红藤方加减治疗卵巢型子宫内膜异位症74例临床观察

Clinical Observation on Modified Hongteng Prescription in the Treatment of 74 Cases of Ovarian Endometriosis

目的:探讨红藤方加减对卵巢型子宫内膜异位症(endometriosis,EM)患者的疗效及对血清激素、糖链抗原125(carbohydrate antigen125,CA125)及基质金属蛋白酶9(Matrix Metalloproteinase 9,MMP-9)表达水平的影响。方法:将147例患者按随机数字表法分为观察组(74例)、对照组(73例)。两组患者均行腹腔镜保守手术治疗。给予对照组患者注射用醋酸亮丙瑞林微球(商用名:抑那通)治疗,观察组在此基础上被给予红藤方加减,两组患者均进行3个月经周期的治疗,结束后对两组患者临床疗效、血清激素、CA125、组织金属蛋白酶抑制剂1(Tissue inhibitor of metalloproteinase-1,TIMP-1)与MMP-9及血液流变学指标进行比较。结果:总有效率观察组为93.24%(69/74),对照组为80.82%(59/73),两组比较差异有统计学意义(P<0.05)。异位囊肿最大截面积、痛经症状积分治疗前两组比较,差异无统计学意义(P>0.05);治疗前后两组组内比较,差异有统计学意义(P<0.05);治疗后两组组间比较,差异有统计学意义(P<0.05)。血清雌二醇(estradiol,E2)、黄体生成素(luteinizing hormone,LH)、促卵泡生成素(follicle-stimulating Hormone,FSH)、CA125、MMP-9、TIMP-1及MMP-9/TIMP-1水平治疗前两组比较,差异无统计学意义(P>0.05);治疗前后两组组内比较,治疗后两组组间比较,差异均有统计学意义(P<0.05)。全血高、低切黏度,红细胞聚集指数及红细胞压积治疗前两组比较,差异无统计学意义(P>0.05);治疗前后两组组内比较,差异有统计学意义(P<0.05);治疗后两组组间比较,差异有统计学意义(P<0.05)。两组治疗过程中不良反应轻微,经对症处理后消失。结论:红藤方加减对卵巢型EM患者具有积极的治疗效果,可改善患者血清激素与CA125及MMP-9水平,调节血液流变学指标,有效改善临床症状。

Objective:To discuss clinical efficacy of modified Hongteng prescription in the treatment of the patients with ovarian endometriosis(EM)and its effects on the expressions of serum hormone,CA125 and MMP-9.Methods:All 147 patients were separated into the observation group(74 cases)and the control group(73 cases).Both groups accepted laparoscopic conservative surgery.The patients in the control group were treated by enantone,and the ones in the observation group by modified Hongteng prescription,both groups were treated for three menstrual cycles,by the end of the therapy,to compare clinical effects,serum hormone,CA125,TIMP-1,MMP-9 and hemorheological indexes between both groups.Results:Total effective rate of the observation group was 93.24%(67/74),higher than 80.82%(59/73)of the control group,and the difference had statistical meaning(P<0.05).The difference had no statistical meaning in maximum cross-sectional area of heterotopic cyst and dysmenorrhea symptom score before treating between both groups(P>0.05);the difference had statistical meaning between both groups before and after treating(P<0.05);the difference was statistically significant between both groups after treating(P<0.05).The difference had no statistical meaning in the levels of E2,LH,FSH,CA125,MMP-9,TIMP-1 and MMP-9/TIMP-1 before treating(P>0.05);the difference presented statistical meaning within two groups before and after treating(P<0.05);the difference presented statistical meaning between two groups after treating(P<0.05).The difference had no statistical meaning in the comparisons of high and low shear viscosity of whole blood,erythrocyte aggregation index and hematocrit between both groups before treating(P>0.05);the difference presented statistical meaning within two groups before and after treating(P<0.05);the difference presented statistical meaning between two groups after treating(P<0.05).Adverse reaction was slight during therapeutic course and disappeared after symptomatic treatment.Conclusion:Modified Hongteng prescription possess the positive therapeutic effects in the treatment of the patients with ovarian EM,it could raise the expressions of serum hormone,CA125 and MMP-9,regulate hemorheological indexes and effectively improve clinical symptoms.