膈下逐瘀汤治疗气滞血瘀型子宫内膜异位症

Therapeutic Effect Observation of Gexia Zhuyu Decoction on Endometriosis with Qi Stagnation and Blood Stasis Syndrome

目的:观察膈下逐瘀汤治疗气滞血瘀型子宫内膜异位症的临床疗效。方法:将92例患者按随机数字表法分为治疗组49例和对照组43例。对照组采用醋酸甲羟孕酮治疗,每次150 mg,肌肉注射,每月1次。治疗组在对照组治疗的基础上加用膈下逐瘀汤治疗,口服,每天1剂,分早晚两次温服。两组患者均以1个月为1个疗程,共用药3个疗程。治疗后,观察两组患者的临床疗效,并比较治疗前后两组患者的疼痛评分、血清激素指标包括雌二醇(estradiol,E2)、卵泡刺激素(follicle-stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、孕酮(Progesterone,P)、促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)及抗子宫内膜抗体(anti-endometrial antibodies,EmAB)、血清癌抗原(carcinoantigen,CA125)水平的变化情况。结果:治疗3个疗程后,两组患者的临床症状均得到明显改善,其中治疗组有效率为93. 88%,明显高于对照组的79. 07%,差异有统计学意义(P <0. 05)。治疗后,两组患者疼痛评分与治疗前比较均显著降低,差异有统计学意义(P <0. 05);在第1疗程结束时,两组患者疼痛评分比较,差异无统计学意义(P> 0. 05),但在第2个疗程、第3个疗程结束时治疗组患者的疼痛评分则显著低于对照组,差异有统计学意义(P <0. 05)。治疗后,两组患者的E2、FSH、LH、P、ACTH、EmAB及CA125的水平与治疗前比较均显著改善,差异有统计学意义(P <0. 05);治疗组患者血清E2、FSH、LH、P、ACTH水平较对照组改善程度更明显,差异有统计学意义(P <0. 05)。治疗后,两组EmAB及CA125的水平比较,差异无统计学意义(P> 0. 05)。结论:膈下逐瘀汤能够显著改善患者临床症状,缓解疼痛,有效调节机体血清激素的水平,可能与其下调血清CA125、促进EmAb转阴有关。

Objective ： To observe the clinical efficacy of Gexia Zhuyu Decoction in treatment of endometriosis with Qi stagnation and Blood stasis Syndrome,as well as the effects on patients＇ dysmenorrhea, serum hormones, EmAB and cancer antigen （CA125）. Methods ：92 patients were divided into treatment group （n = 49） and control group （n = 43 ） according to random number table. The control group was treated with medroxyprogesterone acetate ,with 150 mg each time, intramuscularly, once a month. The treatment group was treated with Gexia Zhuyu Decoction in addition to that of the control group, orally, with 1 dose per day. Both groups of patients took 3 month as 3 courses of treatment. After treatment, the clinical efficacy of the two groups of patients was observed, and the pain scores and serum hormones, including estradiol （E2 ）, follicle-stimulating hormone （FSH）, and luteinizing hormone. Changes in the levels of （luteinizing hormone, LH）, progesterone （P）, Adrenocorticotropic hormone （ACTH） and anti-endometri- al antibodies （EmAB） and serum CA~：s of the two groups were compared before and after treatment. Results ： After 3 courses of treatment, the clinical symptoms of the two groups were significantly improved. The effective rate of the treatment group was 93.88%, which was significantly higher than that （79.07%） of the control group （ P 〈 0. 05 ）. After treatment, the pain scores of the two groups were significantly lower than those before treatment, and the difference was statistically significant （P 〈 0.05 ）. At the end of the first course of treatment, the pain scores of the two groups were not statistically significant （ P 〉 0. 05 ）, but the pain scores of the treatment group were significantly lower than those of the control group at the end of the second course and the third course of treatment （P 〈 0. 05 ）. After treatment, the levels of E2 , FSH, LH, P, ACTH, EmAB and CA125 in the two groups were significantly improved compared with those before treatment （P 〈 0.05 ）. The serum E2 , FSH, LH in the treatment group and the levels of P and ACTH were more obvious than those of the control group, and the difference was statistically significant （ P 〈 0. 05 ）. After treatment, there was no significant difference in the levels of EmbAB and CA125 between the two groups （P 〉 0. 05 ）. Conclusion：Gexia Zhuyu Decoction can significantly improve the clinical symptoms, relieve pain and effectively regulate the serum hormone levels of the body,which may be related to the down-regulation of serum CA125 and the promotion of EmAb.