腹腔镜联合消癥方和消癥灌肠汤治疗子宫内膜异位症的临床观察

Clinical Observation of Endometriosis Treated with Laparoscope Combined Xiao Fang Decoction and Enema

目的:观察腹腔镜联合消癥方和消癥灌肠汤治疗子宫内膜异位症的临床疗效。方法:选取景德镇市中医医院2014年11月至2016年8月收治的子宫内膜异位症患者58例,随机分为治疗组28例和对照组30例,治疗组与对照组均在月经干净后3~7d内行腹腔镜下保守性手术,治疗组手术后指导患者口服消癥方和消癥灌肠汤,共服用6个月经周期,观察组给予米非司酮口服6个月治疗,比较两组术后痛经程度、复发情况、妊娠情况、血清CA125水平及毒副作用等情况。结果:两组患者接受治疗后,痛经程度评分均有所降低,但治疗组患者的痛经程度评分降低程度要优于对照组,组间数据存在统计学差异,P<0.05。两组2月内、半年内、1年内复发例数均只有1例,经χ2检验,P>0.05,差异无显著性。对比两组患者3月内、半年内妊娠数据,组间数据对比存在统计学差异,P=0.01<0.05,差异显著;两组患者1年内的总妊娠率无统计学差异,P>0.05,差异无显著性。治疗后,两组血清CA125水平经t检验,t=4.732,P=0.304>0.05,差异无显著性。治疗组消癥方+消癥灌肠汤无明显毒副作用。对照组30例服药后面部痤疮明显9例,阴道异常出血13例,停药后恢复正常。结论:对行腹腔镜手术的子宫内膜异位症患者,术后给予消癥灌肠汤和消癥方治疗,能够有效地改善患者手术后半年内的妊娠情况,毒副作用较小,可以在临床上推广应用。

Objective:To observe the clinical effect of laparoscopic combined with Xiaozheng decoction in treating endometriosis.Methods:Fifty-eight patients in our hospital from Nov2014to Aug2016with endometriosis were randomly divided into treatmentgroup(n=28)and control group(n=30).The treatment group and control group were treated with menstruation The patients underwentlaparoscopic conservative operation.After operation,the patients were treated with oral decoction and Xiaozhi enema decoction.Theobservation group patients were treated with mifepristone for6months.Post-dysmenorrhea,recurrence,pregnancy,serum CA125levels and side effects and so on were compared.Results:After treatment,the scores of dysmenorrhea were decreased in both of thetwo groups,but the degree of dysmenorrhea was lower in the treatment group than in the control group(P<0.05).There was only1caseof recurrent cases in the two groups within two months and six months.There was no significant difference in the total pregnancy rateor serum CA125level between the two groups(P>0.05).Treatment group Xiaoxie Zheng+Xiaozhi enema soup showed no obviousside effects.In the control group of13cases,9cases of facial acne,13cases of abnormal bleeding,and recovered to normal afterstopping the treatment.Conclusion:In patients with endometriosis underwent laparoscopic surgery,the treatment with Xiaozhi andXiaozheng decoction can improve the pregnancy after six months of operation.The side effects are small,thus it is worth promotion andapplication.