清热化瘀方对瘀热互结型子宫内膜异位症患者疼痛及凝血功能的影响

目的观察清热化瘀方对瘀热互结型子宫内膜异位症(EMT)患者疼痛及凝血功能的影响。方法将60例瘀热互结型EMT患者按照随机数字表法分为2组。治疗组30例予清热化瘀方治疗;对照组30例予血府逐瘀汤治疗。2组疗程均为3个月,疗程结束后随访3个月。比较2组治疗前后痛经视觉模拟评分法(VAS)评分;比较2组治疗后痛经及非经期慢性盆腔痛程度;比较2组治疗前后血小板计数(PLT)、D-二聚体(D-D)及血管内皮生长因子(VEGF);比较2组治疗前后血液流变学指标血浆黏度、全血黏度(高切)、全血黏度(低切)、红细胞聚集指数;比较2组治疗前后癌胚抗原125(CA125)及子宫内膜异位囊肿直径;比较2组远期疗效。结果治疗组治疗后痛经及非经期慢性盆腔痛程度缓解均优于本组治疗前、对照组治疗后(P<0.05);对照组治疗后非经期慢性盆腔痛程度缓解优于本组治疗前(P<0.05)。2组治疗后PLT、D-D及VEGF均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后痛经VAS评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。治疗组治疗后血浆黏度、全血黏度(高切)、全血黏度(低切)及红细胞聚集指数均较本组治疗前降低(P<0.05);对照组治疗后血浆黏度、全血黏度(高切)及全血黏度(低切)均较本组治疗前降低(P<0.05);治疗组治疗后血浆黏度、全血黏度(高切)、全血黏度(低切)及红细胞聚集指数均低于对照组(P<0.05)。2组治疗后CA125、子宫内膜异位囊肿直径均较本组治疗前降低(P<0.05),且治疗组治疗后降低更明显(P<0.05)。治疗组远期总有效率83.33%(25/30),对照组63.33%(19/30),治疗组远期疗效优于对照组(P<0.05)。结论清热化瘀方治疗瘀热互结型EMT疼痛疗效满意,其机制可能与改善机体凝血相关指标有关。

Effect of Qingre Huayu recipe on pain and coagulation function in patients with endometriosis of stasis-heat type

Objective To observe the effect of Qingre Huayu recipe on pain and coagulation function in patients with endometriosis(EMT)of stasis-heat type.Methods 60 cases of EMT with stasis-heat type were divided into two groups according to random number table method.30 cases in treatment group were treated by Qingre Huayu decoction.30 cases in control group were treated by Xuefu Zhuyu decoction.Both groups were treated for 3 months,and were follow up for 3 months after treatment.The visual analogue score(VAS)of dysmenorrhea before and after treatment was compared between the two groups.After treatment,the relief of chronic pelvic pain in dysmenorrhea and non menstrual were compared between the two groups.The platelet count(PLT),D-Dimer(D-D)and vascular endothelial growth factor(VEGF)were compared before and after treatment in the two groups.The hemorheology indexes such as plasma viscosity,whole blood viscosity(high cut),whole blood viscosity(low cut)and erythrocyte aggregation index were compared before and after treatment in the two groups.The carcinoembryonic antigen 125(CA125)and cyst diameter were compared before and after treatment in the two groups.The long-term effect of the two groups was compared.Results After treatment,the relief chronic pelvic in dysmenorrhea and nonmenstrual painl in the treatment group was better than that before treatment(P<0.05).After theatment,the relief of chronic pain in non menstrual in control group was better than that before treatment(P<0.05).After treatment,the VAS score of dysmenorrhea in the two groups was lower than that before treatment(P<0.05),and the VAS score of dysmenorrhea in the treatment group was significantly lower(P<0.05).After treatment,PLT,D-D and VEGF in the two groups were lower than those in the group before treatment(P<0.05),and the decrease in the treatment group was more significant(P<0.05).After treatment,the plasma viscosity,whole blood viscosity(high cut),whole blood viscosity(low cut)and red blood cell aggregation index in the treatment group were lower than those before treatment(P<0.05).After treatment,the plasma viscosity,whole blood viscosity(high cut)and whole blood viscosity(low cut)in the control group were lower than those before treatment(P<0.05).The plasma viscosity,whole blood viscosity(high cut),whole blood viscosity(low cut)and red blood cell aggregation aggregation index in the treatment group were lower than those in the control group(P<0.05).The serum CA125 and cyst diameter in the two groups were lower than those in the group before treatment(P<0.05),and the decrease in the treatment group was more significant(P<0.05).The total long-term effective rate of the treatment group was 83.33%(25/30),while that of the control group was 63.33%(19/30).The long-term effect of the treatment group was better than that of the control group(P<0.05).Conclusion Qingre Huayu decoction has a satisfactory therapeutic effect on EMT pain of stasis-heat type,and its mechanism may be related to the improvement of coagulation related indexes.