GnRHa联合温肾消癥汤用于腹腔镜子宫内膜异位症术后辅助治疗的临床观察

Adjunctive Treatment of GnRHa Combined Wenshen Xiaozheng Decoction in Treating Endometriosis after Laparoscopy:a Clinical Observation

目的观察促性腺激素释放激素激动剂（GnRHa）联合中药温肾消症汤口服辅助治疗腹腔镜子宫内膜异位症术后的有效性和安全性。方法选择腹腔镜手术病理确诊为子宫内膜异位症的患者134例,按照是否接受辅助治疗及中药治疗的原则分为对照组、观察1组及观察2组。对照组22例术后未采用辅助治疗;观察1组42例,术后月经第1～5天开始予GnRHa.3.6.mg皮下注射,每隔28天注射1次;观察2组70例,术后月经第1～5天开始予GnRHa.3.6.mg皮下注射并联合中药温肾消症汤7剂口服,每隔28天注射并联合中药温肾消症汤口服1次,连续治疗观察3～6个月。观察治疗前后3组患者雌二醇（E_2）、促卵泡刺激素（FSH）及促黄体生成激素（LH）的变化、血清糖类癌抗原125（CA1.25）的变化、临床疗效及药物不良反应。结果与对照组比较,观察1、2组E_2、FSH及LH差异均有统计学意义（P〈0.05）,而观察1组与观察2组间E、FSH及LH比较,差异无统计学意义（P〉0.05）,3组间临床疗效比较差异有统计学意义（P〈0.05）;3组血清CA125的水平术前、术后比较,差异有统计学意义（P〈0.01）,与对照组比较,观察1、2组术后不同治疗时段差异均无统计学意义（P〉0.05）。用药期间未见明显不良反应。结论.GnRHa联合温肾消症汤辅助治疗腹腔镜子宫内膜异位症术后临床疗效确切,并可降低E_2、FSH、LH水平,是治疗子宫内膜异位症较为理想的治疗方案。

Objective To observe the therapeutic efficacy and safety of gonadotropin-releasing hormone agonist （GnRHa） combined Wenshen Xiaozheng Decoction （WXD） in auxiliary treating endome- triosis after laparoscopy. Methods One hundred and thirty-four endometriosis patients with confirmative pathological diagnosis were assigned to three groups depending on whether they would receive adjuvant therapy or Chinese medicine treatment, i.e., the control group, the observation 1 group, and the obser- vation 2 group. The 22 patients in the control group received no adjuvant therapy after laparoscopy. The 42 patients in the observation 1 group were treated with GnRHa 3.6 mg by subcutaneous injection starting from the 1st day to the 5th day of menstruation, once per 28 days. The 70 patients in the observation 2 group were treated with GnRHa 3.6 mg by subcutaneous injection in combination with WXD starting from the 1st day to the 5th day of menstruation, once per 28 days. They also took WXD for 7 doses, one cycle per every 28 days. The treatment lasted for three to six months. Serum levels of estradiol （E2）, follicle- stimulating hormone （FSH）, luteinizing hormone （LH）, and cancer antigen 125 （CA125）, as well as clinical efficacy, and adverse drug reactions were observed before and after treatment. Results There was statistical difference in serum levels of E2, FSH, or LH between the control group and the observa- tion 1 and 2 groups （P 〈0.05）. There was no statistical difference in serum levels of E2, FSH, or LH be- tween the observation 1 group and the observation 2 group （P 〉0.05）. There was statistical difference in the clinical efficiency among the 3 groups （P 〈 0.05）. There was statistical difference in the pre-post difference of CA125 levels among the three groups （P 〈0.01 ）. Compared with the control group, there was no statistical difference in the pre-post difference of CA125 levels between the observation 1 group and the observation 2 group （P 〉0.05）. No obvious adverse reaction occurred during the treatment. Con- clusions GnRHa combined WXD showed confirmative clinical efficacy in treating endometriosis after laparoscopy. It also could lower serum levels of E2, FSH, and LH levels. So it was an ideal solution for treatment of endometriosis.