益肾疏肝方结合曲普瑞林治疗肾虚血瘀证卵巢巧克力囊肿临床疗效及安全性研究

Clinical Efficacy and Safety of Yiqi Shugan Prescription Combined with Tripurelin in Treatment of Chocolate Cyst of Ovary with Kidney Deficiency and Blood Stasis Syndrome

目的探究益肾疏肝方结合曲普瑞林治疗肾虚血瘀证卵巢巧克力囊肿临床疗效及安全性。方法研究共计纳入116例肾虚血瘀证卵巢巧克力囊肿,均由医院2017年1月—2018年6收治,采取随机数字表法将患者分为观察组及对照组,每组58例,对照组患者给予腹腔镜剥除术治疗,手术完成后首次月经来潮时肌注曲普瑞林;观察组患者在对照组治疗基础上联合益肾疏肝方治疗。比较两组临床治疗效果、治疗前后患者中医症状积分、疼痛评分(VAS)、术后并发症发生率、治疗前后血清性激素水平变化及肿瘤坏死因子α(TNF-α)及血清CA125、CA199水平变化、治疗前后生活质量评分(QOL评分)、治疗后3个月、治疗后6个月疾病复发率情况及妊娠率。结果观察组患者治疗有效率(100.00%,58/58)高于对照组(89.66%,52/58)(P<0.05);治疗前,两组患者中医症状积分、VAS评分及血清雌二醇(E2)、孕激素(P)、促黄体素(LH)及促卵泡素(FSH)等性激素水平、TNF-α、CA125、CA199水平、QOL评分均相当(P>0.05);治疗后各组患者中医症状积分、VAS及QOL评分、E2、P、LH、FSH、TNF-α、CA125、CA199水平均改善,观察组患者治疗后中医症状积分、VAS及QOL评分、E2、P、LH、FS对照组相当,均较低(P>0.05);观察组并发症率(1.72%,1/58)与对照组(3.45%,2/58)相当(P>0.05);治疗3个月后,观察组及对照组患者疾病复发率及妊娠率均为0.00%(P>0.05),治疗6个月后,观察组患者疾病复发率为0.00%,低于对照组(10.34%,6/58),妊娠率为6.90%(4/58),高于对照组(0.00%),P<0.05。结论益肾疏肝方结合曲普瑞林治疗肾虚血瘀证卵巢巧克力囊肿临床疗效佳,患者疼痛缓解,卵巢功能改善,并发症率低,安全性高,可一定程度降低疾病复发率,提升妊娠率,值得推广及应用。

Objective To explore the clinical efficacy and safety of Yiqi Shugan Prescription combined with tripurelin in the treatment of chocolate cyst of ovary caused by kidney deficiency and blood stasis. Methods A total of 116 cases of 58 cases in each, chocolate cyst of ovary with kidney deficiency and blood stasis syndrome were included in the study, all of which were admitted to our hospital from January 2017 to June 2018. The patients were divided into observation group and control group by random number table method. The control group used laparoscopic dissection and injected triptorelin after operation. The observation group combined Yiqi Shugan Prescription on the basis of the control group. We compared two groups’ clinical therapeutic effect, symptoms integral, pain score(VAS), incidence of postoperative complications, serum sex hormone levels before and after treatment,serum levels of tumor necrosis factor α(TNF-α),CA125 and CA199 before and after treatment, quality of life score(QOL score), disease recurrence rate and pregnancy rate after 3 and 6 months after treatment. Results The effective rate in the observation group(100.00%,58/58) was higher than that in the control group(89.66%,52/58)(P<0.05). Before treatment, TCM symptom scores, VAS scores, serum levels of estradiol(E2), progesterone(P), luteinizing hormone(LH) and follicle-stimulating hormone(FSH), levels of TNF-α, CA125 and CA199 and QOL scores of the patients in the two groups were all similar(P>0.05). After treatment, the TCM symptom scores, VAS and QOL scores, levels of E2, P, LH, FSH, TNF-α, CA125 and CA199 were all improved in each group. After treatment, the TCM symptom scores, VAS and QOL scores, levels of E2, P, LH and FS in the control group were similar(P>0.05). The complication rate of observation group(1.72%,1/58) was the same as that of control group(3.45%,2/58)(P>0.05). After 3 months of treatment, the disease recurrence rate and pregnancy rate in the observation group and the control group were 0.00%(P>0.05). After 6 months of treatment, the disease recurrence rate in the observation group was 0.00%, lower than that in the control group(10.34%,6/58), and the pregnancy rate was 6.90%(4/58), higher than that in the control group(0.00%)(P<0.05). Conclusion Yiqi Shugan Prescription combined with tripurelin in the treatment of chocolate cyst of ovary caused by kidney deficiency and blood stasis has good clinical efficacy,relieving pain and improving ovarian function, with low complication rate and high safety. It can reduce the recurrence rate to a certain extent and can improve the pregnancy rate and it is worthy of promotion and application.