通瘀注射液盆腔给药法治疗外在型子宫内膜异位症的临床研究

目的　运用通瘀注射液在非直视下经输卵管盆腔给药对子宫内膜异位症 (EEMs)的治疗作用 ,探讨活血化瘀法对EEMs的作用机理及此给药法的优势。方法　将临床治疗的EEMs患者 60例随机分为治疗组 (通瘀注射液组 )和对照组 (丹那唑组 ) ,疗程各为 3个月。用药前后测定下列指标 :临床症状与体征、内分泌激素、血液流变学、癌抗原 12 5 (CA12 5)和子宫内膜抗体 (EMAb)的阳性率变化。结果　治疗组的临床症状与体征、血液粘滞度和红细胞压积、CA12 5和EMAb的阳性率均降低 ,卵泡刺激素 (FSH)、黄体生成素 (LH)、雌二醇 (E2 )和孕激素 (P)的含量均受到调节 ,与对照组相比 ,差异有显著性。而治疗组对内分泌的调节能力弱于对照组 ,但作用柔和、均衡。结论　通瘀注射液对EEMs的作用是通过清除月经时异位内膜的瘀血、水肿、改善微循环及组织供氧、调节免疫功能和内分泌紊乱而实现的 ,与丹那唑相比其副作用小、并以治本为主。盆腔给药法则可使药物直达病灶 ,见效快

Clinical Trial of Pelvic Cavity Administration of Tongyu Injection in the Treatment of External Endometriosis

Objective Based on the efficacy of pelvic cavity administration (PCA) of Tongyu Injection (TI) given by fallopian tube under indirect vision for the treatment of external endometriosis (EEMs), to investigate the mechanism of the TCM therapy of activating circulation and removing stasis for the treatment of EEMs, and to study the advantage of PCA. Methods 60 EEMs cases were randomly divided into TIgroup and danazolgroup, and the course of treatment for both groups was 3 months. The positive rates of the changes in clinical symptoms and signs, endocrine hormones, blood rheology, CA 125 and endometrial antibody (EMAB) were detected before and after the administration. Results The positive rates of the changes in the clinical symptoms and signs, blood viscosity and packed cell volume, CA 125 and EMAB were decreased, and the levels of follicule-stimulating hormone, luteotropic hormone, estradiol and progestogen were regulated in the TIgroup; the results were statistically significant as compared with those from the danazol-group. The endocrineregulative effects of TI were found to be weaker than those of danazol, but they were of a mild and balanced nature. Conlusion TI exerts its effects on EEMs by clearing out the menstruous blood stasis and edema in ectopic endometria, improving microcirculation and tissue oxygen supply, and regulating immune dysfunction and endocrine disorder. TI shows weaker side effects than does danazol, and acts mainly on the cause of the disease. TI given by PCA can make the drug directly act on the focus and exert fast effects.