戈舍瑞林联合戊酸雌二醇对子宫内膜异位症术后患者疼痛程度、性激素水平的影响

Effects of Goserrelin combined with estradiol valerate on pain and sex hormone levels in patients with endometriosis after surgery

目的探讨戈舍瑞林联合戊酸雌二醇治疗子宫内膜异位症术后患者的临床疗效,分析其对疼痛程度、性激素、氧化应激水平的影响。方法选取2019年1月至2021年1月于本院行子宫内膜异位症术患者80例为研究对象,依据术后治疗方案分为单一组40例、联合组40例。单一组予以戊酸雌二醇治疗,联合组予以戈舍瑞林+戊酸雌二醇治疗。对比分析两组临床疗效。统计对比两组治疗前、治疗1个月、3个月后氧化应激水平[活性氧簇(ROS)、维生素E(VE)、超氧化物歧化酶(SOD)]、血清学指标[雌二醇(E_(2))、卵泡刺激素(FSH)、促黄体生成素(LH)、性激素结合球蛋白(SHBG)、血管内皮生长因子(VEGF)、胰岛素样生长因子-1(IGF-1)、血栓素B2(TXB2)]及疼痛程度[采用视觉模拟评分法(VAS)]、Kupperman评分。结果联合组总有效率92.50%高于单一组75.00%(P<0.05);治疗1个月、3个月后联合组E_(2)、FSH、LH、VEGF、IGF-1、TXB2、ROS水平低于单一组,SHBG、VE、SOD水平高于单一组(P<0.05);治疗1个月、3个月后联合组VAS、Kupperman评分低于单一组(P<0.05);联合组术后复发率8.33%低于单一组28.57%(P<0.05)。结论子宫内膜异位症患者术后联合应用戈舍瑞林、戊酸雌二醇的疗效确切,可减轻其疼痛程度,纠正性激素紊乱状态,减轻氧化应激反应,改善其临床症状,降低复发风险。

Objective To investigate the clinical efficacy of goserelin combined with estradiol valerate in the treatment of postoperative patients with endometriosis,and to analyze its effects on pain levels,sex hormones,and oxidative stress levels.Methods Eighty patients who underwent endometriosis surgery in our hospital from January 2019 to January 2021 were selected for the study,and were divided into a single group of 40 cases and a combined group of 40 cases based on the postoperative treatment plan.The single group was treated with estradiol valerate and the combination group was treated with goserelin+estradiol valerate.The clinical efficacy of the two groups was compared and analyzed.The levels of oxidative stress[reactive oxygen species cluster(ROS),vitamin E(VE),superoxide dismutase(SOD)],serological indicators[estradiol(E_(2)),follicle-stimulating hormone(FSH),luteinizing hormone(LH),sex hormone-binding globulin(SHBG),vascular endothelial growth factor(VEGF),insulin-like growth factor-1(IGF-1),thromboxane B2(TXB2)]and pain level[using visual analog scoring(VAS)],Kupperman score.Results The total effective rate of the combined group was 92.50%higher than that of the single group 75.00%(P<0.05);the levels of E_(2),FSH,LH,VEGF,IGF-1,TXB2 and ROS in the combined group were lower than those in the single group,and the levels of SHBG,VE and SOD were higher than those in the single group after 1 month and 3 months of treatment(P<0.05).VAS and Kupperman scores were lower in the combined group than in the single group after 1 month and 3 months of treatment(P<0.05);the postoperative recurrence rate was lower in the combined group 8.33%than in the single group 28.57%(P<0.05).Conclusion The combined application of goserelin and estradiol valerate in postoperative patients with endometriosis has definite efficacy in reducing their pain level,correcting the state of sex hormone disorder,reducing oxidative stress,improving their clinical symptoms and reducing the risk of recurrence.