痛经宁汤联合西药治疗子宫内膜异位症对细胞外基质和血管形成的影响

Impact of Tongjingning Decoction combined with Western medicine in treating endometriosis on extracellular matrix and angiogenesis

目的探讨痛经宁汤联合西药治疗子宫内膜异位症(EMT)的疗效,以及其对细胞外基质和血管形成的影响。方法选取2021年1月至2022年6月该院收治的EMT患者136例,随机分为观察组和对照组,每组68例。对照组予以常规西药治疗,观察组在此基础上予以痛经宁汤。观察两组疗效和不良反应,以及治疗前后卵巢功能指标、子宫动脉血流参数、血清基质金属蛋白酶抑制剂-1(TIMP-1)、基质金属蛋白酶-9(MMP-9)、单核细胞趋化蛋白-1(MCP-1)、血管内皮生长因子可溶性受体-1(sflt-1)水平的变化。结果观察组总有效率为95.59%,显著高于对照组的80.88%,差异有统计学意义(P<0.05),而两组不良反应发生率比较,差异无统计学意义(P>0.05)。两组治疗前窦卵泡数、异位囊肿直径、卵巢体积、子宫动脉的搏动指数(PI)、阻力指数(RI)、舒张末期流速(EDV)、收缩期最大流速(PSV)、TIMP-1、MMP-9、MCP-1和sflt-1水平比较,差异均无统计学意义(P>0.05),两组治疗后窦卵泡数、卵巢体积、PSV、EDV、TIMP-1和sflt-1水平均较治疗前明显增加/升高(P<0.05),与对照组比较,观察组增加/升高更为明显(P<0.05),而两组异位囊肿直径、PI、RI、MMP-9和MCP-1水平均较治疗前明显降低(P<0.05),与对照组比较,观察组降低更为明显(P<0.05)。结论痛经宁汤联合西药治疗EMT具有疗效显著、不良反应少等特点,其疗效可能与痛经宁汤能够调节细胞外基质平衡、抑制血管形成有关。

Objective To investigate the efficacy of Tongjingning Decoction combined with Western medicine in the treatment of endometriosis(EMT)and its impact on extracellular matrix and angiogenesis.Methods A total of 136 patients with EMT admitted to this hospital from January 2021 to June 2022 were selected and randomly divided into the observation group and control group,68 cases in each group.The control group was given the conventional Western medicine treatment,and the observation group was given Tongjingning Decoction on the basis of control group.The efficacy and adverse reactions after treatment were observed in two groups.The changes of ovarian function indexes,uterine artery blood flow parameters,serum matrix metalloproteinase inhibitor-1(TIMP-1),matrix metalloproteinase-9(MMP-9),monocyte chemotactic protein-1(MCP-1)and vascular endothelial growth factor soluble receptor-1(sflt-1)levels before and after treatment were compared between the two groups.Results The total effective rate in the observation group was 95.59%,which was significantly higher than 80.88%in the control group,and the difference was statistically significant(P<0.05),but there was no statistically significant difference in the incidence rate of adverse reactions between the two groups.There were no statistically significant differences in the number of follicles in anterior sinus,ectopic cyst diameter,ovarian volume,PI,RI,PSV,EDV,TIMP-1,MMP-9,MCP-1 and sflt-1 between the two groups(P>0.05).The number of sinus follicles,ovarian volume,PSV,EDV,TIMP-1 and sflt-1 levels after treatment in the two groups were significantly increased compared with those before treatment(P<0.05),compared with the control group,the increase in the observation was more significant(P<0.05).The ectopic cyst diameter,PI,RI,MMP-9 and MCP-1 levels after treatment in the two groups were significantly decreased compared with those before treatment(P<0.05),and compared with the control group,the decrease in the observation group was more significant(P<0.05).Conclusion Tongjingning Decoction combined with Western medicine has the characteristics of significant curative effect and little adverse reactions in the treatment of EMT.Its curative effect may be related to Tongjingning Decoction′s ability to adjust the balance of extracellular matrix and inhibit angiogenesis.