摘要
目的:探讨血府逐瘀胶囊辅助黄体酮胶囊对子宫内膜息肉(EP)切除术后子宫内膜改变、复发的影响及可能分子机制。方法:选取2018年2月-2020年2月本院接收行宫腔镜息肉切除术的EP患者78例,随机数字表法分为联合组和西医组各39例,两组术后均予以黄体酮胶囊,联合组加用血府逐瘀胶囊,均治疗3个月经周期。比较两组治疗前后子宫内膜厚度、月经失血图(PBAC)评分、中医证候积分、血清炎症因子[白细胞介素(IL)-4、IL-6、肿瘤坏死因子-α(TNF-α)]水平及孕激素受体(PR)、雌激素受体(ER)、细胞增殖核抗原-67(Ki-67)表达,统计两组疗效、不良反应及术后6、12个月复发率。结果:联合组治疗后子宫内膜厚度(0.61±0.19mm)、PBAC评分(56.74±9.17分)、中医证候积分(7.68±1.95分)均低于西医组(0.74±0.21mm、64.25±12.08分、10.32±2.27分),血清IL-4水平高于西医组,IL-6、TNF-α水平低于西医组,PR表达高于西医组,ER、Ki-67表达低于西医组,总有效率(94.9%)高于西医组(79.5%)(均P<0.05);治疗期间不良反应发生率联合组(15.4%)与西医组(10.3%)无差异,术后6、12个月复发率(0、2.7%)与西医组(8.1%、13.5%)无差异(P>0.05)。结论:子宫内膜息肉术后应用血府逐瘀胶囊辅助黄体酮胶囊治疗可降低术后患者子宫内膜厚度,改善临床症状,减少术后复发,安全有效,其机制可能与减轻炎症反应、调节PR、ER与Ki-67表达有关。
Objective:To investigate the influence of Xuefu zhuyu capsules combined with progesterone capsules for treating women after endometrial polyps(EP)surgery on their endometrial changes and the recurrence of their EP,and to study its molecular mechanism.Methods:A total of 78 women with EP who underwent hysteroscopic polypectomy were selected and were divided into group A(39 women with treatment of Xuefu zhuyu capsules combined with progesterone capsules for three menstrual cycle)and group B(39 women with treatment of progesterone capsules for three menstrual cycle)according to the random number table method from February 2018 to February 2021.The endometrial thickness,the menstrual blood loss chart(PBAC)score,the syndrome score,the levels of serum inflammatory factors,such as interleukin(IL)-4,IL-6,and tumor necrosis factor-α(TNF-α),and the expressions of progesterone receptor(PR),estrogen receptor(ER),and proliferating nuclear antigen-67(Ki-67)of the women before and after treatment were compared between the two groups.The curative effect and the rates of the adverse reactions and recurrence of PE in the 6th month and the 12th month after operation of the women in the two groups were counted.Results:After treatment,the endometrial thickness(0.61±0.19mm),PBAC score(56.74±9.17 points),and TCM syndrome score(7.68±1.95 points)of the women in group A were significantly lower than those(0.74±0.21mm,64.25±12.08 points,and 10.32±2.27 points)of the women in group B.The levels of serum IL-4 and PR of the women in group A were significantly higher than those of the women in group B.The levels of serum IL-6,TNF-α,ER,and Ki-67 of the women in group A were significantly lower than those of the women in group B.The total effective rate(94.9%)of the women in group A was significantly higher than that(79.5%)of the women in group B(all P<0.05).There were no significant differences in the incidences of adverse reactions(15.4%vs.10.3%)and the recurrence of PE in the 6th month(0 vs.2.7%)and the 12th month(8.1%vs.13.5%)between the two groups(P>0.05).Conclusion:The application of Xuefu zhuyu capsules combined with progesterone capsules for treating the women after hysteroscopic endometrial polypectomy can reduce their endometrial thickness and the postoperative recurrence of PE,improve their clinical symptoms with safe and effectiveness.The mechanism may be related to reducing the inflammatory response and to regulating the PR,ER and Ki-67 expressions levels of the women.
作者
王雅红
闫亚男
张艳云
周艳辉
冉淑玲
梁娜
WANG Yahong;YAN Yanan;ZHANG Yanyun;ZHOU Yanhui;RAN Shuling;LIANG Na(The Second People's Hospital of Fengrun District,Tangshan,Hebei Province,064000)
出处
《中国计划生育学杂志》
2022年第11期2457-2462,共6页
Chinese Journal of Family Planning
关键词
子宫内膜息肉
血府逐瘀胶囊
黄体酮胶囊
炎症因子
雌孕激素
复发率
Endometrial polyps
Xuefu zhuyu capsule
Progesterone capsule
Inflammatory factors
Estrogen and progesterone
Recurrence rate
