桃核承气汤对子宫内膜异位症患者临床疗效及可能作用机制研究

目的:探究桃核承气汤对子宫内膜异位症(EMT)患者临床疗效及可能作用机制。方法:选取2011年6月至2017年6月北京市海淀医院收治的EMT患者70例作为研究对象,按照入院先后顺序法随机分为对照组和观察组,每组35例。2组均予以西医治疗,观察组再予以桃核承气汤加减治疗。比较2组治疗前、治疗8周后性激素、VEGF、卵巢功能、症状积分、血液流变学、免疫学的变化。结果:治疗8周后,观察组患者血清E2、P、VEG水平、黄体期和卵泡期PI、RI、PSV改善效果均优于对照组(P<0.05)。治疗8周后,观察组在临床症状积分改善及高切全血黏度、低切全血黏度、血浆黏度、红细胞沉降率、红细胞聚集指数、纤维蛋白原改善效果均优于对照组(P<0.05)。2组糖类抗原125(CA125)、子宫内膜抗体(EmAb)阳性率较治疗前均显著下降(P<0.05),治疗8周后观察组以上指标水平均显著低于对照组(P<0.05)。结论:桃核承气汤能改善抑制性激素和VEGF,提高卵巢功能,从而改善症状,提高疗效。

Research on Clinical Therapeutic Effects and Mechanism of Taohe Chengqi Decoction on Endometriosis

Objective:To explore the clinical therapeutic effects and possible mechanism of Taohe Chengqi Decoction on patients with endometriosis(EMT).Methods:A total of 70 patients with EMT were randomly divided into a control group and a study group.Both groups were treated with Western medicine,and the study group was treated with modified Taohe Chengqi Decoction based on the control group.The changes of sex hormone,VEGF,ovarian function,symptom score,hemorheology and immunology were observed and compared between the 2 groups before and after 8 weeks of treatment.Results:After 8 weeks of treatment,the level of serum E 2,P,VEG,PI,RI and PSV in luteal and follicular phase in the study group were better than those in the control group(P<0.05).After 8 weeks of treatment,the improvement of clinical symptom scores,high shear whole blood viscosity,low shear whole blood viscosity,plasma viscosity,ESR,RBC aggregation index and fibrinogen in the study group was better than those in the control group(P<0.05).The positive rates of CA125 and EMAb in the 2 groups were significantly lower than those before treatment(P<0.05),and the levels of the above indexes in the study group were significantly lower than those in the control group(P<0.05).Conclusion:Taohe Chengqi Decoction could improve the inhibition of sex hormones and VEGF,the ovarian function,so as to improve the symptoms and the therapeutic effects.