少腹逐瘀颗粒联合戈舍瑞林治疗子宫内膜异位症的临床研究

目的探讨少腹逐瘀颗粒联合醋酸戈舍瑞林缓释植入剂治疗子宫内膜异位症的临床研究。方法选取2016年3月—2017年5月日照市东港区妇幼保健院收治的86例子宫内膜异位症患者,按照随机数字表法将所有患者分为对照组和治疗组,每组各43例。对照组于月经来潮第2天皮下注射醋酸戈舍瑞林缓释植入剂,每4周1次,每次3.6mg,连续治疗3次。治疗组在对照组治疗的基础上温水冲服少腹逐瘀颗粒,3次/d,每次1.6g,连续治疗12周。观察两组患者临床疗效,同时比较治疗前后两组患者改良Kupperman评分、视觉模拟评分(VAS)、子宫体积、性激素水平和复发、自然妊娠情况。结果治疗后,对照组、治疗组总有效率分别为76.74%、93.02%,两组患者临床总有效率比较差异有统计学意义(P0.05)。治疗后,两组改良Kupperman评分、VAS评分、子宫体积明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗后治疗组这些指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清性激素雌二醇(E2)、促卵泡成熟激素(FSH)、黄体生成激素(LH)、催乳激素(PRL)、睾酮(T)水平均明显降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组性激素水平明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗组的复发率低于对照组,自然妊娠高于对照组,差异有统计学意义(P0.05)。结论少腹逐瘀颗粒联合醋酸戈舍瑞林缓释植入剂治疗子宫内膜异位症具有较好的临床疗效,可改善临床症状,降低性激素水平,降低复发率,提高自然妊娠,具有一定的临床推广应用价值。

Clinical study of Shaofu Zhuyu Granules combined with goserelin in treatment of endometriosis

Objective To investigate the clinical efficacy of Shaofu Zhuyu Granules combined with Goserelin Acetate Sustained-Release Depot in treatment of endometriosis. Methods Patients (86 cases) with endometriosis in Women and Child Health Care Hospital Donggang from March 2016 to May 2017 were randomly divided into control (43 cases) and treatment (43 cases) group. Patients in the control group were ih administered with Goserelin Acetate Sustained-Release Depot on the second day of menstruation, once every 4 weeks, 3.6 mg/time, and continuous treatment 3 times. Patients in the treatment group were po administered with Shaofu Zhuyu Granules on the basis of the control group, 3 times/d, 1.6 g/time, and continuous treatment for 12 weeks. After treatment, the clinical efficacy was evaluated, and modified Kupperman score, visual analog scale (VAS) score, uterine volume, recurrence and natural pregnancy in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 76.74% and 93.02%, respectively, and there were significant differences between two groups (P<0.05). After treatment, modified Kupperman score, VAS score, and uterine volume in the treatment group were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observation indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of E₂, FSH, LH, PRL, and T in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the levels of serum cytokine levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the recurrence rates in the treatment group were lower than those in the control group, but the natural pregnancy in the treatment group was higher than that in the control group. Conclusion Shaofu Zhuyu Granules combined with Goserelin Acetate Sustained-Release Depot has clinical curative effect in treatment of endometriosis, can improve clinical symptoms, reduce sex hormone levels, and reduce relapse rate and improve natural pregnancy, which has a certain clinical application value.