桂枝茯苓胶囊联合戈舍瑞林对子宫内膜异位症患者子宫动脉血流动力学及Th1/Th2细胞因子的影响

目的:探讨桂枝茯苓胶囊联合戈舍瑞林对子宫内膜异位症(EMs)患者子宫动脉血流动力学及辅助性T细胞1/辅助性T细胞2(Th₁/Th₂)细胞因子的影响。方法:选择192例EMSs患者作为研究对象,随机分为观察组和对照组,各96例。对照组皮下注射戈舍瑞林治疗,观察组采用戈舍瑞林与桂枝茯苓胶囊联合治疗,均治疗3个月,并随访6个月。比较两组治疗后的治疗总有效率,治疗前和治疗后的中医证候积分、搏动指数(PI)、收缩期最大流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)、血清白介素-2(IL-2)、白介素-4(IL-4)、干扰素-γ(INF-γ)和血清卵泡刺激素(FSH)、黄体生成素(LH)及雌二醇(E₂)水平,统计随访期间的复发率、受孕率以及治疗期间的不良反应发生率。结果:治疗后,观察组的治疗总有效率93.75%明显高于对照组的81.25%(P<0.05); 同时,观察组腰部酸胀、经期腹痛、月经异常和神疲乏力的中医证候积分均比对照组低(P<0.05); 且观察组PI、RI、E₂、IL-4水平均低于对照组(P<0.05); 观察组PSV、EDV和血清IL-2和INF-γ水平均高于对照组(P<0.05)。随访期间,观察组患者的复发率低于对照组(P<0.05),受孕率高于对照组(P<0.05); 治疗期间,两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论:将桂枝茯苓胶囊与戈舍瑞林联合应用于EMSs的治疗中,可有效减轻中医证候,降低血清Th₁/Th₂细胞因子水平,改善雌激素紊乱和子宫动脉血流动力学,减少术后复发并提高受孕率,具有较好的临床疗效。

Effects of Guizhi Fuling capsule combined with goserelin on uterine artery hemodynamics and Th1/Th2 cytokines in endometriosis patients

Objective:To investigate the effects of Guizhi Fuling capsule combined with goserelin on uterine artery hemodynamics and helper T cell 1/helper T cell 2(Th₁/Th₂)cytokines in patients with endometriosis(EMs).Methods:A total of 192 patients with EMs were randomly divided into observation group and control group,96 cases in each group.The control group was subcutaneously injected with goserelin,while observation group was additionally treated with Guizhi Fuling capsules.All were treated for 3 months and then followed up for 6 months.The total response rate after treatment,scores of TCM syndromes,pulsatility index(PI),peak systolic velocity(PSV),end diastolic velocity(EDV),resistance index(RI),levels of serum interleukin-2(IL-2),interleukin-4(IL-4),interferon-γ(INF-γ),follicle stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E₂)before and after treatment in the two groups were compared.The recurrence and fertilization rates during follow-up,and the incidence of adverse reactions during treatment were statistically analyzed.Results:After treatment,total response rate of treatment was significantly higher in observation group than control group(93.75% vs 81.25%)(P<0.05),scores of TCM syndromes(waist soreness,menstrual abdominal pain,abnormal menstruation,fatigue)were lower in observation group(P<0.05),PI,RI,E₂ and IL-4 levels were lower in observation group(P<0.05),PSV,EDV,serum IL-2 and INF-γ levels were higher in observation group(P<0.05).During follow-up,recurrence rate was lower in observation group than control group(P<0.05),while fertilization rate was higher in observation group(P<0.05).During treatment,difference in the total incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion:The application of Guizhi Fuling capsule combined with goserelin can effectively relieve TCM syndromes,reduce levels of serum Th₁/Th₂ cytokines,improve estrogen disorders and uterine artery hemodynamics,reduce postoperative recurrence and increase fertilization rate in EMs patients,with significant clinical curative effect.