清热化瘀方对子宫内膜异位症患者雌激素、NGF和炎症因子的影响

Effect of Qingre Huayu Formula on Estrogen, NGF and Inflammatory Factors in Patients with Endometriosis

目的:观察清热化瘀方联合孕三烯酮治疗子宫内膜异位症的临床疗效及其对雌激素、神经生长因子(NGF)和炎症水平的影响。方法:选择符合纳入标准的子宫内膜异位症患者112例,依照随机数表法随机分为观察组(56例)和对照组(56例)。对照组予以孕三烯酮治疗,观察组在对照组的基础上予以清热化瘀方治疗。观察两组患者的临床疗效、治疗前后痛经评分、症状评分、子宫内膜厚度、CA125、血液黏度、孕激素(P)、雌二醇(E 2)、卵泡刺激素(FSH)、黄体生成素(LH)、NGF、白介素-1β(IL-1β)、白介素-8((IL-8)和肿瘤坏死因子-α(TNF-α)水平的变化情况。结果:观察组的总有效率为89.28%(50/56)与对照组71.43%(40/56)比较,差异显著(χ^2=4.582,P<0.05)。两组治疗前全血高切黏度、全血低切黏度、血液黏度和红细胞压积比较,差异无统计学意义(P>0.05),治疗后观察组较治疗前明显降低(P<0.01),且优于对照组(P<0.01)。两组治疗前痛经评分、症状评分、子宫内膜厚度、CA125、E 2、FSH、P、LH、NGF、IL-1β、IL-8和TNF-α水平比较,无显著性差异(P>0.05),治疗后与治疗前比较均明显降低(P<0.01),且观察组与对照组治疗后比较,差异显著(P<0.01)。结论:清热化瘀方联合孕三烯酮治疗子宫内膜异位症疗效显著,能够降低血液黏度,降低女性激素水平和痛经程度,其机理可能与降低机体NGF水平,从而进一步降低与疼痛相关的炎症介质有关。

Objective:To observe the efficacy of Qingre Huayu Formula combined with western medication on the levels of estrogen,nerve growth factor(NGF)and inflammation factors in patients with endometriosis.Methods:112 patients with endometriosis who were randomly divided into the observation group(n=56)and the control group(n=56).The control group was treated with gestrinone;on which basis,the observation group was also treated with Qingre Huayu Formula.The clinical efficacy,dysmenorrhea score,symptom score,endometrial thickness,CA125,blood viscosity,and the levels of progesterone(P),estradiol(E 2),follicle stimulating hormone(FSH),luteinizing hormone(LH),NGF,interleukin(IL)-1β,IL-8 and tumor necrosis factor(TNF)-αwere observed and compared before and after the treatment in the two groups.Results:The total effective rate was 89.28%(50/56)in the observation group,which was significantly higher than 71.43%(40/56)in the control group(χ^2=4.582,P<0.05).There were no significant differences in whole blood high-shear viscosity,whole blood low-shear viscosity,blood viscosity and hematocrit value before the treatment between the two groups(P>0.05);after the treatment,the levels were significantly lowered in the observation group than those before the treatment and lower than those after the treatment in the control group(P<0.01).There were no statistical differences in the dysmenorrhea score,symptom score,endometrial thickness,as well as the levels of CA125,E 2,FSH,P,LH,NGF,IL-1β,IL-8 and TNF-αbetween the two groups before the treatment(P>0.05);the levels were significantly decreased in the two groups after the treatment(P<0.01);of which the decreases in the observation group were more significant(P<0.01).Conclusion:Qingre Huayu Formula combined with western medication is effective in the treatment of endometriosis.It can reduce blood viscosity and female hormone,and it can relieve dysmenorrhea.The mechanism may be related to reducing NGF level,thus further reducing pain-related inflammatory mediators.