妇科千金胶囊联合戈舍瑞林治疗子宫内膜异位症的临床研究
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摘要
目的观察妇科千金胶囊联合戈舍瑞林治疗子宫内膜异位症的临床疗效和安全性。方法选取2015年5月—2017年12月在公安县人民医院就诊的子宫内膜异位症患者200例,随机分为对照组和治疗组,每组各100例。对照组患者皮下植入醋酸戈舍瑞林缓释植入剂,1次/4周,3.6mg/次;治疗组患者在对照组的基础上口服妇科千金胶囊,2粒/次,3次/d。两组患者均治疗24周。观察两组患者临床疗效,同时比较治疗前后两组患者的性激素水平、血清学指标、Kupperman评分和视觉模拟评分(VAS)。结果治疗后,对照组总有效率为79%,显著低于治疗组的88%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者雌激素(E2)、促黄体激素(LH)和促卵泡激素(FSH)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组上述性激素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);治疗后,两组血清癌抗原125(CA125)水平显著降低,治疗组肿瘤坏死因子(TNF)-α和白细胞介素(IL)-6水平显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组CA125、TNF-α和IL-6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);治疗后,两组患者的Kupperman和VAS评分均显著下降,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组Kupperman和VAS评明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论妇科千金胶囊联合戈舍瑞林治疗子宫内膜异位症不仅可以更好地改善患者卵巢功能,调节性激素的紊乱,而且可以降低炎症反应,同时改善患者疼痛和月经状况,具有一定的临床推广应用价值。
Objective To observe the clinical efficacy and safety of Fuke Qianjin Capsules combined with goserelin in treatment of endometriosis. Methods Patients(200 cases) with endometriosis in Gong'an People's Hospital from May 2015 to December 2017 were randomly divided into control and treatment groups, and each group had 100 cases. Patients in the control group were subcutaneously implanted Goserelin Acetate Sustained-release Implant, once every four weeks, 3.6 mg/time. Patients in the treatment group were po administered with Fuke Qianjin Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 24 weeks. After treatment, the clinical efficacy was evaluated, and sex hormone levels, serum markers,Kupperman scores, and VAS scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 79%, which was significantly lower than 88% in the treatment group, and there were differences between two groups(P < 0.05). After treatment, E2, LH, and FSH in two groups were significantly decreased, and there were differences between two groups(P < 0.05). And sex hormone levels in the treatment group were significantly lower than those in the control group,with significant difference between two groups(P < 0.05). After treatment, CA125 level in two groups were significantly decreased, but TNF-α and IL-6 levels in the treatment group were significantly decreased, and there were differences between two groups(P < 0.05).And CA125, TNF-α, and IL-6 levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). After treatment, Kupperman and VAS scores in two groups were significantly decreased, and there were differences between two groups(P < 0.05). And Kupperman and VAS scores in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Fuke Qianjin Capsules combined with goserelin in treatment of endometriosis can not only improve ovarian function, regulate the disorder of sex hormones,but also reduce inflammation, and improve the pain and menstrual status of patients, which has a certain clinical application value.
Objective To observe the clinical efficacy and safety of Fuke Qianjin Capsules combined with goserelin in treatment of endometriosis. Methods Patients(200 cases) with endometriosis in Gong'an People's Hospital from May 2015 to December 2017 were randomly divided into control and treatment groups, and each group had 100 cases. Patients in the control group were subcutaneously implanted Goserelin Acetate Sustained-release Implant, once every four weeks, 3.6 mg/time. Patients in the treatment group were po administered with Fuke Qianjin Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 24 weeks. After treatment, the clinical efficacy was evaluated, and sex hormone levels, serum markers,Kupperman scores, and VAS scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 79%, which was significantly lower than 88% in the treatment group, and there were differences between two groups(P < 0.05). After treatment, E2, LH, and FSH in two groups were significantly decreased, and there were differences between two groups(P < 0.05). And sex hormone levels in the treatment group were significantly lower than those in the control group,with significant difference between two groups(P < 0.05). After treatment, CA125 level in two groups were significantly decreased, but TNF-α and IL-6 levels in the treatment group were significantly decreased, and there were differences between two groups(P < 0.05).And CA125, TNF-α, and IL-6 levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). After treatment, Kupperman and VAS scores in two groups were significantly decreased, and there were differences between two groups(P < 0.05). And Kupperman and VAS scores in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Fuke Qianjin Capsules combined with goserelin in treatment of endometriosis can not only improve ovarian function, regulate the disorder of sex hormones,but also reduce inflammation, and improve the pain and menstrual status of patients, which has a certain clinical application value.
引文
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[3]Bulun S E,Lin Z,Imir G,et al.Regulation of aromatase expression in estrogen-responsive breast and uterine disease:from bench to treatment[J].Pharmacol Rev,2005,57(3):359-383.
[4]吴喜枝,李俊晓.子宫内膜异位症术后应用戈舍瑞林的效果评定与护理[J].首都食品与医药,2018(4):37.
[5]谢小青,李梅生.妇科千金胶囊治疗子宫内膜异位症临床观察[J].临床医药实践,2009,18(11):871-873.
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[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]李诵炫,于传鑫.实用妇科内分泌学[M].上海:上海医科大学出版社,1997:178-254.
[9]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):273.
[10]洪进德,汪志春.戈舍瑞林联合腹腔镜治疗卵巢型子宫内膜异位症的临床效果观察[J].当代医学,2018,24(4):83-84.
[11]李建辉.子宫内膜异位症患者血清CA125、HE4、CA199、炎性因子及组织雌孕激素受体的表达分析[J].海南医学院学报,2014,20(7):902-904
[12]韩玉双,徐伟,徐延明.血清CA125、TIMP-1及EMAb在子宫内膜异位症诊断中的价值[J].中国妇幼保健,2018,33(12):2657-2659.
[13]Harada T,Enatsu A,Mitsunari M,et al.Role of cytokines in progression of endometriosis[J].Gynecol Obstet Invest,1999,47(1):34-40.
[14]范玉香.VEGF、IL-6、IL-8在子宫内膜异位症患者血清和腹腔液的表达及意义[J].海南医学院院报,2015,21(11):1525-1531.
[2]Giudice L C.Clinical practice.Endometriosis[J].N Engl J Med,2010,362(25):2389-2398.
[3]Bulun S E,Lin Z,Imir G,et al.Regulation of aromatase expression in estrogen-responsive breast and uterine disease:from bench to treatment[J].Pharmacol Rev,2005,57(3):359-383.
[4]吴喜枝,李俊晓.子宫内膜异位症术后应用戈舍瑞林的效果评定与护理[J].首都食品与医药,2018(4):37.
[5]谢小青,李梅生.妇科千金胶囊治疗子宫内膜异位症临床观察[J].临床医药实践,2009,18(11):871-873.
[6]谢幸,苟文丽.妇产科学[M].第8版.北京:人民卫生出版社,2013:345.
[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]李诵炫,于传鑫.实用妇科内分泌学[M].上海:上海医科大学出版社,1997:178-254.
[9]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):273.
[10]洪进德,汪志春.戈舍瑞林联合腹腔镜治疗卵巢型子宫内膜异位症的临床效果观察[J].当代医学,2018,24(4):83-84.
[11]李建辉.子宫内膜异位症患者血清CA125、HE4、CA199、炎性因子及组织雌孕激素受体的表达分析[J].海南医学院学报,2014,20(7):902-904
[12]韩玉双,徐伟,徐延明.血清CA125、TIMP-1及EMAb在子宫内膜异位症诊断中的价值[J].中国妇幼保健,2018,33(12):2657-2659.
[13]Harada T,Enatsu A,Mitsunari M,et al.Role of cytokines in progression of endometriosis[J].Gynecol Obstet Invest,1999,47(1):34-40.
[14]范玉香.VEGF、IL-6、IL-8在子宫内膜异位症患者血清和腹腔液的表达及意义[J].海南医学院院报,2015,21(11):1525-1531.