摘要
【目的】观察五子四物加减方治疗卵巢子宫内膜异位囊肿合并不孕(肾虚血瘀证)患者术后的临床疗效。【方法】将50例卵巢子宫内膜异位囊肿合并不孕(肾虚血瘀证)患者随机分为治疗组和对照组,每组各25例。2组患者均行妇科腹腔镜手术治疗,对照组患者术后给予醋酸戈舍瑞林缓释植入剂(诺雷得)腹壁皮下注射治疗,相隔28 d注射1次,共使用3次;治疗组患者术后给予服用五子四物加减方治疗,每个月经周期连续服用14剂,共治疗6个月经周期。观察2组患者治疗前后的中医证候评分和人类抗缪勒氏管激素(AMH)、糖类抗原125(CA125)的变化情况,比较2组的中医证候疗效及术后6个月的妊娠率。【结果】(1)治疗6个月经周期后,治疗组的总有效率为92.0%(23/25),对照组为72.0%(18/25),治疗组的中医证候疗效明显优于对照组,差异有统计学意义(P<0.01)。(2)治疗后,2组患者的中医证候评分均较治疗前明显改善(P<0.01),且治疗组的改善作用明显优于对照组(P<0.01)。(3)治疗后,2组患者的AMH和CA125水平均较治疗前明显降低(P<0.01),但治疗组对AMH的降低程度明显小于对照组(P<0.05),而2组治疗后CA125水平比较,差异无统计学意义(P>0.05)。(4)术后6个月内,治疗组的总受孕率及Ⅲ期和Ⅳ期患者受孕率分别为36.0%、53.8%和16.7%,对照组分别为8.0%、7.7%和8.3%,组间比较,治疗组的总受孕率及Ⅲ期患者受孕率优于对照组(P<0.05),而2组Ⅳ期患者受孕率比较,差异无统计学意义(P>0.05)。【结论】五子四物加减方治疗卵巢子宫内膜异位囊肿合并不孕(肾虚血瘀证)的术后患者,疗效确切,可有效改善患者的临床证候和卵巢储备功能,提高患者的妊娠率。
Objective To investigate the clinical effect of the modified Wuzi Siwu Decoction for the treatment of ovarian endometrial cyst patients complicated with kidney deficiency and blood stasis type of infertility after laparoscopic operation.Methods Fifty ovarian endometrial cyst patients complicated with kidney deficiency and blood stasis type of infertility were randomly divided into treatment group and control group,25 cases in each group.The patients in the two groups were given gynecological laparoscopic operation.After the operation,the control group was given abdominal subcutaneous injection of Goserelin Acetate Sustained-Release Depot,once every 28 days,a total of three times.The treatment group was given oral use of the modified Wuzi Siwu Decoction and was continuously medicated for 14 doses in each menstrual cycle,and the treatment covered 6 menstrual cycles.Before and after treatment,the scores of traditional Chinese medicine(TCM)syndrome and the levels of human anti-Mullerian hormone(AMH)and carbohydrate antigen 125(CA125)in the two groups were observed.And the efficacy for TCM syndrome and the pregnancy rate 6 months after operation in the two groups were compared.Results(1)After treatment for 6 menstrual cycles,the total effective rate of the treatment group was 92.0%,and was higher than that of the control group(72.0%).The treatment group had stronger clinical efficacy for TCM syndrome than the control group,and the difference was statistically significant(P<0.01).(2)After treatment,the scores of TCM syndrome in the two groups were much improved in comparison with those before treatment(P<0.01),and the improvement in the treatment group was superior to that in the control group(P<0.01).(3)After treatment,the levels of AMH and CA125 in the two groups were markedly decreased in comparison with those before treatment(P<0.01),and the descend of AMH in the treatment group was milder than that in the control group(P<0.05),while the difference of CA125 level between the two groups was insignificant(P>0.05).(4)During the postoperative 6 months,the total pregnancy rate and the pregnancy rate of stageⅢpatients and stageⅣpatients in the treatment group were 36.0%,53.8%,16.7%respectively,and in the control group were 8.0%,7.7%,8.3%respectively.The intergroup comparison showed that the total pregnancy rate and the pregnancy rate of stageⅢpatients in the treatment group were higher than those in the control group(P<0.05),but the difference of the pregnancy rate of stageⅣpatients was insignificant(P>0.05).Conclusion The modified Wuzi Siwu Decoction exerts certain effect for the treatment of ovarian endometrial cyst patients complicated with kidney deficiency and blood stasis type of infertility after operation by improving the clinical symptoms and ovarian reserve,and by increasing the pregnancy rate of infertile patients.
作者
司雨
郭哲璇
廖慧慧
冯丽
SI Yu;GUO Zhe-Xuan;LIAO Hui-Hui;FENG Li(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2020年第5期838-843,共6页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
张玉珍全国名老中医药专家传承工作室。
关键词
卵巢子宫内膜异位囊肿
不孕
肾虚血瘀证
五子四物加减方
卵巢储备功能
ovarian endometrial cyst
infertility
kidney deficiency and blood stasis syndrome
modified Wuzi Siwu Decoction
ovarian reserve
