桃核承气汤加减对子宫内膜异位症性激素、卵巢功能及血管内皮生长因子的影响

目的:观察桃核承气汤对子宫内膜异位症临床疗效,并分析治疗前后患者性激素、卵巢功能以及血管内皮生长因子(VEGF)的变化。方法:选取80例子宫内膜异位症患者,随机分为对照组及观察组,其中对照组口服达那唑,自月经第1日口服,200 mg/次,2次/d,连续治疗6个月。观察组患者在上述治疗基础上加用桃核承气汤加减,1剂/d,煎煮200 m L早晚温服,连续治疗6个月。观察指标治疗前后2组患者中医证候积分、性激素、卵巢功能及VEGF水平。结果:观察组临床总有效率92.5%,对照组为85%,差异有统计学意义(P0.05)。2组患者的中医证候积分均较治疗前有所下降,治疗后观察组中医证候积分明显低于对照组,差异有统计学意义(P0.05)。治疗后2组患者雌二醇及孕激素水平均比治疗前降低,差异有统计学意义(P0.05),观察组降低得更明显,与对照组比较差异有统计学意义(P0.05)。排卵前1日观察组卵泡的卵泡直径、卵泡生长平均速度明显优于对照组,差异有统计学意义(P0.05);观察组黄体期/卵泡期卵巢基底动脉血PSV明显高于对照组,PI、RI明显较对照组降低,差异有统计学意义(P0.05)。2组治疗后外周血VEGF水平均下降,其中观察组下降的更明显,差异有统计学意义(P0.05)。结论:桃核承气汤可明显改善子宫内膜异位症的卵巢功能,其作用机制可能与降低VEGF水平有关。

Effects of Modified Taohe Chengqi Decoction on Sex Hormone, Ovarian Function and VEGF of Patients with Endometriosis

To observe clinical curative effects of Taohe Chengqi Decoction on endometriosis, and to analyze the significance of changes of sex hormone, ovarian function, and vascular endothelial growth factor (VEGF) before and after treatment. Methods: A total of 80 cases of patients with endometriosis who were admitted and treated in Luoyang Central Hospital Affiliated to Zhengzhou University were randomly divided into the control group and the observation group. The patients of control group were treated with oral administration of danazol, since 1st day of menstruation, 200 mg/time, bid, continuous treatment for 6 months. Patients of observation group were treated combined with Taohe Chengqi Decoction on the basis of the above treatment, 1 dose per day, 200 mL warm decoction was taken in the morning and evening, continuous treatment for 6 months. The changes of indicators of two groups including TCM syndrome integrals, sex hormone, and ovarian function and VEGF concentration were observed before and after treatment. Results: The clinical total effective rate of the observation group was 92.5%, and the control group was 85%, which had statistical significance (P<0.05). After 6 months of treatment, the TCM syndrome integrals of two groups were decreased. TCM syndrome integrals of the observation group after treatment were significantly lower than the control group, and the differences were statistically significant (P<0.05). After treatment, estradiol and progesterone levels in patients of the two groups were lower than before treatment and the differences were statistically significant (P<0.05). It was found that the observation group reduced more significantly, compared with the control group, with statistically significant differences (P<0.05). Follicle diameter and follicle growth average speed of the observation group 1 day before ovulation were better than those in the control group, and the differences were statistically significant (P<0.05); During the luteal phase/follicular phase, PSV of ovarian basal artery in the observation group were significantly higher than that in the control group, and the PI and RI were significantly reduced than that in the control group, and the differences were with statistical significance (P<0.05). VEGF levels of peripheral blood decreased in the two groups after treatment, and the decrease of the observation group was more significant. The differences were with statistical significance (P<0.05). Conclusion: Taohe Chengqi Decoction can significantly improve the ovarian function of endometriosis, and the mechanism may be associated with reducing the levels of VEGF.