少腹逐瘀汤加减联合孕三烯酮胶囊治疗子宫腺肌病的疗效

Effect of modified Shaofu Zhuyu Decoction combined with Progesterone Capsules in patients with adenomyosis

目的观察少腹逐瘀汤加减联合孕三烯酮胶囊治疗子宫腺肌病的效果及对患者子宫内膜容受性及流产风险的影响。方法选取子宫腺肌病患者90例,根据随机数字表法均分为2组。对照组采用孕三烯酮胶囊治疗,观察组采用少腹逐瘀汤加减联合孕三烯酮胶囊治疗。记录2组糖类抗原125(sugar antigen 125,CA125)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)、性激素及视觉模拟(visual analogue scale,VAS)评分、子宫内膜异位症患者生存质量量表(endometriosis health profile-30,EHP-30)评分、子宫体积和子宫内膜厚度水平,比较1年内妊娠率和流产率。结果治疗3个月经周期后,观察组和对照组的CA125、VEGF和bFGF下降,雌二醇(estradiol,E2)上升,且观察组治疗3个月经周期后CA125、VEGF、bFGF和卵泡刺激素(follicle stimulating hormone,FSH)较对照组低,但2组E2、FSH比较差异无统计学意义。治疗3个月经周期和6个月经周期后,观察组和对照组的VAS评分、EHP-30评分、子宫体积和子宫内膜厚度下降,且观察组治疗3个月经周期和6个月经周期后VAS评分、EHP-30评分、子宫体积和子宫内膜厚度较对照组低(P<0.05)。2组1年内妊娠率、流产率比较,差异无统计学意义。结论少腹逐瘀汤加减联合孕三烯酮胶囊可减轻子宫腺肌病患者疼痛程度,促进血管形成和组织再生,改善子宫内膜容受性,且未增加流产风险。

Objective To observe the effect of modified Shaofu Zhuyu Decoction combined with Progesterone Capsules on endometrial receptivity and abortion risk in patients with adenomyosis.Methods The patients with adenomyosis were divided into 2 groups according to random number table method.The control group were treated with Progesterone Capsules,and the observation group were treated with modified Shaofu Zhuyu Decoction combined with Progesterone Capsules.The scores of sugar antigen 125(CA125),vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF),sex hormone and visual analogue scale(VAS),endometriosis health profile-30(EHP-30),uterine volume,and endometrial thickness levels of patients with endometriosis were recorded.The pregnancy rates and abortion rates within 1 year were compared.Results After 3 menstrual cycle treatment,the levels of CA125,VEGF and bFGF in observation and control groups were decreased,and the estradiol(E2)increased.The CA125,VEGF,bFGF and follicle stimulating hormone(FSH)in observation group was lower than that in control group.The levels of E2 and FSH of the 2 groups showed no statistical significance(P>0.05).After 3 and 6 cycles of treatment,the VAS score,EHP-30 score,uterine volume,and endometrial thickness decreased in observation group and control group,and the observation group was lower than the control group(P<0.05).The pregnancy rate and abortion rate of the 2 groups within 1 year were not statistically significant(P>0.05).Conclusion Modified Shaofu Zhuyu Decoction combined with Progesterone Capsules can alleviate the pain of adenomyosis,promote the vascular formation and tissue regeneration,improve the endometrial receptivity,and do not increase the risk of abortion.