左炔诺孕酮宫内节育系统联合丹莪妇康煎膏治疗子宫内膜异位症患者术后的临床疗效

Clinical Efficacy of Levonorgestrel Intrauterine System Combined with Dan'e Fukang Decoction for Treatment of Postoperative Patients with Endometriosis

目的探讨左炔诺孕酮宫内节育系统联合丹莪妇康煎膏治疗子宫内膜异位症患者术后的临床疗效。方法选择2012年1月至2014年7月泰州市第二人民医院接诊的子宫内膜异位症患者120例作为研究对象,按照随机数字法分为观察组和对照组,各60例。两组患者均实行腹腔镜手术,对照组术后在宫腔内放入左炔诺孕酮宫内节育系统进行治疗,观察组在对照组的基础上加用丹莪妇康煎膏,每次15 g,每天2次,经期仍持续用药,15 d为1个疗程,连续使用3个疗程。3个疗程后,观察两组患者治疗前后血尿素氮(BUN)、肌酐(Cr)、丙氨酸转氨酶(ALT)、糖类抗原125(CA125)的变化,比较治疗后临床疗效及不良反应发生情况,并对两组患者进行1年的随访,观察复发率。结果治疗前,两组患者的BUN、Cr、ALT、CA125水平比较差异无统计学意义(P>0.05)。治疗后,两组患者的BUN、Cr、ALT水平与治疗前比较差异无统计学意义(P>0.05);CA125水平显著低于治疗前,且观察组水平显著低于对照组[(23.23±3.51)kU/L比(34.37±4.15)kU/L](P<0.05);观察组总有效率显著高于对照组[96.67%(58/60)比78.33%(47/60)],不良反应发生率显著低于对照组[3.33%(2/60)比21.67%(9/60)](P<0.5);通过随访,观察组复发率显著低于对照组[3.33%(2/60)比18.33%(11/60)](P<0.05)。结论左炔诺孕酮宫内节育系统联合丹莪妇康煎膏治疗子宫内膜异位症患者术后疗效优异,能有效降低CA125水平,值在临床上应用推广。

Objective To investigate the clinical efficacy of levonorgestrel intrauterine system combined with Dan ′e Fukang decoction for treatment of postoperative patients with endometriosis .Methods A total of 120 patients with endome-triosis in Taizhou Second People′s Hospital from Jan.2012 to Jul.2014 were collected as research objects ,and the patients were divided into an observation group and a control group according to the random number method ,60 cases each.Both groups were performed laparoscopic surgery ,and the control group was placed levonorgestrel intrauterine system in the uter-ine cavity for treatment ,while the observation group was added with Dan′e Fukang ecoction ,15 g per time,2 times a day on the basis of the control group′s regimen, continued during menstruation ,15 days as a course of treatment ,three courses con-tinuously.After three courses,the blood urea nitrogen (BUN),creatinine(Cr),alanine aminotransferase(ALT),change of carbohydrate antigen 125 ( CA125 ) of the two groups before and after treatment were observed ,and the clinical efficacy and adverse reactions after treatment were compared ,and the two groups were followed for one year to observe the recurrence rate.Results BUN, Cr,ALT,CA125 levels of the two groups before treatment were not statistically significantly diferent (P>0.05);after treatment the BUN,Cr,ALT of the two groups were not statistically changed (P>0.05);the levels of CA125 were significantly lower than before treatment ,and the level of the observation group was significantly lower than that of the control group[(23.23 ±3.51) kU/L vs (34.37 ±4.15) kU/L](P<0.05);the total effective rate of the observa-tion group was higher than that of the control group [ 96.67% ( 58/60 ) vs 78.33%( 47/60 ) ] , the incidence of adverse&nbsp;reactions was lower than that of the control group [3.33%(2/60) vs 21.67%(9/60)](P<0.05);during the follow-up, the recurrence rate of the observation group was significantly lower than that of the control group [ 3.33%( 2/60 ) vs 18.33%(11/60)](P<0.05).Conclusion Levonorgestrel intrauterine system combined with Dan′e Fukang decoction has excellent curative effect in the treatment of endometriosis ,which can effectively reduce the CA125S level,thus is worthy of promotion in the clinical practice .