摘要
目的分析三元气血针法+腹腔镜手术对子宫内膜异位症(EMT)患者术后血流动力学及血清前列腺素F2α(PGF2α)、前列腺素E2(PGE2)水平的影响。方法采取前瞻性研究,选取2022年10月~2023年10月医院收治的154例EMT患者作为研究对象,按随机数字表法分为两组,各77例。对照组接受腹腔镜手术治疗,观察组接受腹腔镜手术+三元气血针法治疗,两组均连续治疗3个月经周期。治疗期间比较两组临床疗效,于治疗前、治疗3个月经周期时比较两组中医证候积分(行经腹痛、质稠有块、得温痛减);于治疗前、治疗1个月经周期、治疗3个月经周期时,比较两组COX痛经症状评价量表(CMSS)评分(严重程度、持续时间)、PGF2α、PGE2、血流动力学指标[收缩期峰值血流速/舒张末期血流速(S/D)、搏动脉指数(PI)、阻力指数(RI)]水平;采用双变量Pearson分析血清PGF2α、PGE2与EMT患者CMSS严重程度评分、持续时间评分、S/D、PI、RI的相关性。结果治疗期间,对照组总有效率低于观察组(P<0.05);治疗3个月经周期时两组行经腹痛、质稠有块、得温痛减中医症状积分低于术前,观察组低于对照组(P<0.05);CMSS严重程度评分、持续时间评分、PGF2α、PGE2、S/D、PI、RI组别主效应显著;治疗前、治疗1个月经周期、治疗3个月经周期CMSS严重程度评分、持续时间评分、PGF2α、PGE2、S/D、PI、RI水平依次下降,均达到显著性水平(P<0.05);经Pearson相关性检验结果显示,EMT患者血清PGF2α、PGE2与CMSS严重程度评分、持续时间评分、S/D、PI、RI呈正相关(r>0,P<0.05)。结论三元气血针法配合腹腔镜手术对EMT患者疗效确切,可降低患者PGF2α、PGE2水平,改善患者临床症状及血流动力学,缓解痛经,PGF2α、PGE2与CMSS评分、血流动力学指标具有正相关性,临床可通过降低PGF2α、PGE2水平,缓解患者痛经症状。
Objective To analyze the effects of three element Qi blood acupuncture combined with laparoscopic surgery on postoperative hemodynamics and serum levels of prostaglandin F2α(PGF2α)and prostaglandin E2(PGE2)in patients with endometriosis(EMT).Methods Adopting a prospective study,154 patients with EMT admitted to the hospital from October 2022 to October 2023 were selected as the research subjects.Divided into two groups with 77 cases in each group.The control group received laparoscopic surgery treatment,while the observation group received laparoscopic surgery and three elements Qi blood acupuncture treatment.Both groups received continuous treatment for three menstrual cycles.Compare the clinical efficacy between two groups during the treatment period.Compare the TCM syndrome scores of two groups before treatment and after 3 menstrual cycles of treatment(abdominal pain during menstruation,thick lumps,and reduced warmth and pain).The levels of COX dysmenorrhea symptom evaluation scale(CMSS)score(severity,duration),PGF2α,PGE2,hemodynamic indexes[peak systolic blood flow velocity/end diastolic blood flow velocity(S/D),pulsatility index(PI),resistance index(RI)]were compared between the two groups before treatment,1 menstrual cycle and 3 menstrual cycles after treatment.Using bivariate Pearson analysis to investigate the correlation between serum PGF2α,PGE2 and CMSS severity score,duration score,S/D,PI,and RI in EMT patients.Results The total effective rate of the control group was lower than that of the observation group(P<0.05).In the treatment of 3 menstrual cycles,the scores of TCM symptoms such as abdominal pain,thick mass and temperature pain in the two groups were lower than those before operation,and those in the observation group were lower than those in the control group(P<0.05).The main effects of CMSS severity score,duration score,PGF2α,PGE2,S/D,PI,and RI groups were significant.The CMSS severity score,duration score,PGF2α,PGE2,S/D,PI,and RI levels decreased successively before treatment,after 1 menstrual cycle of treatment,and after 3 menstrual cycles of treatment,all of which reached significant levels(P<0.05).The Pearson correlation test results showed that serum PGF2αand PGE2 in EMT patients were positively correlated with CMSS severity score,duration score,S/D,PI,and RI(r>0,P<0.05).Conclusion The combination of the three element Qi blood acupuncture method and laparoscopic surgery has a definite therapeutic effect on EMT patients,which can reduce the levels of PGF2αand PGE2,improve clinical symptoms and hemodynamics,alleviate dysmenorrhea.PGF2αand PGE2 are positively correlated with CMSS score and hemodynamic indicators,and clinical treatment can alleviate dysmenorrhea symptoms by reducing the levels of PGF2αand PGE2.
作者
彭云涵
邓高丕
PENG Yunhan;DENG Gaopi(Guangzhou University of Traditional Chinese Medicine/The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510400,China)
出处
《四川中医》
2025年第8期100-106,共7页
Journal of Sichuan of Traditional Chinese Medicine
