GnRH-α联合桂枝茯苓丸对卵巢子宫内膜异位囊肿患者腹腔镜术后卵巢储备功能的影响

Effect of GnRH-α combined with Guizhi Fuling Pill on Ovarian Reserve Function in Patients with Ovarian Endometriosis Cyst after Laparoscopic Surgery

【目的】探讨促性腺激素释放激素激动剂(GnRH-α)联合桂枝茯苓丸对卵巢子宫内膜异位囊肿腹腔镜术后卵巢储备功能的影响。【方法】选取2017年1月至2018年12月在本院诊治的106例卵巢子宫内膜异位囊肿患者,按照随机数表法分为对照组和观察组,每组53例。两组患者均接受腹腔镜手术,对照组术后采用GnRH-α治疗,观察组术后采用GnRH-α联合桂枝茯苓丸治疗,两组均治疗6个月。比较两组患者术后6个月的疗效及治疗前后基础性激素、卵巢储备功能、VAS评分。【结果】观察组患者总有效率为92.45%(49/53),显著高于对照组的73.58%(39/53),其差异有统计学意义(χ^(2)=6.692,P=0.0097)。治疗前,两组患者血清卵泡刺激素(FSH)、雌二醇(E_(2))、促黄体生成素(LH)水平比较差异无统计学意义(P>0.05);治疗6个月后,两组患者FSH水平增高,E_(2)、LH水平降低,其差异均有统计学意义(P<0.05);与对照组比较,观察组患者E_(2)、LH及FSH表达低于对照组,其差异有统计学意义(P<0.05)。治疗前,两组卵巢储备功能指标比较无统计学意义(P>0.05);治疗6个月后,观察组血清抗苗勒管激素(AMH)水平降低,卵巢基础窦卵泡数目(AFC)个数增加,卵巢基质动脉血流收缩期峰值(PSV)无明显变化(P>0.05);对照组治疗后AFC数量无明显变化(P>0.05),AMH、PSV水平显著降低,其差异有统计学意义(P<0.05)。治疗前,两组患者VAS评分比较无统计学意义(P>0.05),治疗6个月后,两组VAS评分较治疗前均有所下降,且观察组VAS评分显著低于对照组,其差异有统计学意义(P<0.05)。【结论】GnRH-α联合桂枝茯苓丸对卵巢子宫内膜异位囊肿腹腔镜患者具有手术后确切疗效,能调节患者性激素水平,提高卵巢储备功能,值得临床推广应用。

【Objective】To investigate the effect of gonadotropin releasing hormone agonist(GnRH-α)combined with Guizhi Fuling pills on the improvement of basic hormones and ovarian reserve function in patients with ovarian endometriosis cysts after laparoscopy.【Methods】A total of patients with endometriosis cysts treated in our hospital from January 2017 to December 2018 were selected as the subjects.The patients in each group were randomly divided into control group(n=53)and observation group(n=53).Both groups received laparoscopic surgery.The control group was treated with GnRH-α after operation while the observation group was treated with GnRH-αcombined with Guizhi Fuling Pill after operation.The course of treatment in both groups was 6 months.The basic hormones,ovarian reserve function,dysmenorrhea,sexual intercourse pain,pelvic pain and other Kupperman scores and VAS scores were compared between the two groups before and after treatment,and the clinical efficacy of the two groups was observed.【Results】The total effective rate in the observation group was higher than that in the control group(92.45%vs73.58%,P<0.05).There was no significant difference in the expression of basic hormones between the two groups before treatment(P>0.05).After 6 months of treatment,the expression of follicular stimulating hormone(FSH)in two groups was increased while the expression of E_(2) and LH(LH)were decreased with statistical significance(P<0.05).The expression of E_(2),LH and FSH in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in ovarian reserve function between the two groups before treatment(P>0.05).After 6 months of treatment,the expression of anti-Muller tube hormone(AMH)decreased,the number of ovarian basal sinus follicles increased,and the peak(PSV)of ovarian stroma artery blood flow did not change significantly(P>0.05).There was no significant difference in the number of AFC in the control group after treatment(P>0.05),The levels of AMH and PSV were significantly decreased(P<0.05).Before treatment,there was no significant difference in VAS score between the two groups in dysmenorrhea,sexual intercourse pain and pelvic pain.After 6 months of treatment,the VAS scores of the two groups were lower than those before treatment,the difference was statistically significant(P<0.05).After treatment,the VAS scores of the observation group were lower than those of the control group(P<0.05).【Conclusion】GnRH-α combined with Guizhi Fuling Pill is effective in improving laparoscopic surgery in patients with ovarian Endometriosis cysts.It can regulate the level of sex hormones,improve ovarian reserve function.It is worthy of clinical application.