散结镇痛胶囊结合地诺孕素防治子宫内膜异位症的作用研究

Effect of Sanjie Analgesia Capsule combined with Dinorgestrel on the prevention and treatment of endometriosis

目的从调控内分泌水平及致痛物质角度探讨散结镇痛胶囊结合地诺孕素防治子宫内膜异位症(endometriosis,EMs)的作用。方法前瞻性纳入2020年2月至2022年2月邢台市人民医院收治的100例EMs患者作为研究对象,根据入院先后顺序分为对照组和研究组,各50例。给予对照组地诺孕素治疗,研究组在对照组基础上加用散结镇痛胶囊治疗。观察两组临床疗效并比较两组患者的痛经VAS评分、囊肿大小、中医证候积分、雌激素水平[促卵泡生成素(follicle stimulating hormone,FSH)、雌二醇(estradiol,E_(2))、孕酮(progesterone,P)]、血清学指标[基质金属蛋白酶-9(matrix metalloprotease-9,MMP-9)、糖类抗原(carbohydrate antigen 125,CA125)及血管内皮生长因子(vascular endothelial growth factor,VEGF)]及致痛物质[前列腺素F2α(prostaglandin,PGF2α)、缓激肽(bradykinin,BK)]水平差异,统计不良反应发生率。结果研究组治疗有效率(98.00%)较对照组(82.00%)更高(P<0.05)。研究组治疗后痛经VAS评分、中医证候积分、血清FSH、E_(2)、P、MMP-9、CA125、VEGF水平、BK及PGF2α水平均低于对照组,且囊肿更小(P<0.05)。治疗后,两组患者均出现程度不一的不良反应,包括乳房轻度胀痛、阴道不规则少量出血及轻度皮疹等,经对症治疗后有效缓解。研究组不良反应发生率(6.00%)低于对照组(24.00%)(P<0.05)。结论在地诺孕素的基础上联合镇痛胶囊治疗EMs可起到协同增效的作用,可明显改善患者的临床症状,下调血清中MMP-9、VEGF、CA125、BK及PGF2α水平,提示两药联用可通过调节内分泌水平及致痛物质水平来起到治疗作用,安全性较高,值得推广。

Objective To investigate the effect of Sanjie Analgesic capsule combined with dinorgestrel on the prevention and treatment of endometriosis(EMs)from the perspective of regulating endocrine level and pain-causing substances.Methods 100 patients with EMs admitted to Xingtai People's Hospital from February 2020 to February 2022 were prospectively included as research objects,and divided into control group and study group according to the order of admission,each group with 50 patients.The control group was treated with dinorgestrel,and the study group was treated with Sanjie Analgesic capsule on the basis of control group.Observed the clinical efficacy of two groups and compared the differences in dysmenorrhea VAS score,cyst size,traditional Chinese medicine syndrome scores,and estrogen levels[follicle stimulating hormone(FSH),estradiol(E_(2)),progesterone(P)],serological indexes[matrix metalloproteinase-9(MMP-9),carbohydrate antigen(CA125)and vascular endothelial growth factor(VEGF)]and pain causing substances[prostaglandin F2α(PGF2α),bradykinin(BK)]between the two groups of patients,and added up the incidence of adverse reactions.Results The effective rate of the study group was 98.00%,which was significantly higher than that of the control group(82.00%)(P<0.05).After treatment,VAS score,TCM syndrome score,serum FSH,E_(2),P,MMP-9,CA125,VEGF,BK and PGF2αlevels in the study group were lower than those in the control group,and cysts were smaller(P<0.05).After treatment,adverse reactions of varying degrees appeared in both groups,including mild breast tenderness,irregular vaginal bleeding and mild rash,which were effectively relieved after symptomatic treatment.The incidence of adverse reactions in the study group was 6.00%,significantly lower than that in the control group(24.00%)(P<0.05).Conclusion On the basis of dinorgestrel combined with analgesic capsules in the treatment of EMs can play a synergistic role,can significantly improve the clinical symptoms of patients,decrease the serum contents of MMP-9,VEGF,CA125,BK and PGF2α,suggesting that the combination of the two drugs can play a therapeutic role by regulating the endocrine level and the level of pain-causing substances,with high safety,worthy of promotion.