腹腔镜联合药物治疗子宫内膜异位症的疗效观察

The effects of combination of laparoscopy and medicine in the treatment of endometriosis

目的探讨中药活血止痛方及GnRH—a用于子宫内膜异位症腹腔镜术后辅助药物治疗的疗效及副反应。方法对该院2005年1月-2008年12月214例子宫内膜异位症患者腹腔镜术后随访资料进行回顾性分析，比较术后应用中药活血止痛方及GnRH-a于单一应用中药活血止痛方及GnRH—a治疗后的复发率和副反应发生率。结果联合组的复发率为5．9％，显著低于GnRH-a组的i5．3％（P〈0．05）．也显著低于中药活血止痛方的13．9％（P〈0．05）。联合治疗组肝功能损伤为4．1％与GnRH—a单一治疗组的11．1％相比差异有显著性（P〈0．05）。而白细胞减少副作用方面，联合治疗组为5．9％低于活血止痛汤治疗组的11．1％，差异有显著性（P〈0．05）。结论中药活血止痛方及GnRH—a用于子宫内膜异位症腹腔镜术后的治疗较单一中药活血止痛方或GnRH-a，能显著降低内异症的复发率，也能显著减少药物副反应。

[ Objective ] To explore the effects of combination of laparoscopy and medicine in the treatment of endometriosis. [Methods] 214 cases with endometfiosis after laparoscopic operation were divided into 3 groups： GnRH-a group was 72 cases, huxue zhitong decoction group was 72 cases, and the allied program of GnRH-a and huxue zhitong decoction group was 70 cases. The the relapse rate and side effect were compared among these three groups. [Results] The relapse rate in the allied program group （5.9%） was significantly lower than that GnRH-a group （15.3%, P 〈0.05） and huxue zhitong decoction group （13.9%, P 〈0.05）. 3 cases （4.1%, 3/70） were liver function impairment in the allied program group, and 8 cases （11.1%, 8/72） in GnRH-a group, P 〈0.05, there were sig- nificant difference; 4 cases had leukopenia in the allied program group （5.9%, 4/70）, and 8 cases in huxue zhitong decoction group （11.1%, 8/72）, P 〈0.05, there were significant difference. [Conclusion] The allied program of GnRH-a and huxue zhitong decoction achieves the good clinical efficacy on endometriosis after laparoscopic surgery. This program of treatment can effectively remove the focus and clinical symptoms, obviously reduce the recurrence rate and has less side reaction in long-term application. Hence, it deserves to be promoted in mice.