摘要
目的探讨中重度子宫内膜异位症(EM)腹腔镜术后采用醋酸曲普瑞林联合复方莪术散序贯疗法治疗的临床价值。方法将行腹腔镜手术治疗的182例中重度EM患者随机分为2组,对照组术后下次月经来潮前5 d肌肉注射醋酸曲普瑞林,每4周注射1次,持续治疗6个月;研究组前3个月的治疗方案同对照组,3个月后停用醋酸曲普瑞林,改用复方莪术散,醋酸曲普瑞林加复方莪术散总疗程6个月。停药4周评价2组临床疗效,观察2组术前及停药3个月、6个月、12个月痛经疼痛评分(VAS)及血清糖链抗原(CA125)、血管内皮生成因子(VEGF)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平和Kupperman评分,观察2组1年内的受孕率、复发率。结果 2组有效率比较差异无统计学意义(P>0.05);2组术前及停药3个月、停药6个月、停药12个月痛经VAS评分比较差异均无统计学意义(P>0.05);2组停药3个月、6个月和12个月FSH、LH和E2、CA125和VEGF水平均较术前明显降低(P均<0.05),但组间各指标水平比较差异无统计学意义(P均>0.05)。2组治疗3个月时Kupperman评分比较差异无统计学意义(P>0.05),停药3个月、6个月和12个月研究组Kupperman评分均显著低于对照组(P均<0.05)。2组1年复发率比较差异无统计学意义(P>0.05);研究组1年内自然受孕率明显高于对照组(P<0.05),治疗费用明显低于对照组(P<0.05)。结论中重度EM患者腹腔镜术后应用醋酸曲普瑞林联合复方莪术散序贯疗法可提高1年受孕率,减轻患者经济负担,具有临床推广价值。
Objective It is to explore the clinical value of compound Wozhu powder combined with Triptorelin Acetate for consolidation therapy in patients with moderate to severe endometriosis after laparoscopic surgery. Methods 182 patients with moderate to severe endometriosis undergoing laparoscopic surgery were randomly divided into 2 groups： control group treated with Triptorelin Acetate by muscle injection one times per 4 weeks at 5 days before menstruation coming, study group treated with the same drugs as control group in the former 3 months and compand Wozhu powder in the latter 3 months. Both groups were treated for 6 months. In 4 weeks after treatment, the curative effects were evaluated, the changes of VAS,serum CA125, VEGF, FSH, LH, E2 and Kupperman scores before operation and in 3, 6, 12 months after treatment were observed, pregnan- cy rate and recurrence rate within one year between the two groups were compared. Results There was no significant difference in effective rate and VAS scores at every time point between the two groups （P 〉 0.05 ）. The levels of FSH, LH and E2 , CA125, VEGF were decreased significantly in 3, 6, 12 months after treatment compared with that before treatment in both groups （P 〈0. 05 ） , but there was no significant difference between the two groups （ P 〉 0.05 ）. There was no significant difference in Kupperman scores between the two groups after 3 months＇ therapy, but the scores were higher in 3, 6, 12 months after treatment in study group than that in control group （ P 〈0. 05 ）. There was no significant difference in recurrence rate within one year between the two groups （ P 〉 0.05 ） , but nature pregnancy rate in study group was more higher while treatment cost was lower than that in control group （ P 〈0. 05 ）. Conclusion Compound Wozhu powder combined with Triptorelin Acetate can increase one year pregnancy rate, decrease treatment cost in consolidation therapy in patients with moderate to severe endometriosis after laparoscopic surgery, it is worthy of wide application in clinic.
出处
《现代中西医结合杂志》
CAS
2016年第32期3566-3569,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
子宫内膜异位症
腹腔镜
醋酸曲普瑞林
Wozhu powder
endometriosis
laparoscopic surgery
Triptorelin Acetate
