子宫内膜异位症术后应用复方莪术散与达菲林临床观察

Clinical Observation of Compound Rhizoma Curcumae Powder and Diphereline preventive Application for Postoperative Endometriosis

目的:探讨子宫内膜异位症患者腹腔镜术后联合药物复方莪术散与达菲林辅助治疗的临床疗效对比。方法:收集112例行腹腔镜治疗并经病理证实为子宫内膜异位症患者并将其随机分为复方莪术散组59例,达菲林组53例,复方莪术散组术后7天开始服药,采用复方莪术散(药物组成:莪术20 g,黄芪20 g,延胡索20 g,三棱20 g,淫羊藿20g),每天2次,早晚冲服,连服3个月,经期不停药。达菲林组术后7天开始,采用皮下注射达菲林,每次3.75 mg,每隔28天1次,连用3个疗程。两组患者均于用药期间每月定期复查及停药后随访12个月。观察两组治疗的临床疗效、术后妊娠情况、药物不良反应及治疗前后血清雌二醇(E2)的对比。结果:用药后复方莪术散组的总体妊娠率高于达菲林组(P<0.05),而副反应发生率明显低于达菲林组(P<0.05);两组的症状好转率、复发率无显著性差异。复方莪术散组用药前后体内E2水平变化不明显,而达菲林组用药后比用药前体内E2水平明显降低,差异有统计学意义(P<0.05)。结论:腹腔镜术后联合中药复方莪术散治疗的不良反应比较少,又可显著提高妊娠率,是一种有效的临床治疗方法。

Objective ： To explore the clinical efficacy of dipherelin and Compound Rhizoma Curcumae Powder assisted therapy for postoperative endometriosis patients. Methods：A total of t 12 patients who received laparoscopic treatment and had pathological- ly confirmed endometriosis were randomly divided into Compound Rhizoma Curcumae Powder group（ n = 59） and dipherelin group （n = 53）. Dipherelin group was administered dipherelin seven days after the surgery, every time 3.75 rag, subcutaneous injection, 28 days,once every 3 courses. Compound Rhizoma Curcumae Powder group（ Drugs：Curcuma 20 g, Astragalus 20 g, Corydalis 20 g, triangular 20 g, Epimedium 20 g）, twice a day, seven days after the surgery, with three consecutive months. The two groups reg- ular monthly reviewed and followed -up of 12 months. The clinical efficacy, postoperative pregnancy and adverse events and ser- um E2 level of the two groups were observed before and after treatment. Results ： The pregnancy rates were higher in the Compound Rhizoma Curcumae Powder group than that in the dipherelin group（P 〈0. 05） ,but the side reaction rate was lower in the Com- pound Rhizoma Curcumae Powder group than that in the dipherelin group（P 〈 0.05）. No significant differences between the two groups were found in the clinical remission rate and recurrence rate. After treatment, the serum E2 level was significantly lower（ P 〈 0. 01 ） in the dipherelin group, but there was no difference in the Compound Rhizoma Curcumae Powder group of Serum E2 level. Conclusion：Rhizoma Curcumae Powder after laparoscopic surgery is an effective clinical treatment which can significantly improve the pregnancy rate with few adverse reactions.