电针联合补肾祛瘀方治疗子宫内膜异位症的疗效观察及对血清CA125和CA19-9的影响

Therapeutic observation of electroacupuncture combined with Bu Shen Qu Yu formula for endometriosis and its effects on serum CA125 and CA19-9

目的观察电针联合补肾祛瘀方治疗子宫内膜异位症的临床疗效及对患者血清糖类抗原125(carbohydrate antigen 125,CA125)和糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)水平的影响。方法将88例子宫内膜异位症患者用随机数字表法分为对照组和联合组,每组44例。对照组予口服补肾祛瘀方治疗,联合组予电针联合口服补肾祛瘀方治疗。观察两组治疗前后患者血清促黄体生成素(luteinizing hormone,LH)、孕激素(progesterone,P)、卵泡刺激素(follicle-stimulating hormone,FSH)、血管生成素受体-2(angiopoietin receptor-2,Tie-2)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、细胞间黏附相关因子-1(intercellular adhesion molecule-1,ICAM-1)、视黄醇结合蛋白4(retinol-binding protein 4,RBP4)、肝激酶-1(fetal liver kinase-1,Flk-1)、环氧化酶-2(cyclooxygenase-2,COX-2)、前列腺素F2α(prostaglandin F2α,PGF2α)、CA125、CA19-9、催产素(oxytocin,OT)及活化调节因子(regulated on activation normal T cell expressed and secreted,RANTES)水平的变化,观察治疗前后两组患者异位病灶面积、中医证候积分及子宫内膜异位症生存质量量表(endometriosis health profile-5,EHP-5)评分的变化,比较两组临床疗效。结果治疗后,联合组血清LH、P、FSH水平低于对照组(P<0.05),联合组血清RBP4、ICAM-1和RANTES水平低于对照组(P<0.05),联合组血清PGF2α、COX-2和OT水平低于对照组(P<0.05),联合组血清VEGF、Tie-2和Flk-1水平低于对照组(P<0.05),联合组血清CA125和CA19-9水平低于对照组(P<0.05)。治疗后,联合组异位病灶面积、中医证候积分和EHP-5评分均优于对照组(P<0.05)。联合组总有效率高于对照组(P<0.05)。结论电针联合补肾祛瘀方治疗子宫内膜异位症可调节患者内分泌水平,抑制机体炎症,改善疼痛指标,抑制血管生成,降低患者血清CA125和CA19-9水平,提高临床疗效及生活质量。

Objective To observe the clinical efficacy of electroacupuncture plus Bu Shen Qu Yu formula in treating endometriosis and its effects on the serum levels of carbohydrate antigen 125(CA125)and carbohydrate antigen 19-9(CA19-9).Method Eighty-eight patients with endometriosis were divided into a control group and a combination group using the random number table method,with 44 cases in each group.The control group was treated with oral administration of Bu Shen Qu Yu formula,and the combination group received electroacupuncture plus oral administration of Bu Shen Qu Yu formula.Before and after the treatment,the serum levels of luteinizing hormone(LH),progesterone(P),follicle-stimulating hormone(FSH),angiopoietin receptor-2(Tie-2),vascular endothelial growth factor(VEGF),intercellular adhesion molecule-1(ICAM-1),retinol-binding protein 4(RBP4),fetal liver kinase-1(Flk-1),cyclooxygenase-2(COX-2),prostaglandin F2α(PGF2α),CA125,CA19-9,oxytocin(OT),and the regulated on activation normal T cell expressed and secreted(RANTES)were observed.The ectopic focus area,symptom score of traditional Chinese medicine(TCM),and endometriosis health profile-5(EHP-5)score were assessed before and after the intervention.The clinical efficacy was also compared between the two groups.Result After the treatment,the serum LH,P,and FSH levels were lower in the combination group than in the control group(P<0.05);the serum levels of RBP4,ICAM-1,and RANTES were lower in the combination group(P<0.05);the serum levels of PGF2α,COX-2,and OT were lower in the combination group(P<0.05);the combination group had lower serum VEGF,Tie-2,and Flk-1 levels(P<0.05);the serum levels of CA125 and CA19-9 were lower in the combination group(P<0.05).After the intervention,the combination group was superior to the control group in comparing the ectopic focus area,TCM symptom score,and EHP-5 score(P<0.05).The combination group achieved a higher total effective rate than the control group(P<0.05).Conclusion In the treatment of endometriosis,electroacupuncture plus Bu Shen Qu Yu formula can regulate the endocrine level,inhibit inflammation,improve pain indicators,suppress angiogenesis,lower the serum CA125 and CA19-9 levels,and enhance clinical efficacy and quality of life.