丹赤饮对子宫内膜异位症患者血清白细胞介素的影响

Effect of Danchi Decoction on Serum Interleukin of Endometriosis

目的基于免疫平衡,探讨丹赤饮抑制气滞血瘀型子宫内膜异位症(EMs)保守术后复发的作用机理。方法采用区组随机方法,将EMs保守术后患者分为中药组(20例)和西药组(10例),分别予丹赤饮、促性腺激素释放激素(GnRH-a)或孕三烯酮治疗3个月,分别于术前、用药3个月、停药3个月时检测血清白细胞介素(IL)-2、IL-6含量及IL-2/IL-6变化,并与卵巢单纯性囊肿(对照组)5例进行比较。结果术前中药组、西药组患者血清IL-2水平低于对照组(P<0.05),IL-6水平高于对照组(P<0.05),IL-2/IL-6低于对照组(P<0.05)。用药3个月及停药3个月,2组患者IL-2水平较术前均明显升高(P<0.05),IL-6水平较术前均明显下降(P<0.05),IL-2/IL-6较术前均明显升高(P<0.05);中药组患者IL-2/IL-6较对照组无明显变化(P>0.05),西药组停药3个月时IL-2/IL-6水平显著低于对照组(P<0.05)。结论免疫失衡与EMs的发生、发展密切相关。丹赤饮、GnRH-a或孕三烯酮治疗均可通过纠正EMs患者免疫失衡状态,达到预防EMs保守术后复发的作用,且丹赤饮的长远效果更为明显。

Objective Based on the immunologic balance, to investigate the mechanisms of Danchi decoction for controlling the recurrence of endometriosis （EMs） of qi stagnation and blood stasis after conservative operation. Methods A multi-center and randomized clinical trial was adopted. EMs patients were divided into Chinese medicine group （CG, 20 cases） and western medicine group （WG, 10 cases）. The two groups were given Danchi decoction and GnRH-a or gestrinone respectively for 3 months. The serum IL-2, IL-6 and IL-2/IL-6 were detected before operation, after 3 months of treatment and 3 months after withdrawal, and compared with the control group （5 cases of simple ovarian cysts）. Results Before operation, the serum IL-2 level of CG and WG was lower than control group （P〈0.05）, IL-6 was higher than control group （P〈0.05）, the ratio of IL-2/IL-6 was lower than control group （P〈0.05）. After treatment and 3 months after withdrawal, IL-2 level of CG and WG was increased than before operation （P〈0.05）, IL-6 was decreased （P〈0.05）, IL-2/IL-6 ratio was increased （P〈0.05）. There was no significant difference in IL-2/IL-6 between CG and control group （P〉0.05）, but 3 months after withdrawal, IL-2/IL-6 of WG was significantly lower than that of control group （P〈0.05）. Conclusion Immune imbalance is closely related to the occurrence and development of EMs. Danchi Decoction or GnRH-a or gestrinone can prevent the recurrence of EMs by adjusting the disorder of immune response, and Danchi Decoction has better effect on long-term result.