活血通络解毒汤治疗血瘀蕴毒型子宫内膜异位症

Treatment of endometriosis with the pattern of blood stasis amassing toxins with Huoxue Tongluo Jiedu Decoction

目的探讨活血通络解毒汤联合孕三烯酮治疗血瘀蕴毒型子宫内膜异位症的临床疗效。方法选择90例血瘀蕴毒型子宫内膜异位症患者作为研究对象,以随机数表法分为对照组与观察组,各45例。对照组口服孕三烯酮胶囊,观察组在对照组的基础.上加用活血通络解毒汤治疗,2组共治疗3个月经周期。比较2组治疗前后中医证候积分、疼痛评分、生活质量评分、卵巢功能及血清细胞因子水平。结果治疗后,2组非经期肛门坠痛、非经期下腹痛、经行腹痛、性交.痛评分、中医证候总分、视觉模拟评分法(VAS)评分、子宫内膜异位症生活质量调查量表(EPH-5)评分及血清糖类抗原125(CA125)、血管内皮生长因子(VEGF).肿瘤坏死因子-α(TNF-α)水平均降低,观察组低于对照组(P<0.05)。治疗后,2组窦卵泡数量升高,观察组高于对照组(P<0.05),卵巢体积增大,观察组大于对照组(P<0.05),异位囊肿包块直径缩短,观察组短于对照组(P<0.05).结论活血通络解毒汤联合孕三烯酮可明显降低血瘀蕴毒型子宫内膜异位症患者血清细胞因子水平,减轻炎症反应,改善患者中医证候,减轻疼痛程度,增强卵巢功能,提高患者生活质量。

Objective To explore the clinical efficacy of the Huoxue Tongluo Jiedu Decoction combined with gestrinone in the treatment of endometriosis with the pattern of blood stasis amassing toxins.Methods A total of 90 endometriosis patients with the pattern of blood stasis amassing toxins were selected as the research subjects,and divided into a control group and an observation group by the random number table method,with 45 cases in each group.The control group took gestrinone capsules orally,while the observation group was given the Huoxue Tongluo Jiedu Decoction on the basis of the control group.The two groups were treated for 3 menstrual cycles.The TCM syndrome scores,pain scores,quality of life scores,levels of the ovarian function and serum cytokine were compared between the two groups before and after treatment.Results After treatment,the score levels of the non-menstrual anal pain,non-menstrual lower abdominal pain,menstrual abdominal pain,dyspareunia,the total scores of traditional Chinese medicine syndromes,the visual analogue scale (VAS) scores,endometriosis quality of life survey scale (EPH-5) scores and serum carbohydrate antigen 125 (CA125),vascular endothelial growth factor (VEGF),and the tumor necrosis factor-α (TNF-α) were all decreased,and the observation group was lower than the control group (P<0.05).After treatment,the number of antral follicles in the two groups was increased,and the observation group was higher than the control group (P<0.05).The ovarian volume was increased,and the observation group was larger than the control group (P<0.05),while the diameter of the ectopic cyst mass was shortened,and the observation group was shorter than the control group (P<0.05).Conclusion In the treatment of endometriosis with the pattern of blood stasis amassing toxins,the Huoxue Tongluo Jiedu Decoction combined with gestrinone can significantly reduce the level of serum cytokine,relieve inflammation,improve TCM syndromes,relieve pains,enhance the ovarian function,and improve patients’ quality of life.