育阴潜阳方加减联合促性腺激素释放激素激动剂治疗子宫内膜异位症对患者性激素和骨密度的影响

Effect of Yuyin Qianyang recipe combined with GnRH-a on endometriosis on sex hormone and bone mineral density in patients with endometriosis

目的探讨育阴潜阳方加减联合促性腺激素释放激素激动剂(GnRH-a)治疗肾虚血瘀型子宫内膜异位症(EM)对患者性激素、骨密度水平的影响。方法选取2017年4月至2018年4月唐山市中医医院收治的78例肾虚血瘀型EM患者作为研究对象。按照随机数字表法分成观察组(n=39)和对照组(n=39)。对照组采用GnRH-a治疗,观察组采用GnRH-a联合育阴潜阳方反向添加治疗,分别于治疗前、治疗3个月时检测两组性激素[雌二醇(E 2)、卵泡刺激素(FSH)、黄体生成素(LH)]水平变化,对比停药后性激素水平恢复正常的时间;评估治疗前、治疗3个月、停药后3个月时主观症状积分及治疗前、治疗3个月、停药6个月时骨密度变化情况。结果治疗3个月、治疗6个月时,观察组E 2、FSH及LH水平均高于对照组(P<0.05),停药后观察组性激素水平恢复至正常时间明显短于对照组(P<0.05);治疗后两组主观症状积分较治疗前明显减少(P<0.05),组间主观症状积分差异无统计学意义(P>0.05);治疗6个月时对照组骨密度明显低于观察组,停药6个月观察组骨密度明显恢复,对照组无明显改变,组间差异有统计学意义(P<0.05)。结论GnRH-a治疗子宫内膜异位症能快速缓解临床症状,但会对患者性激素和骨密度造成影响,配合育阴潜阳方反向添加可快速恢复性激素水平,抑制骨量流失,值得推广。

Objective To investigate the effect of Yuyin Qianyang recipe combined with gonadotropin-releasing hormone agonist(GnRH-a)on endometriosis on sex hormone and bone mineral density(BMD)in patients with endometriosis(EM).Methods A total of 78 EM patients with kidney deficiency and blood stasis type admitted to Tangshan Traditional Chinese Medicine Hospital from April 2017 to April 2018 were selected and divided into observation group(n=39)and control group(n=39)according to random number table method.The control group was treated with GnRH-a,while the observation group was treated with GnRH-a combined with Yuyin Qianyang recipe.The levels of the sex hormones[estradiol(E 2),follicle-stimulating hormone(FSH),and luteinizing hormone(LH)]in the two groups were measured before and 3 months of treatment,respectively.The recovery time of sex hormone levels to normal after drug withdrawal was compared.Subjective symptom scores were evaluated before treatment,3 months after treatment,and 3 months after drug withdrawal,as well as bone mineral density changes before treatment,3 months after treatment,and 6 months after drug withdrawal.Results After 3 months and 6 months of treatment,E 2,FSH and LH levels in the observation group were all higher than those in the control group(P<0.05),and the recovery time of sex hormone levels in the observation group was significantly shorter than that in the control group(P<0.05).After treatment,the scores of subjective symptoms in the two groups were significantly reduced compared with that before treatment(P<0.05),and there was no statistically significant difference in the scores of subjective symptoms between the two groups(P>0.05).Bone mineral density in the control group was significantly lower than that in the observation group after 6 months of treatment,and bone mineral density in the observation group was significantly restored after 6 months of drug withdrawal,while no significant changes were observed in the control group,with statistically significant differences between groups(P<0.05).Conclusions GnRH-a in the treatment of endometriosis can quickly relieve clinical symptoms,but it will affect the sex hormone and bone mineral density.The reverse addition of Yuyin Qianyang recipe can quickly restore the level of sex hormone and inhibit bone loss,which is worthy of promotion.