虹.“消异汤”治疗子宫内膜异位症保守性术后30例临床研究[J].江苏中医药,2016,48(7):49-50.
[3] 张媛,刘筱茂,霍艳宁,等.中药口服联合保留灌肠治疗子宫内膜异位症生存质量及疗效评价[J].环球中医药,2017,10(7):712-715.
[4] 叶青,孙立兰,何双.活血化瘀补肾中药治疗联合腹腔镜手术治疗子宫内膜异位症不孕患者临床研究[J].中国性科学,2016,25(6):139-143.
[5] 周艳,刘明珠.宫瘤消胶囊对子宫内膜异位症气滞血瘀证血管生成机制的影响[J].中国实验方剂学杂志,2017,23(21):200-205.
[6] 陈能,康佳丽,刘晓俊,等.促性腺激素释放激素激动剂联合加味桂枝茯苓汤对子宫内膜异位症不孕患者血清细胞因子的影响[J].中国药业,2017,26(15):27-29.
[7] 谢琼.中药周期疗法治疗子宫内膜异位症术后30例临床观察[J].江苏中医药,2014,46(1):40-41.
[8] 裴芳利,黎玲.曾诚论治子宫内膜异位症的中医思路[J].广州中医药大学学报,2016,33(6):892-896.
[9] 马迎红,黎烈荣.益气化瘀方预防子宫内膜异位症术后复发的临床研究[J].南京中医药大学学报,2015,31(3):291-294.
[10] 肖新春,彭光霞.宫瘤消胶囊对子宫内膜异位症模型大鼠异位病灶体积及血清E2、P含量的影响[J].中医药导报,2017,23(14):27-30.
[11] 费春香,吴江平,吴瑛,等.宫瘤消胶囊联合散结镇痛胶囊对子宫腺肌病患者月经量、痛经的影响[J].现代中西医结合杂志,2015,24(35):3929-3931.
[12] 费春香,吴江平,吴瑛,等.宫瘤消胶囊联合散结镇痛胶囊对子宫腺肌病患者月经量及痛经的影响[J].河北中医,2016,38(6):924-926.
[13] 杨慧君,赵鲜.藏红花加温胆汤对子宫内膜异位症患者外周血基质金属蛋白酶9水平的影响[J].中国生化药物杂志,2016,36(9):104-107.
[14] 魏郁清,王淼,杨艳琳,等.补肾序贯结合活血化瘀法治疗子宫内膜异位症所致痛经40例临床观察[J].江苏中医药,2015,47(1):44-45.
[15] 朱锋,彭启松,居蓉.VEGF、MMP-2和MMP-9检测在子宫内膜异位症诊断中的应用价值[J].海南医学,2016,27(6):880-882.
[16] 韩晶,吴文英.桂枝茯苓丸对子宫内膜异位症患者血清MAPK、ERK和VEGF水平影响研究[J].中国生化药物杂志,2015,35(12):125-127.
[17] 万莉,卢艳丽,谢群,等.补肾温阳化瘀法对子宫内膜异位症患者子宫内膜腺上皮细胞OPN与MMP-9的影响[J].现代生物医学进展,2017,17(18):3520-3523,3527.
[18] 桂玉然,马迎红.益气化瘀方治疗保守性手术后复发子宫内膜异位症的临床研究[J].湖北中医药大学学报,2017,19(4):84-87.
[19] 张玉虹,刘晓娟,孙喜斌,等.腹腔镜联合地诺孕素和中药治疗子宫内膜异位症的临床观察[J].中国药房,2015,26(35):4960-4962.
[20] 唐晓琳,石璇.中药治疗子宫内膜异位症的临床效果[J].西部中医药,2017,30(1):66-68.
[21] 孟俊玲,林燕,汤莉.益肾化瘀汤联合中药外敷治疗子宫内膜异位症50例临床观察[J].河北中医,2014,36(9):1294-1296.