内炎方联合地屈孕酮片对TCRP后患者炎症因子、内分泌水平及复发的影响

Effect of Nei Yan Fang Combined with Dydrogesterone on Inflammatory Factors,Endocrine Levels and Recurrence in Patients after TCRP

目的观察内炎方联合地屈孕酮片对TCRP后EPs患者炎症因子、内分泌水平及复发的影响。方法选择2018年1月-2019年8月符合纳入标准的80例TCRP后患者,随机分成两组,对照组给予地屈孕酮片治疗;治疗组在对照组治疗基础上加予内炎方,连续治疗3个月,比较两组术后、术后3个月、术后6个月宫腔内膜组织IL-6、TNF-α及ER、PR的免疫荧光表达情况以及治疗后3个月、6个月、9个月、12个月的息肉复发率。结果(1)对比两组复发率,治疗后3个月、6个月两组复发率未见明显差异,但停药后3个月及6个月治疗组的复发率低于对照组。(2)对比IL-6、TNF-α、ER及PR的荧光表达强度及平均光密度值,各组ER、TNF-a、Ⅱ-6表达随治疗进行均减弱,PR表达均增强。(3)治疗3个月后两组蛋白有着同趋势的表达变化,但停药3个月后,对照组的TNF-α蛋白表达有升高趋势,IL-6蛋白表达变化不明显,治疗组的TNF-α、IL-6蛋白表达进一步的降低,同时ER蛋白表达较对照组进一步减少,PR蛋白表达则较对照组进一步增加。结论在地屈孕酮片治疗的基础上,采用内炎方治疗,可有效的纠正子宫内膜PR的低水平表达状态,抑制ER、IL-6、TNF-α高表达,改善宫腔内环境,降低子宫内膜息肉切除术后复发率。

Objective To observe the effect of Nei Yan Fang combined with dydrogesterone tablets on inflammatory factors,endocrine levels and recurrence in patients with EPs after TCRP.Methods Eighty patients with post-TCRP who met the inclusion criteria from January 2018 to August 2019 were randomly divided into two groups.The control group was treated with dydrogesterone.The control group was additionally treated with Nei Yan Fang for 3 months.The changes of TCM score,immunofluorescence expression of IL-6,TNF-α,ER and PR in intrauterine endometrial tissue and polyp recurrence rate at 3 months,6 months,9 months and 12 months after treatment were compared between the two groups.Results(1)Comparing the recurrence rate between the two groups,there was no significant difference in the recurrence rate between the two groups at 3 months and 6 months after treatment,but the recurrence rate in the treatment group was lower than that in the control group at 3 months and 6 months after drug withdrawal.(2)Compared with the fluorescence expression intensity and mean optical density of IL-6,TNF-α,ER and PR,the expression of ER,TNF-a and II-6 in each group decreased with treatment,and the expression of PR increased.(3)After treatment for 3 months,the expression of TNF-αprotein in the two groups had the same trend,but after drug withdrawal for 3 months,the expression of TNF-αprotein in the control group had an increasing trend,while the expression of IL-6 protein had no significant change.The expression of TNF-αand IL-6 protein in the treatment group was further decreased,while the expression of ER protein was further reduced compared with the control group,while the expression of PR protein was further increased compared with the control group.Conclusion On the basis of dydrogesterone tablets treatment,the use of Nei Yan Fang treatment,can effectively correct the low level expression of endometrial PR,inhibit the high expression of ER,IL-6,TNF-α,improve the intrauterine environment,reduce the recurrence rate of endometrial polypectomy.