坤泰胶囊用于腹腔镜下卵巢囊肿剥除术后对卵巢功能恢复及炎症因子的影响

Effects of K untai capsule for treating patients after laparoscopic ovarian cyst removal on their ovarian funct ion and inflam-matory factors levels

目的:探讨坤泰胶囊用于腹腔镜下卵巢囊肿剥除术后对患者卵巢功能恢复及炎症因子的影响。方法:选取2019年8月-2020年8月行腹腔镜下卵巢囊肿剥除手术者124例,使用随机数字表法分为观察组和对照组各62例。观察组术后服用坤泰胶囊,4粒/次,3次/d,疗程3个月,对照组同期服用安慰剂。分别于术前、术后1个月、术后3个月的月经第2~3天采血检测雌二醇(E_(2))、黄体生成激素(LH)、卵泡刺激素(FSH)、抗苗勒氏管激素(AMH)、白介素-21(IL-21)、肿瘤坏死因子-a(TNF-a)。月经干净后3~5d经阴道超声测定患侧卵巢窦卵泡数(AFC)。收集两组术后3个月内的月经情况,比较上述指标差异(P<0.05)。结果:术后1个月,两组E_(2)、AMH、AFC水平均较术前降低,FSH、LH水平较术前升高(P<0.05),两组间无差异(P>0.05);术后3个月,观察组E_(2)、FSH、LH、AMH、AFC水平恢复到术前水平(P>0.05),而对照组相应指标则未能恢复到术前水平(P<0.05),且观察组指标水平均优于对照组(P<0.05)。术后1个月两组IL-21、TNF-a水平均较术前上升(P<0.05),两组无差异(P>0.05);术后3个月,观察组IL-21、TNF-a水平恢复至术前水平(P>0.05),且均低于对照组(P<0.05),对照组则未能恢复至术前水平(P<0.05)。Pearson相关性分析表明,IL-21、TNF-a分别与FSH、LH呈正相关,与E_(2)、AMH呈负相关。观察组在术后3个月内累积发生月经周期异常、经量过少和月经总异常率均低于对照组(均P<0.05)。结论:坤泰胶囊可能通过降低卵巢囊肿剥除手术后炎症因子水平恢复受损的卵巢功能,减少月经异常率。

Objective: To investigate the effects of Kuntai capsule for treating patients after laparoscopic ovarian cyst removal on their ovarian function and inflammatory factors levels. Methods: 124 patients after laparoscopic ovarian cyst removal were selected and were randomly divided into two groups(62 cases each group) from August 2019 to August 2020. The patients in study group were given Kuntai capsule for 3 months(4 capsules per time, 3 times per day), and the patients in control group were given placebo for 3 months during the same time. The blood of the patients in the two groups was collected on the 2 nd to 3 rd day of menstruation before surgery, and in the 1 st and 3 rd month after surgery for detecting the levels of estradiol(E_(2)), luteinizing hormone(LH), follicle stimulating hormone(FSH), anti-Müllerian hormone(AMH), interleukin-21(IL-21), and tumor necrosis factor-a(TNF-a) of the patients in the twogroups. Antral follicle count(AFC) in the ovary with ovarian cyst of the patients was measured by ultrasound in the 3 rd to the 5 th day after menstruation, and was compared between the two groups. The situation of menstruation of the patients within 3 months after surgery was observed and was compared between the two groups. Results: 1 month after surgery, the levels of E_(2) and AMH, and the AFC of the patients in both groups were significantly lower than those before surgery,while the levels of FSH and LH of the patients in both groups were significantly higher(P<0.05),and which of the patients had no statistically significant differences between the two groups(P >0.05).3months after surgery,the levels of E_(2),FSH,LH,and AMH,and AFC of the patients in the observation group returned to their preoperative levels(P<0.05),while which of the patients in the control group did not return to their preoperative levels(P>0.05),and which of the patients in the observation group were significantly better than those of the patients in the control group(P<0.05).1month after surgery,the levels of IL-21and TNF-a of the patients in both groups were significantly lower than those before surgery,and which of the patients had no statistically significant differences between the two groups(P>0.05).3months after surgery,the levels of IL-21and TNF-a of the patients in the observation group returned to their preoperative levels(P<0.05),and which of the patients in the observation group were significantly lower than those of the patients in the control group(P<0.05),while which of the patients in the control group did not return to their preoperative levels(P>0.05).Pearson correlation analysis showed that the IL-21and TNF-A levels of the patients were positively correlated with their FSH and LH levels,but were negatively correlated with their E_(2) and AMH levels.The cumulative incidences of abnormal menstrual cycle frequency,oligomania,and total abnormal menstruation of the patients within 3 months after surgery in the observation group were significantly lower than those of the patients in the control group(all P<0.05).Conclusion:Kuntai capsule would improve the recovery of the impaired ovarian function of the patients by decreasing their levels of postoperative inflammatory factors,which is conducive to reduce menstrual abnormality.