乾坤愈胆汤加减联合醋酸亮丙瑞林对子宫腺肌病患者血清糖类抗原125及复发率的影响

Effect of modified Qiankun Yudan Decoction combined with leuprorelin acetate on serum carbohydrate antigen 125 and recurrence rate in patients with adenomyosis

目的 分析乾坤愈胆汤加减联合醋酸亮丙瑞林治疗子宫腺肌病(AM)患者的疗效及对血清糖类抗原125(CA125)水平和复发率的影响。方法 将120例AM患者随机分为对照组(给予醋酸亮丙瑞林治疗)和实验组(在对照组基础上配合乾坤愈胆汤加减治疗),每组60例。比较2组疗效、中医证候积分、痛经积分、血清CA125水平、子宫体积以及不良反应发生情况、复发率。结果 实验组治疗总有效率为95.00%,高于对照组的80.00%,差异有统计学意义(P<0.05)。治疗3、6个月时,2组中医证候积分、痛经积分均低于同组治疗前,且实验组低于对照组,差异有统计学意义(P<0.05)。治疗3、6个月时,2组血清CA125、子宫体积低于或小于同组治疗前,且实验组低于或小于对照组,差异有统计学意义(P<0.05)。实验组不良反应总发生率为1.67%,低于对照组的11.67%,差异有统计学意义(P<0.05)。随访至治疗结束后3个月,实验组无复发,对照组复发率为5.00%,但差异无统计学意义(P>0.05);随访至治疗结束后6个月,实验组复发率为1.67%,低于对照组的13.33%,差异有统计学意义(P<0.05)。结论 乾坤愈胆汤加减联合醋酸亮丙瑞林可提高AM患者的疗效,缓解患者中医证候以及痛经症状,对血清CA125具有较好的调控效果,并能缩小子宫体积,减轻胃肠道不适以及肝功能损伤,降低复发率。

Objective To analyze the efficacy of modified Qiankun Yudan Decoction combined with leuprorelin acetate in the treatment of patients with adenomyosis(AM)and its effect on serum carbohydrate antigen 125(CA125)level and recurrence rate.Methods A total of 120 patients with AM were randomly divided into control group(treated with leuprorelin acetate)and experimental group(treated with modified Qiankun Yudan Decoction on the basis of control group),with 60 cases in each group.Efficacy,the traditional Chinese medicine(TCM)syndrome score,dysmenorrhea score,serum CA125 level,uterine volume,occurrence of adverse reactions and recurrence rate were compared between the two groups.Results The total effective rate in the experimental group was 95.00%,which was significantly higher than 80.00%in the control group(P<0.05).After 3 and 6 months of treatment,the TCM syndrome score and dysmenorrhea score in both groups were significantly lower than those before treatment,and the scores in the experimental group were significantly lower than those in the control group(P<0.05).After 3 and 6 months of treatment,serum CA125 and uterine volume in both groups were significantly lower or smaller than those before treatment,and the two indicators in the experimental group were significantly lower or shorter than those in the control group(P<0.05).The total incidence rate of adverse reactions in the experimental group was 1.67%,which was significantly lower than 11.67%in the control group(P<0.05).At the time point of follow-up to 3 months after the treatment,the experimental group had no recurrence cases,and the recurrence rate of control group was 5.00%,but there was no significant difference between two groups(P>0.05);at the time point of follow-up to 6 months after treatment,the recurrence rate was 1.67%in the experimental group,which was significantly lower than 13.33%in the control group(P<0.05).Conclusion Modified Qiankun Yudan Decoction combined with leuprorelin acetate can enhance the therapeutic efficacy in patients with AM,alleviate the TCM syndrome and dysmenorrhea symptoms,perform a good regulation effect on serum CA125,reduce the uterine volume,relieve the gastrointestinal discomfort and liver injury,and reduce the recurrence rate.