化瘀消癥颗粒口服联合止痛消癥颗粒保留灌肠、GnRH-a治疗复发性子宫内膜异位症临床观察

Clinical observation on oral Huayuxiaozheng granules combined with Zhitongxiaozheng granulesretention-enema and GnRH-a in the treatment of recurrent endometriosis

目的观察促性腺激素释放激素激动药(GnRH-a)治疗基础上,加用化瘀消癥颗粒口服联合止痛消癥颗粒保留灌肠治疗复发性子宫内膜异位症的临床疗效。方法复发性子宫内膜异位症患者168例随机分为4组(A、B、C、D组)各42例。A组给予醋酸亮丙瑞林微球治疗,B组在A组基础上加用化瘀消癥颗粒口服治疗,C组在A组基础上加用止痛消癥颗粒保留灌肠治疗,D组在A组基础上同时加用化瘀消癥颗粒口服联合止痛消癥颗粒保留灌肠治疗。比较4组患者治疗前后主要临床症状、生存质量、血清糖抗原125(CA125)和血管内皮生长因子(VEGF)水平变化,观察4组的临床疗效和药品不良反应。结果治疗后4组的临床症状评分、生存质量评分、血清CA125和VEGF水平均较治疗前下降(P<0.05),且B、C、D组均明显低于A组,D组明显低于B、C组(P<0.05),B、C组间差异无统计学意义(P>0.05)。D组总有效率高于A组(P<0.0083),但与B、C组总有效率比较无统计学差异(P>0.0083);4组药品不良反应发生率的差异无统计学意义(P>0.05)。结论复发性子宫内膜异位症患者在GnRH-a醋酸亮丙瑞林微球治疗基础上,加用瘀消癥颗粒口服联合止痛消癥颗粒保留灌肠,可缓解临床症状、改善患者生存质量,降低血清CA125和VEGF水平,效果良好。

Objective To investigate the clinical effect of oral Huayuxiaozheng granules combined with retention-enema with Zhitongxiaozheng granules on the basis of gonadotropin-releasing hormone agonist(GnRH-a)in the treatment of recurrent endometriosis(EMT).Methods 168 patients with recurrent EMT were randomly divided into four groups(group A,B,C and D)with 42 cases in each group.Group A was treated with leuprorelin acetate microspheres,group B was treated with oral Huayuxiaozheng granules on the basis of group A,group C was treated with retention-enema with Zhitongxiaozheng granules on the basis of group A,and group D was treated with oral Huayuxiaozheng granules combined with retention enema with Zhitongxiaozheng granules on the basis of group A.The changes of main clinical symptoms,quality of life,the serum levels of carbohydrate antigen-125(CA125)and vascular endothelial growth factor(VEGF)before and after treatment in four groups were compared,and the clinical efficacy and adverse reactions of the four groups were observed.Results After treatment,the scores of clinical symptoms and quality of life as well as the levels of serum CA125 and VEGF in the four groups were lower than those before treatment(P<0.05),the above scores and levels of the group B,C and D were significantly lower than those of group A(P<0.05)and the above score and level of the group D were significantly lower than those of group B and C(P<0.05),but there was no significant difference in the above scores and levels between group B and C(P>0.05).The total effective rate of group D was higher than that of group A(P<0.0083),but it was not statistically different from the total effective rates of group B and group C(P>0.0083).There was no statistically significant difference in the incidence of adverse reactions among the four groups(P>0.05).Conclusion On the basis of treatment with GnRH-a leuprorelin acetate microsphere,the application of oral Huyuxiaozheng granules combined with retention-enema with Zhitongxiaozheng granules in the treatment of recurrent EMT can alleviate the clinical symptoms,improve patients’quality of life,reduce the levels of serum CA125 and VEGF,and has good effect.