小金胶囊联合戈舍瑞林缓释植入剂治疗子宫内膜异位症腹腔镜术后的临床研究
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摘要
目的:探讨小金胶囊联合戈舍瑞林缓释植入剂治疗子宫内膜异位症腹腔镜术后的临床疗效。方法:将146例子宫内膜异位症患者随机分为对照组及观察组,两组均给予腹腔镜手术进行治疗,对照组另给予戈舍瑞林缓释植入剂治疗,观察组则在对照组治疗基础上另口服给予小金胶囊,所有患者治疗时间均为16周。治疗后,观察两组临床疗效。治疗前后,分别观察两组患者中医证候积分(腰部酸胀、经期腹痛、月经异常、头晕目眩及大便稀薄);观察两组患者生活质量评分(生理领域、生活领域、社会关系领域及环境领域)。治疗前后,分别检测两组患者外周血性激素含量[雌激素(E_2)、黄体生成素(LH)及卵泡刺激素(FSH)],检测两组子宫内膜异位症标记物含量[基质金属蛋白酶-3(MMP-3)、糖类抗原125(CA-125)及抗子宫内膜抗体(EMAb)]。结果:治疗后,观察组总有效率明显高于对照组(P<0.05)。治疗后,观察组腰部酸胀、经期腹痛、月经异常、头晕目眩及大便稀薄评分均明显低于对照组(P<0.05);生理领域、生活领域、社会关系领域及环境领域评分均明显高于对照组(P<0.05)。治疗后,观察组MMP-3、CA-125、EMAb、FSH、E_2及LH含量均明显低于对照组(P<0.05)。结论:小金胶囊联合戈舍瑞林缓释植入剂治疗子宫内膜异位症腹腔镜术后疗效确切,值得进行深入研究。
Objective: To explore the effect of Xiaojin Capsule combined with goserelin sustained-release implant in the treatment of patients with endometriosis after laparoscopic surgery. Methods: A total of 146 cases of endometriosis patients were divided into the control group(73 cases) and the observation group(73 cases). The two groups were treated by laparoscopic surgery. The control group treated with goserelin sustained-release implant and the observation group was given Xiaojin Capsule on the basis of the control group. The treatment course was 16 weeks. The effects were evaluated in the two groups after treatment. Before and after treatment, the scores of Chinese medicine syndrome(waist ache, menstrual cramps, abnormal menstruation, dizziness and excrement thinness), and the scores of life quality(physical, living, social and environmental) were observed in the two groups. Before and after treatment, the levels of sex hormones [estrogen(E2), luteinizing hormone(LH) and follicle-stimulating hormone(FSH)], endometriosis markers [matrix metalloproteinases-3(MMP-3), carbohydrate antigen 125(CA-125) and resistance of endometrial antibody(EMAb)] were detected in the two groups. Results: After treatment, the total effective rate was significantly higher in observation group than that in the control group(P<0.05). After treatment, the symptom scores of waist ache, menstrual cramps, abnormal menstruation, dizziness and excrement thinness were significantly lower in the observation group than those in the control group(P<0.05). After treatment, the levels of MMP-3, CA-125, EMAb, IgG, FSH, E2 and LH in the observation group were significantly lower than those in the control group(P<0.05). Conclusion: Xiaojin Capsule combined with goserelin sustained-release implant in the treatment of patients with endometriosis after laparoscopic surgery has a good clinical curative effect, worthy to the further study.
Objective: To explore the effect of Xiaojin Capsule combined with goserelin sustained-release implant in the treatment of patients with endometriosis after laparoscopic surgery. Methods: A total of 146 cases of endometriosis patients were divided into the control group(73 cases) and the observation group(73 cases). The two groups were treated by laparoscopic surgery. The control group treated with goserelin sustained-release implant and the observation group was given Xiaojin Capsule on the basis of the control group. The treatment course was 16 weeks. The effects were evaluated in the two groups after treatment. Before and after treatment, the scores of Chinese medicine syndrome(waist ache, menstrual cramps, abnormal menstruation, dizziness and excrement thinness), and the scores of life quality(physical, living, social and environmental) were observed in the two groups. Before and after treatment, the levels of sex hormones [estrogen(E2), luteinizing hormone(LH) and follicle-stimulating hormone(FSH)], endometriosis markers [matrix metalloproteinases-3(MMP-3), carbohydrate antigen 125(CA-125) and resistance of endometrial antibody(EMAb)] were detected in the two groups. Results: After treatment, the total effective rate was significantly higher in observation group than that in the control group(P<0.05). After treatment, the symptom scores of waist ache, menstrual cramps, abnormal menstruation, dizziness and excrement thinness were significantly lower in the observation group than those in the control group(P<0.05). After treatment, the levels of MMP-3, CA-125, EMAb, IgG, FSH, E2 and LH in the observation group were significantly lower than those in the control group(P<0.05). Conclusion: Xiaojin Capsule combined with goserelin sustained-release implant in the treatment of patients with endometriosis after laparoscopic surgery has a good clinical curative effect, worthy to the further study.
引文
[1] Borrelli GM, Abrao MS, Taube ET, et al. Immunohistochemical Investigation of Metastasis-Related Chemokines in Deep-Infiltrating Endometriosis and Compromised Pelvic Sentinel Lymph Nodes [J]. Reprod Sci, 2015, 22 (12): 1632-1642.
[2] 曹阳,曹莉莉,王唯迪,等.良方温经汤治疗子宫内膜异位症浅析[J].河北中医,2017,39(3):449-452.
[3] 欧蓉菁, 郭英. 子宫内膜异位症中西医发病机制的研究进展[J]. 新疆中医药, 2015, 33(1): 63-66.
[4] 张艳, 王夕梅. 卵巢子宫内膜异位症恶变病因研究进展[J]. 医学综述, 2015, 21(1): 59-61.
[5] 王梦梦, 闫宏宇, 韩璐. 子宫内膜异位症临床治疗新进展[J]. 新疆中医药, 2017, 35 (2): 108-110.
[6] 张媛媛, 李丽, 薛娟, 等. 米非司酮联合小金胶囊治疗子宫内膜异位症的临床研究 [J]. 世界中医药, 2017, 12(9): 2047-2049.
[7] 王曼丽, 王韦. 内异消方联合保守手术及戈舍瑞林治疗子宫内膜异位症疗效研究 [J]. 中华中医药学刊, 2016, 34(6): 1354-1356.
[8] 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断与治疗规范[J]. 中华妇产科杂志, 2007, 42(9):645-648.
[9] 郑筱萸. 中药新药临床研究指导原则(试行)[S]. 北京:中国医药科技出版社, 2002.
[10] 李佳玲, 赵艳霞, 顾菁, 等. 基于项目反应理论修订生存质量测定量表简表WHOQOL-BREF[J]. 中山大学学报(医学科学版), 2015, 36(2): 284-293.
[11] Facchin F, Barbara G, Saita E, et al. Impact of endometriosis on quality of life and mental health: pelvic pain makes the difference[J]. J Psychosom Obstet Gynaecol, 2015, 36(4): 135-141.
[12] 吴雯君, 陈光盛. 血府逐瘀汤联合亮丙瑞林治疗生育期子宫内膜异位症不孕临床疗效及安全性研究[J]. 中华中医药学刊, 2017, 35(4): 927-930.
[13] 张余芳, 林尧, 卢秀英, 等. 醋酸亮丙瑞林治疗子宫内膜异位症的临床观察[J]. 中国药房, 2016, 27(26): 3675-3677.
[14] 沈栗帆, 何艳, 季菲, 等. 醋酸亮丙瑞林对子宫内膜异位症内分泌水平及骨密度的影响 [J]. 新疆医科大学学报, 2017, 40(2): 170-173.
[15] 马遇春,丛慧芳,王素,等. 从伏邪理论探讨子宫内膜异位症的发病特点 [J]. 辽宁中医杂志,2015,42(3):496-498.
[16] 王晓彤, 林海雄, 邓翀, 等. 基于虚实辨证探讨中药治疗腹腔镜术后子宫内膜异位症 [J]. 中华中医药学刊, 2017, 35(9): 2365-2368.
[17] 何珏, 胡国华. 子宫内膜异位症(子宫腺肌病)痛经的中医治疗方法研究进展 [J]. 中华中医药学刊, 2017, 35(3): 692-695.
[18] 邓娟, 马瑞芬. 144例子宫内膜异位症患者中医证型分布与手术分期规律研究 [J]. 浙江中医杂志, 2016, 51(9): 629-630.
[19] 李雪梅. 子宫内膜异位症手术前后中医证候与复发相关性研究 [J]. 中医临床研究, 2016, 35(8): 18-20.
[20] 张霞. 全国名老中医何成瑶教授治疗子宫内膜异位症临床经验总结 [J]. 中西医结合心血管病电子杂志, 2017, 5(28): 165-166.
[21] 叶美秀, 曾美玲, 魏绍斌. 养正除积治疗子宫内膜异位症思路浅析 [J]. 湖南中医杂志, 2016, 32(2): 144-145.
[22] 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.
[23] 夏纯, 赵刚, 徐胜, 等. 小金胶囊疽证理论探析 [J]. 世界中医药, 2016, 11(12): 2580-2583.
[24] 陈奇. 中药药理研究方法学 [M]. 北京: 人民卫生出版社, 2011: 189-220.
[25] 耿丹. 腹腔镜术后结合注射用醋酸戈舍瑞林治疗子宫内膜异位症的效果探析[J]. 中国现代药物应用, 2016, 10(15): 150-151.
[26] Das S, Batra SK. Understanding the Unique Attributes of MUC16 (CA125): Potential Implications in Targeted Therapy [J]. Cancer Res,2015,75 (22): 4669-4674.
[27] Richards A, Herbst U, Manalang J, et al. HE4, CA125, the Risk of Malignancy Algorithm and the Risk of Malignancy Index and complex pelvic masses-a prospective comparison in the pre-operative evaluation of pelvic masses in an Australian population[J]. Aust N Z J Obstet Gynaecol, 2015, 55(5): 493-497.
[28] 韩玉双,马凤英,孙晓燕. 血清CA125、MMP-3及EMAb水平与子宫内膜异位症的相关性分析 [J]. 医疗装备,2016,29(8):7-8.
[2] 曹阳,曹莉莉,王唯迪,等.良方温经汤治疗子宫内膜异位症浅析[J].河北中医,2017,39(3):449-452.
[3] 欧蓉菁, 郭英. 子宫内膜异位症中西医发病机制的研究进展[J]. 新疆中医药, 2015, 33(1): 63-66.
[4] 张艳, 王夕梅. 卵巢子宫内膜异位症恶变病因研究进展[J]. 医学综述, 2015, 21(1): 59-61.
[5] 王梦梦, 闫宏宇, 韩璐. 子宫内膜异位症临床治疗新进展[J]. 新疆中医药, 2017, 35 (2): 108-110.
[6] 张媛媛, 李丽, 薛娟, 等. 米非司酮联合小金胶囊治疗子宫内膜异位症的临床研究 [J]. 世界中医药, 2017, 12(9): 2047-2049.
[7] 王曼丽, 王韦. 内异消方联合保守手术及戈舍瑞林治疗子宫内膜异位症疗效研究 [J]. 中华中医药学刊, 2016, 34(6): 1354-1356.
[8] 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断与治疗规范[J]. 中华妇产科杂志, 2007, 42(9):645-648.
[9] 郑筱萸. 中药新药临床研究指导原则(试行)[S]. 北京:中国医药科技出版社, 2002.
[10] 李佳玲, 赵艳霞, 顾菁, 等. 基于项目反应理论修订生存质量测定量表简表WHOQOL-BREF[J]. 中山大学学报(医学科学版), 2015, 36(2): 284-293.
[11] Facchin F, Barbara G, Saita E, et al. Impact of endometriosis on quality of life and mental health: pelvic pain makes the difference[J]. J Psychosom Obstet Gynaecol, 2015, 36(4): 135-141.
[12] 吴雯君, 陈光盛. 血府逐瘀汤联合亮丙瑞林治疗生育期子宫内膜异位症不孕临床疗效及安全性研究[J]. 中华中医药学刊, 2017, 35(4): 927-930.
[13] 张余芳, 林尧, 卢秀英, 等. 醋酸亮丙瑞林治疗子宫内膜异位症的临床观察[J]. 中国药房, 2016, 27(26): 3675-3677.
[14] 沈栗帆, 何艳, 季菲, 等. 醋酸亮丙瑞林对子宫内膜异位症内分泌水平及骨密度的影响 [J]. 新疆医科大学学报, 2017, 40(2): 170-173.
[15] 马遇春,丛慧芳,王素,等. 从伏邪理论探讨子宫内膜异位症的发病特点 [J]. 辽宁中医杂志,2015,42(3):496-498.
[16] 王晓彤, 林海雄, 邓翀, 等. 基于虚实辨证探讨中药治疗腹腔镜术后子宫内膜异位症 [J]. 中华中医药学刊, 2017, 35(9): 2365-2368.
[17] 何珏, 胡国华. 子宫内膜异位症(子宫腺肌病)痛经的中医治疗方法研究进展 [J]. 中华中医药学刊, 2017, 35(3): 692-695.
[18] 邓娟, 马瑞芬. 144例子宫内膜异位症患者中医证型分布与手术分期规律研究 [J]. 浙江中医杂志, 2016, 51(9): 629-630.
[19] 李雪梅. 子宫内膜异位症手术前后中医证候与复发相关性研究 [J]. 中医临床研究, 2016, 35(8): 18-20.
[20] 张霞. 全国名老中医何成瑶教授治疗子宫内膜异位症临床经验总结 [J]. 中西医结合心血管病电子杂志, 2017, 5(28): 165-166.
[21] 叶美秀, 曾美玲, 魏绍斌. 养正除积治疗子宫内膜异位症思路浅析 [J]. 湖南中医杂志, 2016, 32(2): 144-145.
[22] 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.
[23] 夏纯, 赵刚, 徐胜, 等. 小金胶囊疽证理论探析 [J]. 世界中医药, 2016, 11(12): 2580-2583.
[24] 陈奇. 中药药理研究方法学 [M]. 北京: 人民卫生出版社, 2011: 189-220.
[25] 耿丹. 腹腔镜术后结合注射用醋酸戈舍瑞林治疗子宫内膜异位症的效果探析[J]. 中国现代药物应用, 2016, 10(15): 150-151.
[26] Das S, Batra SK. Understanding the Unique Attributes of MUC16 (CA125): Potential Implications in Targeted Therapy [J]. Cancer Res,2015,75 (22): 4669-4674.
[27] Richards A, Herbst U, Manalang J, et al. HE4, CA125, the Risk of Malignancy Algorithm and the Risk of Malignancy Index and complex pelvic masses-a prospective comparison in the pre-operative evaluation of pelvic masses in an Australian population[J]. Aust N Z J Obstet Gynaecol, 2015, 55(5): 493-497.
[28] 韩玉双,马凤英,孙晓燕. 血清CA125、MMP-3及EMAb水平与子宫内膜异位症的相关性分析 [J]. 医疗装备,2016,29(8):7-8.