清热化瘀中药方治疗子宫内膜异位症临床研究

Clinical study on the treatment of endometriosis with clearing away heat and removing bloodstasis therapy

目的观察腹腔镜术后配合清热化瘀中药方治疗子宫内膜异位症(EMs)的临床疗效。方法将90例EMs患者按照随机数字表法分为2组,2组均行腹腔镜下卵巢囊肿剥离术。治疗组30例术后予清热化瘀中药方治疗,治疗3个月经周期,经期不服用;对照组30例于术后第1次月经来潮第1～5 d予注射用醋酸曲普瑞皮下注射1次,每4周1次,共用4次。比较2组治疗前后疼痛视觉模拟评分法(VAS)评分、中医症状积分、子宫内膜异位症患者生存质量调查表-30(EHP-30)评分、血清糖类抗原-125(CA125)及性激素六项水平变化,统计比较2组临床疗效。结果治疗后2组疼痛VAS评分、中医症状积分、EHP-30各维度评分及总分均较本组治疗前下降(P<0.05),且治疗组均低于对照组(P<0.05)。治疗后2组CA125水平及雌激素(E_2)水平均较本组治疗前下降(P<0.05),且治疗组均低于对照组(P<0.05)。治疗组总有效率93.33%,对照组总有效率83.33%,2组总有效率比较差异无统计学意义(P> 0.05)。结论腹腔镜术后配合清热化瘀中药方可以显著减轻EMs患者疼痛等症状,改善其生活质量,并能够降低CA125及E_2水平。

Objective To observe the clinical efficacy of laparoscopic surgery combined with clearing away heat and removing bloodstasis recipe in the treatment of patients with endometriosis （EMs）. Methods 90 patients with EMs were randomly divided into two groups according to random numble table method. Both groups underwent laparoscopic ovarian cyst dissection. 30 patients in the treatment group were treated by clearing away heat and removing bloodstasis, and were treated for 3 menstrual cycles without menstruation. 30 cases in the control group were injected subcutaneously with triptoryl acetate for 1 to 5 days after the first menstrual cramps, and once every four weeks, four times in total. The pain visual analogue scale（VAS）scores, TCM symptom scores, endometriosis Health Profile Questionnaire （EHP-30） scores, serum saccharide antigen-125 （CA125） and six levels of sex hormone changes of two groups were compared before and after treatment. Results After treatment, the pain VAS score, TCM symptom score, EHP-30 score and total score of the two groups were lower than those before treatment （ P 〈 0.05 ）, and the treatment group was lower than the control group （ P 〈0.05）. After treatment, the levels of CA125 and E 2 in the two groups were lower than those in the group before treatment （ P 〈0.05）, and the treatment group was lower than the control group （ P 〈0.05）. The total effective rate was 93.33 % in the treatment group and 83.33% in the control group. There was no significant difference in the total effective rate between the two groups （ P 〉 0.05 ）. Conclusion Laparoscopic surgery combined with clearing away heat and removing bloodstasis recipe can significantly improve the symptoms of pain and improve the quality of life of patients with EMs, and can reduce the levels of E 2 and CA125.