加味二陈汤对肾虚痰湿型子宫内膜异位症疗效及其机制研究

Effect and Mechanism study of Modified Erchen Decoction Treating Endometriosis of Kidney-Deficiency and phlegm-Dampness

目的:探讨加味二陈汤对肾虚痰湿型子宫内膜异位症(Endometriosis,EMs)疗效及对血流变学、免疫功能及内分泌功能的影响。方法:选取符合纳入标准的167例肾虚痰湿型EMs患者随机分为治疗组84例,对照组83例。对照组EMs患者给予达那唑、结合雌激素片与安宫黄体酮联合治疗,治疗组在对照组基础上给予加味二陈汤,两组均进行3个月的连续治疗,结束后对两组患者临床疗效、血流变学、免疫功能、内分泌功能及可溶性细胞黏附因子-1(sICAM-1)及细胞间黏附分子-1(ICAM-1)表达情况进行比较。结果:治疗组肾虚痰湿型EMs患者临床总有效率为92.86%(78/84),对照组为80.72%(67/83),差异有统计学意义(P<0.05);治疗后治疗组与对照组两组患者全血高、低切黏度、红细胞聚集指数、红细胞压积都显著的下降,且治疗组下降幅度显著低于对照组,差异具有显著性(P<0.05);治疗后两组患者CD3^+、CD4^+、CD4^+/CD8^+比值均有明显上升,CD8^+水平明显下降(P<0.05),两组相较对比,治疗组CD3^+、CD4^+与CD4^+/CD8^+比值明显升高,CD8^+水平明显降低,组间比较差异具有统计学意义(P<0.05);通过治疗,两组肾虚痰湿型EMs患者血清雌二醇(E2)、促黄体生成激素(LH)、卵泡刺激素(FSH)明显降低,治疗组显著低于对照组(P<0.05)。两组治疗后sICAM-1水平降低,ICAM-1表达升高,且治疗组改善水平优于对照组(P<0.05)。结论:肾虚痰湿型EMs患者使用加味二陈汤进行治疗后效果显著,能够显著改善患者血液流变学指标,提高机体免疫功能,调节患者内分泌功能。

Objective: To explore the effect of Modified Erchen Decoction on curative effect,hemorrheology,immune function and endocrine function in the treatment of endometriosis(EMs) of Kidney-deficiency and phlegm-dampness.Methods: 167 EMs patients with Kidney-deficiency and phlegm-dampness were randomly divided into the treatment group( n =84) and the control group( n =84).The control group was treated with Danazol combined with estrogen and progesterone;on which basis,the treatment group was also treated with Modified Erchen Decoction.The treatment duration was three continuous months.The curative effect,hemorheology,immune function,endocrine function,and the expressions of soluble cell adhesion factor-1 (sICAM-1) and intercellular cell adhesion molecule-1(ICAM-1) were compared between the two groups.Results: The total effective rate was 92.86%(78/84) in the treatment group,which was significantly higher than 80.72%(67/83) in the control group( P <0.05).The whole blood viscosity at low shear rate,whole blood viscosity,erythrocyte aggregation index were lower after the treatment in the two groups;the decreases were more significant in the treatment group than those in the control group( P <0.05).The levels of CD3 ^+,CD4 ^+ and CD4 ^+/CD8 ^+ significantly increased,and the level of CD8 ^+ significantly decreased after the treatment in the two groups( P <0.05);of which the changes in the treatment group were more remarkable than those in the control group( P <0.05).Estradiol(E 2),luteotropic hormone(LH) and follicle-stimulating hormone(FSH) decreased after the treatment in the two groups,and the decreases were more obvious in the treatment group( P <0.05).The expression of sICAM-1 was decreased,whereas the expression of ICAM-1 was increased after the treatment in the two groups,and the improvements were more significant in the treatment group( P <0.05).Conclusion: Modified Erchen Decoction has better effect on EMs,and it can significantly improve hemorheology,enhance the immunity function and endocrine function.