祛瘀散结方保留灌肠防治盆腔子宫内膜异位症术后复发疗效观察

Efficacy observed on prevention and treatment of postoperative recurrence of pelvic endometriosis with Quyusanjie Fang for retention enema

目的探讨祛瘀散结方保留灌肠用于盆腔子宫内膜异位症术后辅助治疗的临床价值。方法选择新疆医科大学附属中医医院妇科2010年2月-2011年8月经腹腔镜手术和病理证实的子宫内膜异位症患者82例,随机分为试验组(42例)和对照组(40例)。试验组于术后1w开始使用祛瘀散结方保留灌肠治疗,1次/d,20d为1个疗程,月经期停用,连用6个疗程。对照组自手术后1w开始口服孕三烯酮,每周2次,疗程6个月。用药期间每3个月复诊,了解药物不良反应,并行盆腔B超及妇科检查,停药后随访12个月。比较两组患者疼痛症状、临床有效率、复发率及妊娠情况。结果试验组有效率(78.6%)高于对照组(55.0%),差异具有统计学意义(P<0.05),试验组复发率(4.8%)低于对照组(20.0%),差异具有统计学意义(P<0.05);试验组妊娠率(58.3%)明显高于对照组(27.2%),但无统计学差异(P>0.05)。结论祛瘀散结方保留灌肠用于子宫内膜异位症术后的辅助治疗可有效地控制症状,减少复发,提高受孕率。

Objective To study clinical value of Quyusanjie Fang for Retention Enema in adjuvant therapy of Postoperative Endometriosis.Methods Selected from Department of gynecology,Affiliated Chinese Medicine Hospital,Xinjiang Medical University（Feb 2010 to August 2011）,82 endometriosis patients confirmed by laparoscopic surgery were randomly divided into two groups：Experimental group （42 patients）with the Quyusanjie Fang for retention enema after post-operative;while the control group（40 patients）with Gestrinone.The experimental group used Quyusanjie Fang for Retention Enema 1 week later after surgery,1 times/day,20 days a period for 6 periods,except for menstrual period;while the control group administrated oral Gestrinone 1 week later after surgery,two times a week,for 6 months. Then patients had pelvic ultrasound examination once three weeks, and the regular follow-up for 1 2 months after the experiment.The two groups were compared with pain symptoms, clinical efficacy,relapse rate and pregnancy.Results Effective treatment rate of experimental group was higher,and re-currence rate lower,and both of the differences had statistically significant （P〈0.05）;while the pregnan-cy rate was significantly higher in the experimental group,but no significant difference （P 〉 0.05）.Con-clusion Quyusanjie Fang for Retention Enema in adjuvant therapy after surgery for endometriosis can ef-fectively control symptoms and reduce recurrence and improve the pregnancy rate.