中药保留灌肠治疗子宫内膜异位症的临床研究

Clinical Observation on Curative Effects of Retention Enema with Chinese Medicine in Treating Endometriosis and Influence on CA125 and IL-6 in Peritoneal Fluid

目的观察以活血化瘀为主的内异灌肠方治疗血瘀型子宫内膜异位症的临床疗效,及其对腹腔液中CA125及IL-6值的影响,探讨中药治疗子宫内膜异位症的可能机制。方法 60例有腹腔镜手术指征的子宫内膜异位症患者,随机分组,30例治疗组给予内异灌肠方治疗,观察治疗前后临床症状包括痛经及性交痛的缓解情况及治疗前后CA125值的变化情况、卵巢囊肿大小的变化,共治疗3个月经周期后行腹腔镜手术;对照组直接行腹腔镜手术。观察治疗组与对照组子宫内膜异位症患者腹腔液中CA125及IL-6水平变化。结果治疗组30例患者中23例痛经、13例性交痛患者经中药保留灌肠治疗3个月后前后症状不同程度改善,有显著性差异(P<0.01)。治疗组与对照组腹腔液CA125及IL-6值比较,有显著性差异(P<0.05),rAFS评分2组间比较无显著性差异。结论内异灌肠方能改善子宫内膜异位症患者痛经及性交痛的疼痛情况,降低腹腔液CA125及IL-6,从而发挥治疗作用。

OBJECTIVE To observe the clinical effect of Neiyi Guanchang Fang for activating blood and removing blood stasis on endometriosis and influence on CA125 and IL-6 in peritoneal fluid for exploring the possible mechanism of Chinese medicine treating endometriosis.METHODS 60 cases of patients were equally grouped into treatment group and control group randomly.The treatment group was administrated Neiyi Guangchang fang.The clinical symptoms before and after treatment were observed,including the relief of dysmenorrhea and dyspareunia,changes of CA125 and ovarian cyst.After 3 menstrual cycles,a laparoscopic surgery was made.The control group received laparoscopic surgery directly.CA125 and IL-6 levels in both groups were observed.RESULTS The symptoms improved in different degrees for 23 cases with dysmenorrhea and 3 cases with dyspareunia in treatment group,whose difference was significant.The differences of CA125 and IL-6 values in both groups were statistically significant.There was no significant difference between both groups on rAFS scores.CONCLUSION Neiyi Guanchang Fang can relieve the pain of dysmenorrhea and dyspareunia for patients with endometriosis,which plays a therapeutic role by reducing CA125 and IL-6 in peritoneal fluid.