活血化瘀法联合去氧孕烯炔雌醇片对宫腔镜下子宫内膜息肉切除术后复发和Ki-67阳性率的影响

Effect of Activating Blood Circulation and Removing Blood Stasis Method Combined with Deoxypregnene Ethinylestradiol Tablets on Recurrence and Ki-67 Positive Rate of Endometrial Polyps after Hysteroscopic Polypectomy

目的探讨活血化瘀法联合去氧孕烯炔雌醇片对宫腔镜下子宫内膜息肉切除术后复发和Ki-67阳性率的影响。方法将110例子宫内膜息肉患者分为研究组和对照组,每组55例。两组患者均采用宫腔镜下子宫内膜息肉切除术治疗,对照组患者在术后第5天口服去氧孕烯炔雌醇片,研究组在对照组治疗的基础上,口服益母四物汤加减和桂枝茯苓丸加减分阶段治疗。两组均治疗3个疗程。比较两组治疗前后腺皮脂和间质ER和PR的表达、两组治疗前后E2和P表达、子宫内膜Ki-67表达和治疗后6个月、9个月和12个月的复发率。结果两组治疗后ER在腺皮脂和间质的表达和对照组比较差异无统计学意义(P>0.05);研究组治疗后PR在腺皮脂和间质的表达低于对照组(P<0.05);两组治疗后E2和P表达和治疗前相比,差异无统计学意义(P<0.05);Ki-67表达水平低于对照组(P<0.05);研究组治疗后6个月、9个月和12个月的复发率低于对照组(P<0.05)。结论在去氧孕烯炔雌醇片治疗的基础上,采用益母四物汤加减和桂枝茯苓丸加减分期治疗,可有效的纠正子宫内膜PR的低水平表达状态,抑制Ki-67的高表达,改善子宫环境,降低子宫内膜息肉切术后复发率。

Objective To observe the effect of activating blood circulation and removing blood stasis method combined with deoxypregnene ethinylestradiol tablets on recurrence and Ki-67 positive rate of endometrial polyps after hysteroscopic polypectomy.Methods A total of 110 patients with endometrial polyps were divided into the study group and the control group,55 cases in each group.Two groups were treated with hysteroscopic endometrial polypectomy.The control group was given deoxypregnene ethinylestradiol tablets orally on the second day after surgery.The study group on the basis of treatment in the control group,took Yimu Siwu Decoction and Guizhi Fuling Pill orally.The two groups were treated for 3 courses.The expressions of ER and PR in glandular sebum and interstitial tissue,the expressions of E2 and P and the expression of Ki-67 in endometrium and the recurrence rate at 6,9 and 12 months after treatment were compared between the two groups.Results There was no significant difference in the expression of ER in glandular sebum and interstitium between the two groups after treatment(P>0.05).The expression of PR in sebum and interstitium in the study group was lower than that in the control group(P<0.05).There was no significant difference in the expressions of E2 or P of the two groups after and before treatment(P<0.05).The recurrence rate at 6,9 and 12 months after treatment in the study group was lower than that in the control group(P<0.05).Conclusion Based on the treatment of deoxypregnene ethinylestradiol tablets,the phased treatment of Yimu Siwu Decoction and Guizhi Fuling Pill can effectively correct the low expression of PR in endometrium,inhibit the high expression of Ki-67,improve the uterine environment and reduce the recurrence rate of endometrial polypectomy.