藏红花加温胆汤对子宫内膜异位症患者外周血基质金属蛋白酶9水平的影响

Effect of Wendan Decoction plus Saffron on serum MMP-9 in endometriosis of uterus

目的探讨藏红花加温胆汤对子宫内膜异位症患者外周血基质金属蛋白酶-9（matrix metalloproteninases-9,MMP-9）水平的影响。方法研究对象选取2014年1月-2015年10月在固原市德隆人民医院收治的74例子宫内膜异位症妇女,随机分成2组,每组37例。对照组予孕三烯酮胶囊口服,研究组在此基础上再予中药温胆汤加藏红花,均治疗24周,检测治疗前后血清雌激素、血清MMP-9、基质金属蛋白酶抑制剂-1（matrix metalloproteninases inhibitor-1,TIMP-1）平,比较疼痛程度及临床疗效。结果与治疗前比较,2组雌二醇（estradiol,E2）、孕酮（progesterone,P）及黄体生成素（luteotropic hormone,LH）水平降低（P〈0.01）,MMP-9水平、MMP-9/TIMP-1降低（P〈0.01）,TIMP-1水平升高（P〈0.01）,CA125水平降低（P〈0.01）,盆腔包块最大径线减少（P〈0.01）,痛经、盆腔痛及性交痛VAS评分降低（P〈0.01）;与对照组比较,研究组E2、P及LH水平较低（P〈0.01）,MMP-9水平、MMP-9/TIMP-1较低（P〈0.01）,TIMP-1水平较高（P〈0.01）,CA125水平较低（P〈0.01）,盆腔包块最大径线较少（P〈0.01）,痛经及盆腔痛VAS评分较低（P〈0.01）,治疗有效率较高（P〈0.05）。结论藏红花加温胆汤治疗子宫内膜异位症疗效显著,减轻痛经及盆腔痛程度,缩少盆腔包块,可能与降低血清MMP-9水平有关。

Objective To explore the effect of Wendan Decoction plus Saffron in the treatment of patients with endometriosis of uterus on serum matrix metalloproteninases-9（MMP-9）. Methods 74 cases of endometriosis of uterus were selected and randomly divided into two groups,37 cases in each group. The control group were treated with oral administration of Gestrinone Capsules,the research group were treated on the basis of the control group with Wendan Decoction plus Saffron treatment,two groups were treated for 24 weeks. The serum estradiol,MMP-9 and matrix metalloproteninases inhibitor-1（TIMP-1） were detected before and after treatment,the degree of pain and clinical efficacy were compared. Results Compared with before treatment,levels of estradiol（E2）,progesterone（P） and luteotropic hormone（LH） decreased in two groups（P〈0. 01）,the levels of MMP-9,MMP-9/TIMP-1 decreased（P〈0. 01）,levels of TIMP-1 increased（P〈0. 01）,levels of CA125 decreased（P〈0. 01）,and the maximum diameter of pelvic mass line decreased（P〈0. 01）,dysmenorrhea pelvic pain,dyspareunia and VAS score decreased（P〈0. 01）. Compared with the control group,levels of E2,P and LH in the research group were lower（P〈0. 01）,the levels of MMP-9,MMP-9/TIMP-1 were lower（P〈0. 01）,levels of TIMP-1 were higher（P〈0. 01）,levels of CA125 were lower（P〈0. 01）,the maximum diameter of pelvic mass line were lower（P〈0. 01）,dysmenorrhea and pelvic pain and VAS scores were lower（P〈0. 01）,and the effective rate of research group was higher（P〈0. 05）. Conclusion Wendan Decoction plus Saffron in the treatment of endometriosis of uterus was effective,and it can reduce endometriosis,dysmenorrhea and pelvic pain degree,reduce pelvic mass,and may reduce the level of serum MMP-9 related.