桂枝茯苓胶囊联合屈螺酮炔雌醇治疗子宫内膜异位症的临床研究

Clinical study of Guizhi Fuling Capsules combined with drospirenone and ethinylestradiol in treatment of endometriosis

目的探讨桂枝茯苓胶囊联合屈螺酮炔雌醇治疗子宫内膜异位症的临床效果。方法选取2013年1月—2017年10月首都医科大学附属北京妇产医院收治的子宫内膜异位症患者82例,随机分成对照组(41例)和治疗组(41例)。对照组患者于月经来潮后第5天开始口服屈螺酮炔雌醇片,1片/次,1次/d,连服至下次月经来潮为1个用药周期,持续治疗6个周期。治疗组在对照组基础上饭后口服桂枝茯苓胶囊,3粒/次,3次/d,连续治疗6个月经周期。观察两组患者临床疗效,同时比较治疗前后两组患者视觉模拟评分(VAS)、盆腔包块直径、子宫体积、雌二醇(E2)和前列腺素E2(PGE2)水平及血流变学指标和子宫内膜异位症健康状况量表-5(EHP-5)评分。结果治疗后,对照组和治疗组临床有效率分别为80.5%和95.1%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组痛经疼痛VAS和EHP-5评分显著降低(P<0.05),盆腔包块直径和子宫体积也均显著缩小(P<0.05),且治疗组这些指标明显优于对照组(P<0.05)。治疗后,两组患者血清E2和PGE2浓度均显著下降(P<0.05),且治疗组E2和PGE2水平明显低于对照组(P<0.05)。治疗后,治疗组患者血浆黏度(PV)、红细胞比容(HCT)和红细胞聚集指数(RCAI)水平显著降低(P<0.05),且治疗后这些指标明显低于对照组(P<0.05)。结论桂枝茯苓胶囊联合屈螺酮炔雌醇治疗子宫内膜异位症,能明显改善患者症状,缩小子宫体积,纠正血液高凝状态,提高生存质量。

Objective To investigate the clinical efficacy on Guizhi Fuling Capsules combined with drospirenone and ethinylestradiol in treatment of endometriosis. Methods Patients(82 cases) with endometriosis in Beijing Obstetrics and Gynecology Hospital of Capital Medical University from January 2013 to October 2017 were randomly divided into control(41 cases) and treatment(41 cases) groups. Patients in the control group were po administered with Drospirenone and Ethinylestradiol Tablets from the fifth day after menstruation, 1 tablet/time, once daily, until the next menstrual cycle was one medication cycle, and treated for 6 medication cycles. Patients in the treatment group were po administered with Guizhi Fuling Capsules after meals on the basis of the control group, 3 grains/time, three times daily. After treatment, the clinical efficacy was evaluated, and the VAS scores, pelvic mass diameter, uterine volume, E2 and PGE2 levels, hemorrheology indexes and EHP-5 scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 80.5% and 95.1% respectively, and there were differences between two groups(P < 0.05). After treatment, the VAS and EHP-5 scores in two groups were significantly decreased(P < 0.05), and the pelvic mass diameter and uterine volume were significantly reduced(P < 0.05), and these indexes in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the serum concentration of E2 and PGE2 in two groups was significantly decreased(P < 0.05), and the E2 and PGE2 level in the treatment group was significantly lower than those in the control group(P < 0.05). After treatment, the PV, HCT and RCAI levels in treatment group were significantly decreased(P < 0.05), and which in the treatment group were significantly lower than those in the control group(P < 0.05). Conclusion Guizhi Fuling Capsules combined with drospirenone and ethinylestradiol in treatment of endometriosis can significantly improve the clinical symptoms, reduce the volume of the uterus, regulate the hypercoagulable state and improve the quality of life.