补肾活血法对卵巢子宫内膜异位囊肿剔除术后卵巢储备功能的干预作用

Intervention of Ovary Reserve Function in Patients After Endometriomas Removal with Therapy of Tonifying Kidney and Activating Blood

【目的】探讨卵巢子宫内膜异位囊肿剔除术对卵巢储备功能的影响及补肾活血中药对术后卵巢储备功能的干预作用。【方法】选择拟行腹腔镜下卵巢子宫内膜异位囊肿剔除术的病例70例,随机分为中药组和对照组各35例,中药组术后给予补肾活血中药口服,对照组术后不予中药治疗。术前、术后第1个月、第4个月观察月经等情况,检测血清基础卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、抑制素B(INHB)水平,评估患者手术前后的卵巢储备功能。【结果】(1)术后第1个月,2组患者月经异常率稍增加,但与术前比较差异无统计学意义(P﹥0.05),且随术后时间延长,月经情况逐渐恢复。(2)术后第1个月2组的LH、FSH水平均升高,E2、INHB水平均下降,与术前比较,差异均有统计学意义(P<0.05)。术后第4个月,中药组LH、FSH水平降低,E2、INHB水平升高(与术后第1个月比较,P<0.05),并基本恢复到术前水平(与术前比较,P>0.05);2组间比较,差异均有统计学意义(P<0.05),表明中药组在改善血清性激素及INHB水平方面优于对照组。【结论】补肾活血中药可降低术后患者的血清基础FSH、LH水平,升高抑制素B、基础E2水平,达到改善卵巢储备功能的目的。

Objective To investigate the effect of endometriomas removal on ovary reserve function and to explore the intervention of postoperative ovary reserve function with kidney-tonifying and blood-activating Chinese herbal medicine.Methods Seventy patients which had received endometriomas removal under laparoscope were equally randomized into control group and Chinese herbal medicine group.The Chinese herbal medicine group was given oral use of kidney-tonifying and blood-activating Chinese herbal medicine after the operation.Menstruation was observed,and serum levels of follicle stimulating hormone（FSH）,luteinizing hormone（LH）,estradiol（E2）,and inhibin B（INHB） were examined to evaluate the ovary reserve function before treatment,one and four month（s） after the operation.Results（1）One month after the operation,the rate of abnormal menstruation was mildly increased,but the difference was insignificant compared with that before operation（P﹥0.05）.The menstruation recovered to be normal as the postoperative time prolonged.（2）LH and FSH levels were increased,and E2 and INHB levels decreased in both group one month after the operation（P0.05 compared with those before treatment）.Four months after the operation,LH and FSH levels were decreased,and E2 and INHB levels increased in Chinese herbal medicine group（P0.05 compared with those one month after the operation）,and the levels of the four indexes recovered to the preoperative levels（P0.05）.The differences of the four indexes were significant between the two groups（P0.05）.Conclusion Chinese herbal medicine can improve the ovary reserve function by decreasing FHS and LH levels,and by increasing E2 and INHB levels in patients after endometriomas removal.