活血化瘀方及米非司酮联合腹腔镜手术治疗子宫内膜异位症疗效观察

Efficacy Observation of Huoxue Huayu Formula and Mifepristone Combined with Laparoscopic Surgery in the Treatment of Endometriosis

目的 探讨活血化瘀方及米非司酮联合腹腔镜手术治疗子宫内膜异位症(EMT)的临床疗效。方法 选取重庆市中医院2021年3月至2022年3月收治的EMT患者80例,随机分为对照组和观察组,各40例。两组患者均行腹腔镜手术,并于术后月经来潮第1天口服米非司酮片,观察组患者加用活血化瘀方。两组均以3个月为1疗程,连续治疗2个疗程。结果 观察组总有效率为90.00%,显著高于对照组的72.50%(P <0.05)。治疗后,两组患者的盆腔包块体积均显著缩小,痛经评分均显著降低;全血黏度(低切、中切、高切)、血浆黏度、红细胞聚集指数,子宫动脉及分支的阻力指数、搏动指数、收缩末期与舒张末期最大血流速率比值,血清雌二醇、黄体生成素、卵泡刺激素水平,血清血管内皮生长因子、血管生成素-2及酪氨酸蛋白激酶受体2水平均显著降低(P <0.05),且观察组上述指标改善更显著(P <0.05)。治疗后,两组患者血尿素氮、肌酐及丙氨酸氨基转移酶水平无显著变化(P> 0.05)。观察组不良反应发生率为10.00%,显著低于对照组的25.00%(P <0.05)。结论 活血化瘀方及米非司酮联合腹腔镜手术治疗EMT,可改善患者的临床症状和子宫血循环状态,通过调节机体性激素及血管生成调节因子水平抑制EMT病灶进展。

Objective To investigate the clinical efficacy of Huoxue Huayu Formula and mifepristone combined with laparoscopic surgery in the treatment of endometriosis(EMT).Methods A total of 80 patients with EMT admitted to the Chongqing Traditional Chinese Medicine Hospital from March 2021 to March 2022 were selected and randomly divided into the control group and the observation group,with 40 patients in each group.The patients in the two groups underwent laparoscopic surgery and took oral Mifepristone Tablets on the first day of menstruation after surgery,on this basis,the patients in the observation group received Huoxue Huayu Formula.Both groups were treated for two courses with three months as one course.Results The total effective rate in the observation group was 90.00%,which was significantly higher than 72.50%in the control group(P<0.05).After treatment,the pelvic mass volume,dysmenorrhea score,whole blood viscosity at low-,medium-and high-shear rates,plasma viscosity,erythrocyte aggregation index,resistance index(RI)of uterine artery and its branches,pulsatility index(PI),maximum end-systolic blood flow velocity(S)/maximum end-diastolic blood flow velocity(D),serum estradiol(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH)levels,serum vascular endothelial growth factor(VEGF),angiopoietin-2(Ang-2)and tyrosine protein kinase receptor 2(Tie-2)levels in the two groups significantly decreased(P<0.05).The above indexes in the observation group were significantly better(P<0.05).After treatment,there was no significant change in the blood urea nitrogen(BUN),creatinine(Cr)and alanine aminotransferase(ALT)levels in both groups(P>0.05).The incidence of adverse reactions in the observation group was 10.00%,which was significantly lower than 25.00%in the control group(P<0.05).Conclusion Huoxue Huayu Formula and mifepristone combined with laparoscopic surgery can improve the clinical symptoms and uterine blood circulation of patients with EMT,and inhibit the progression of EMT lesions by regulating the sex hormones and angiogenesis regulatory factor levels in the body.