散结镇痛胶囊联合醋酸甲羟孕酮片治疗子宫内膜异位症患者的疗效及对其血清瘦素、癌胚抗原125和雌二醇的影响

Curative effect of Sanjie Zhentong capsule combined with medroxyprogesterone acetate pill in treatment of endometriosis and the impacts on serum leptin,CA125,and estradiol

目的探讨散结镇痛胶囊联合醋酸甲羟孕酮片治疗子宫内膜异位症患者的疗效及对其血清瘦素(Leptin)、血清癌抗原125 (CA125)和雌二醇(E2)的影响,为临床治疗提供参考依据。方法选取丽水市妇幼保健院2016年5月-2018年5月就诊收治的200例子宫内膜异位症患者作为研究对象,随机分为观察组、对照组(各100例)。对照组给予醋酸甲羟孕酮片治疗,观察组在对照组基础上联合散结镇痛胶囊治疗。比较两组临床疗效、不良反应情况及治疗前后的Leptin、视黄醇结合蛋白4(RBP4)、高迁移率族蛋白B1 (HMGB1)、CA125、E2、血清卵泡刺激素(FSH)及黄体生成素(LH)水平变化及痛经评分、盆腔包块体积。结果 (1)观察组治疗总有效率明显高于对照组(92. 00%%vs. 82. 00%),差异有统计学意义(P<0. 05);(2)两组患者治疗后Leptin、RBP4、HMGB1水平均低于治疗前,差异有统计学意义(均P<0. 05),且治疗后观察组Leptin、RBP4、HMGB1水平均低于对照组,差异有统计学意义(均P<0. 05);(3)两组治疗后CA125水平、痛经评分、盆腔包块直径均低于治疗前,差异有统计学意义(均P<0. 05),且治疗后观察组CA125水平、痛经评分、盆腔包块直径均低于对照组,差异有统计学意义(均P<0. 05);(4)两组患者治疗后E2、FSH、LH水平均低于治疗前,差异有统计学意义(均P<0. 05),且治疗后观察组E2、FSH、LH水平均低于对照组,差异有统计学意义(均P <0. 05);(5)观察组不良反应总发生率稍低于对照组(19. 00%vs.23. 00%),但差异无统计学意义(P>0. 05)。结论散结镇痛胶囊联合醋酸甲羟孕酮片治疗子宫内膜异位症患者临床疗效显著,可有效地改善卵巢功能,降低血清Leptin、CA125水平,安全性较高。

Objective To explore the curative effect of Sanjie Zhentong capsule combined with medroxyprogesterone acetate in treatment of endometriosis and the impacts on serum leptin,CA125,and estradiol(E2),provide a reference basis for clinical treatment.Methods From May 2016 to May 2018,200 patients with endometriosis were selected from Lishui Municipal Maternal and Child Health Care Hospital and randomly divided into observation group and control group,100 patients in each group.The patients in control group were treated by medroxyprogesterone acetate pill,and the patients in observation group were treated by medroxyprogesterone acetate pill and Sanjie Zhentong capsule.The clinical effects,incidence rates of adverse reactions,and levels of leptin,retinol conjugated protein 4(RBP4),high mobility group box B1(HMGB1),CA125,E2,serum follicle-stimulating hormone(FSH),and luteinizing hormone(LH)before and after treatment,dysmenorrheal scores,and pelvic mass volumes in the two groups were compared.Results The total effective rate of treatment in observation group(92.00%)was statistically significantly higher than that in control group(82.00%)(P<0.05).The levels of leptin,RBP4,and HMGB1 after treatment in the two groups were statistically significantly lower than those before treatment(P<0.05).After treatment,the levels of leptin,RBP4,and HMGB1 in observation group were statistically significantly lower than those in control group(P<0.05).After treatment,the levels of CA125,dysmenorrheal score,diameter of pelvic mass in the two groups were statistically significantly lower than those before treatment(P<0.05),the levels of CA125,dysmenorrheal score,diameter of pelvic mass in observation group were statistically significantly lower than those in control group(P<0.05).The levels of E2,FSH,and LH after treatment in the two groups were statistically significantly lower than those before treatment(P<0.05).The levels of E2,FSH,and LH after treatment in observation group were statistically significantly lower than those in control group(P<0.05).The total incidence rate of adverse reactions in observation group(19.00%)was lower than that in control group(23.00%),but there was no statistically significant difference(P>0.05).Conclusion The curative effect of Sanjie Zhentong capsule combined with medroxyprogesterone acetate pill in treatment of endometriosis is significant,the therapy can effectively improve ovarian function,reduce the levels of serum leptin and CA125,the safety is high.