摘要
目的观察桂枝茯苓丸加味联合地屈孕酮片预防子宫内膜息肉切除术后复发的疗效。方法将90例血瘀型子宫内膜息肉切除术后患者按照随机数字表法分为3组,西药组30例予地屈孕酮片口服,中药组30例予桂枝茯苓丸加味治疗,联合组30例予桂枝茯苓丸加味联合地屈孕酮片治疗。3组均治疗3个月经周期。比较3组治疗前后中医证候评分、血清炎症因子[白细胞介素4(IL-4)、IL-6、肿瘤坏死因子α(TNF-α)]和性激素[雌二醇(E_(2))、孕酮(P)]水平,并统计3组疗效及6个月后复发率。结果联合组总有效率93.33%(28/30),中药组总有效率86.67%(26/30),西药组总有效率73.33%(22/30),联合组总有效率高于西药组(P<0.05)。3组治疗后中医证候各项评分及总分均较本组治疗前降低(P<0.05),联合组治疗后各项主症评分、经期小腹痛评分及总分均低于西药组、中药组(P<0.05),中药组治疗后各项主症评分、经期小腹痛评分及总分均低于西药组(P<0.05)。3组治疗后血清IL-4水平均较本组治疗前升高(P<0.05),IL-6、TNF-α水平均降低(P<0.05),且联合组治疗后IL-4水平均高于中药组、西药组(P<0.05),IL-6、TNF-α水平均低于中药组、西药组(P<0.05),中药组治疗后IL-4水平高于西药组(P<0.05),IL-6、TNF-α水平均低于西药组(P<0.05)。3组治疗后血清E_(2)水平均较本组治疗前降低(P<0.05),P水平均升高(P<0.05),且联合组治疗后E_(2)水平均低于中药组、西药组(P<0.05),P水平均高于中药组、西药组(P<0.05),中药组治疗后E_(2)水平低于西药组(P<0.05),P水平高于西药组(P<0.05)。联合组复发率3.33%(1/30),中药组复发率6.67%(2/30),西药组复发率23.33%(7/30),联合组复发率低于西药组(P<0.05)。结论桂枝茯苓丸加味联合地屈孕酮片有助于提高血瘀型子宫内膜息肉切除术后患者临床疗效,预防术后复发,可能与拮抗炎性反应、调节雌孕激素水平等因素有关。
Objective To observe the preventive effect of modified Guizhi Fuling Pills combined with Dydrogesterone tablets on postoperative recurrence of patients underwent endometrial polypectomy.Methods Totally 90 patients underwent endometrial polypectomy(blood stasis type)were randomly divided into 3 equal groups,the Western medicine(WM)group(Dydrogesterone tablets),the traditional Chinese medicine(TCM)group(modified Guizhi Fuling Pills),and the combination group(modified Guizhi Fuling Pills+Dydrogesterone tablets).The treatment continued for 3 menstrual cycles,TCM syndrome score,serum inflammatory factors(interleukin-4[IL-4],IL-6,tumor necrosis factor-α[TNF-α]),sex hormone(SH)(estradiol[E_(2)],progesterone[P])were included as comparators;the curative effect and the recurrence rate on month 6 were assessed.Results The overall effective rate in the combination group,the TCM group and the WM group was 93.33%(28/30),86.67%(26/30)and 73.33%(22/30),respectively,which was better in the combination group than in the WM group(P<0.05).After treatment,TCM symptom scores in groups were decreased(P<0.05),the main symptom scores and lower abdominal pain score during the menstrual cycle in the combination group were the lowest(P<0.05),followed by the TCM group and the WM group(P<0.05);IL-4 in groups was increased(P<0.05),which in the combination group was higher than the TCM group and the WM group in turn(all P<0.05);IL-6 and TNF-αand serum E_(2) in groups were decreased(all P<0.05),which in the combination group were lower than in the TCM group and the WM group in turn(all P<0.05);P level in groups was increased(P<0.05),the combination group was more prevalent(P<0.05),followed by the TCM group and the WM group(P<0.05).The recurrence rate in the combination group,the TCM group and the WM group was 3.33%(1/30),6.67%(2/30)and 23.33%(7/30),respectively,which was lower in the combination group than in the WM group(P<0.05).Conclusion Modified Guizhi Fuling Pills combined with Dydrogesterone tablets is beneficial to prevent postoperative recurrence in patients underwent endometrial polypectomy(blood stasis type)by inhibiting anti-inflammatory responses and regulating progesterone.
作者
单锦霞
郑艳莉
郭正刚
韩煜雯
葛凤琴
SHAN Jinxia;ZHENG Yanli;GUO Zhenggang;HAN Yuwen;GE Fengqin(Department of Gynecology,First People's Hospital of Nantong,Nantong,Jiangsu 226001;Department of Traditional Chinese Medicine,First People's Hospital of Nantong,Nantong,Jiangsu 226001)
出处
《河北中医》
2022年第2期253-257,262,共6页
Hebei Journal of Traditional Chinese Medicine
基金
江苏省妇幼健康科研项目(编号:F201836)。
关键词
桂枝茯苓丸
子宫疾病
地屈孕酮
中西医结合疗法
复发
Guizhi Fuling Pills
Uterine disease
Dydrogesterone
Integrated traditional Chinese and Western medicine therapy
Recurrence
