祛瘀解毒方治疗血瘀蕴毒型子宫内膜异位症30例临床观察

Clinical Observation on Quyu Jiedu Formula in the Treatment of 30 Cases of Endometriosis with Blood Stasis and Toxin Accumulation Syndrome

目的观察祛瘀解毒方治疗子宫内膜异位症(EM)的临床疗效及作用机制。方法将EM血瘀蕴毒型患者60例随机分为治疗组和对照组各30例,治疗组予祛瘀解毒方(膏方),对照组予丹莪妇康煎膏,两组均于经期结束后开始服用,连服20天,治疗3个月经周期。观察两组患者治疗前后中医证候积分、痛经积分,检测血清白细胞介素6(IL-6)、可溶性细胞黏附因子-1(s ICAM-1)及在位内膜细胞黏附因子-1(ICAM-1)的表达情况,并判定临床疗效。结果治疗组临床疗效总有效率83.33%,对照组为60.00%,治疗组优于对照组(P<0.05)。两组治疗后较治疗前中医证候积分、痛经积分明显降低,血清IL-6、s ICAM-1水平降低,在位内膜ICAM-1表达升高(P<0.05);治疗组治疗后上述指标均较对照组改善明显(P<0.05)。结论祛瘀解毒方治疗血瘀蕴毒型EM疗效显著,其作用机制可能与下调血清IL-6、s ICAM-1表达、上调在位内膜ICAM-1表达有关。

Objective To observe the clinical efficacy and discuss the mechanism of Quyu Jiedu Formula（ Formula for removing stasis and toxins） in the treatment of endometriosis（ EM）. Methods Totally 60 EM patients with blood stasis and toxin accumulation syndrome were randomly divided into treatment group and control group,with 30 cases each. The treatment group was given Quyu Jiedu Formula in herbal paste,while the control group was given Dan＇ e Fukang Decocted Extract. The treatments started after the end of menstrual period and lasted for 20 days.Treatment course was 3 menstrual periods. The symptom scores,dysmenorrhea scores were recorded and the expression of interleukin-6（ IL-6）,soluble intercellular adhesion molecule-1（ s ICAM-1） and eutopic endometrim cells＇ intercellular adhesion molecule-1（ ICAM-1） was detected before and after treatments,so as to determine the clinical efficacy. Results The overall effective rate was 83. 33% in the treatment group and 60. 00% in the control group,the results in the treatment group was superior（ P〈0. 05）. The symptom scores,dysmenorrhea scores were significantly lower after treatments and the expression of IL-6,s ICAM-1 in serum was reduced and eutopic endometrim cells＇ ICAM-1 was increased with statistical significance（ P〈0. 05）. Also all indexes from above in the treatment group were improved in a larger scale than in the control group（ P〈0. 05）. Conclusion Quyu Jiedu Formula was effective in EM patients with blood stasis and toxin accumulation syndrome. The mechanism could be the down-regulated expression of serum IL-6 and s ICAM-1,as well as up-regulated expression of eutopic endometrim cells＇ ICAM-1.