自拟补气消瘀方用于子宫腺肌病GnRHa治疗对患者中医证候、血清CA199、CA125的影响

Effects ofself-made Buqi Xiaoyu Decoction on TCM syndromes,serum CA199 and CA125 in patients with adenomyosis after GnRHa treatment

目的:探究自拟补气消瘀方用于子宫腺肌病(AM)患者促性腺激素释放激素类似物(GnRHa)治疗对中医证候、血清糖类抗原199(CA199)、糖类抗原125(CA125)的影响。方法:按随机数字表法将2020年1月~2022年12月泰州市中医院收治的78例AM患者分成对照组(39例)和治疗组(39例)。对照组予以GnRHa治疗,在此基础上治疗组予以自拟补气消瘀方治疗,时长为3个月。比较两组疗效、中医证候积分、血清指标(CA199、CA125)、临床康复指标[子宫体积、经期疼痛程度(VAS)、月经失血图(PBAC)、COX痛经症状量表(CMSS)]、用药安全性和复发率的差异。结果:治疗后,治疗组的总有效率高于对照组(P<0.05);两组经期/前小腹痛、行经不规律、经量异常、次证总分均低于同组治疗前,且治疗组低于对照组(P<0.05);两组CA199、CA125水平均低于同组治疗前,且治疗组低于对照组(P<0.05);两组子宫体积、VAS、PBAC、CMSS(持续时间、严重程度)评分均低于同组治疗前,且治疗组低于对照组(P<0.05);治疗组的不良反应发生率低于对照组(P<0.05);随访6个月后,治疗组的复发率低于对照组(P<0.05)。结论:自拟补气消瘀方辅助GnRHa治疗AM的疗效显著,能有效改善中医证候及痛经相关积分,降低血清CA199、CA125水平,缩小子宫体积,减少不良反应发生及疾病复发。

Objective:To explore the effects of self-made Buqi Xiaoyu Decoction on TCM syndromes,serum carbohydrate antigen 199(CA199)and carbohydrate antigen 125(CA125)in patients with adenomyosis(AM)after treatment with gonadotropin-releasing hormone agonist(GnRHa).Methods:According to random number table method,78 patients with AM admitted to Taizhou Hospital of Traditional Chinese Medicine were enrolled and divided into control group(39 cases)and treatment group(39 cases)between January 2020 and December 2022.The control group was treated with GnRHa,while treatment group was treated with self-made Buqi Xiaoyu Decoction+GnRHa for 3 months.The curative effect,scores of TCM syndromes,serum indexes(CA199,CA125),clinical rehabilitation indexes[uterine volume,scores of visual analogue scale(VAS),pictorial blood loss assessment chart(PBAC)and Cox menstrual symptom scale(CMSS)],medication safety and recurrence rate were compared between the two groups.Results:After treatment,total response rate of treatment group was higher than that of control group(P<0.05).After treatment,scores and total scores of secondary syndromes(lower abdominal pain during/before menstruation,irregular menstruation,abnormal menstrual volume)were decreased in both groups,which werelower in treatment group than control group(P<0.05).After treatment,levels of CA199,CA125,VEGF and MMP-9 were decreased in both groups,which were lower in treatment group than control group(P<0.05).After treatment,uterine volume,scores of VAS,PBAC and CMSS(duration,severity)were decreased in both groups,which were lower in treatment group than control group(P<0.05).The incidence of adverse reactions in treatment group was lower than that in control group(P<0.05).After 6 months of follow-up,recurrence rate in treatment group was lower than that in control group(P<0.05).Conclusion:The curative effect of self-made Buqi Xiaoyu Decoction+GnRHa is significant in AM patients,which can effectively improve TCM syndromes and dysmenorrhea,reduce levels of serum CA199,CA125,uterine volume,occurrence of adverse reactions and disease recurrence.