摘要
目的观察桂枝茯苓丸联合左炔诺孕酮宫内节育系统治疗子宫腺肌症的临床疗效及其对血清血管内皮生长因子(VEGF)、糖类抗原125(CA125)水平的影响。方法将108例子宫腺肌症患者随机分为治疗组与对照组,每组54例。对照组予左炔诺孕酮宫内节育系统,治疗组在对照组治疗措施基础上加用桂枝茯苓丸。两组疗程均为6个月,观察临床疗效及用药安全性,比较子宫内膜厚度、子宫体积、痛经评分、月经量评分及血清性激素指标[黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)]、VEGF、CA125水平的变化情况。结果①治疗组、对照组总有效率分别为90.74%、75.93%;组间临床疗效比较,治疗组明显优于对照组(P<0.05)。②组间治疗后比较,治疗组子宫内膜厚度、子宫体积及痛经评分、月经量评分明显低于对照组(P<0.05)。③组间治疗后比较,治疗组LH、FSH、VEGF、CA125水平明显低于对照组(P<0.05),而E2水平明显高于对照组(P<0.05)。④治疗组、对照组不良反应发生率分别为14.81%、11.11%,组间比较差异无统计学意义(P<0.05)。结论在左炔诺孕酮宫内节育系统的基础上,加用桂枝茯苓丸治疗子宫腺肌症,可更有效地改善患者痛经及月经量过多症状,缩减子宫体积及子宫内膜厚度,降低血清VEGF、CA125水平,整体疗效得到提高,且不会增加不良反应。
Objective To observe the clinical efficacy of Guizhi Fuling Pills combined with levonorgestrel intrauterine system ( IUS) in the treatment of uterine adenomyosis and the effects on the levels of vascular endothelial growth factor ( VEGF) and carbohydrate antigen 125 ( CA125) in serum. Methods A total of 108 patients with uterine adenomyosis were randomly assigned into treatment group and control group,54 patients in each group. The control group was given levonorgestrel IUS,and the treatment group was treated with Guizhi Fuling Pills and levonorgestrel IUS. The course of treatment was 6 months. The clinical efficacy and safety were observed. The changes in endometrial thickness,uterine volume,dysmenorrhea score, menstrual volume score,serum sex hormone index[luteinizing hormone ( LH),follicle stimulating hormone ( FSH) and estradiol ( E2)]and the levels of VEGF and CA125 were compared. Results ①The total effective rate was 90. 74% and 75. 93% in the treatment group and the control group, respectively. The clinical efficacy in the treatment group was significantly superior to that in the control group ( P<0.05).②After treatment,the endometrial thickness,uterine volume,dysmenorrhea score and menstrual volume score were significantly lower in the treatment group than in the control group ( P<0.05).③After treatment,the levels of LH,FSH,VEGF and CA125 were significantly lower in the treatment group than in the control group ( P<0.05),while the E2 level was significantly higher than in the control group ( P<0.05).④The incidence of adverse reactions were 14.81% and 11. 11% in the treatment group and the control group,respectively,with no significant difference between the groups ( P<0.05). Conclusion In the treatment of uterine adenomyosis,Guizhi Fuling Pills combined with levonorgestrel IUS can more effectively improve the symptoms of dysmenorrhea and menorrhagia,reduce the uterine volume and endometrial thickness,and lower the levels of serum VEGF and CA125,resulting in better overall efficacy without increasing adverse reactions.
作者
郑振丽
高玉青
韩宁
ZHENG Zhenli;GAO Yuqing;HAN Ning(Department of Obstetrics and Gynecology,Zhoukou Central Hospital of Henan Province,Zhoukou 466000,China)
出处
《上海中医药杂志》
2019年第7期52-55,65,共5页
Shanghai Journal of Traditional Chinese Medicine
基金
2016年度河南省医学科技攻关计划项目(201602056)
