腹腔镜联合莪棱内异汤保留灌肠治疗子宫内膜异位症不孕临床观察  

Clinical Observation of Combination Treatment of Laparoscopy and Retention Enema with E'leng Neiyi Tang for Infertility Due to EMs

作　　者：秦文敏 

机构地区：[1]徐州市中医院,江苏徐州221000

出　　处：《新中医》2017年第10期97-100,共4页New Chinese Medicine

基　　金：江苏省中医药局科研项目(LZ13130)

摘　　要：目的:观察腹腔镜联合莪棱内异汤保留灌肠治疗子宫内膜异位症(EMs)不孕的临床疗效及对患者血清基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)的影响。方法:将85例EMs患者随机分为A、B、C3组,A组30例采用腹腔镜手术联合莪棱内异汤保留灌肠治疗,B组28例采用腹腔镜手术配合米非司酮片口服治疗,C组27例单纯行腹腔镜手术治疗。观察3组治疗前后中医证候积分及血清MMP-9、TIMP-1水平的变化,比较3组术后3、6、12月后的妊娠率。结果:治疗后,A、B2组的中医证候积分均较治疗前下降(P<0.05),A、B2组治疗前后中医证候积分的差值均大于C组(P<0.05)。术后3月,A、C2组的妊娠率均高于B组(P<0.05)。术后6月和术后12月,A、B2组的妊娠率均高于C组(P<0.05)。治疗后,3组MMP-9水平及MMP-9/TIMP-1值均较治疗前下降(P<0.05),A、B2组TIMP-1水平均较治疗前升高(P<0.05)。A、B组2组MMP-9水平及MMP-9/TIMP-1值均较C组下降更明显(P<0.05),TIMP-1水平均较C组上升更明显(P<0.05)。结论:腹腔镜联合莪棱内异汤保留灌肠可有效改善EMs不孕患者的临床症状,使MMP-9和TIMP-1趋于平衡,提高临床妊娠率。Objective： To observe the clinical effect of combination treatment of laparoscopy and retention enema with E＇leng Neiyitang for infertility due to endometriosis（EMs）,and its effect on matrix metalloproteinase 9（MMP-9） and tissue inhibitor of metalloproteinase-1（TIMP-1）. Methods：Divided 85 EMs patients into the group A,group Band group C. The 30 cases in the group Awere treated with combination treatment of laparoscopy and retention enema with E＇leng Neiyitang,while the group Bwas treated with laparoscopy combined with oral Mifepristone tablets and the group Cwas treated with laparoscopy only. Observed change of Chinese syndrome score of the three groups before and after treatment,and level of serumMMP-9 and TIMP-1,and compared pregnancy rate of the three groups after three months,six months and twelve months of operation. Results：After treatment,Chinese syndrome scores of the group Aand group Bwere lower than those before treatment（P 0.05）, and the difference of Chinese syndrome score in the group Aand group Bbefore and after treatment was both significant than that in the group C（P0.05）. After three months of treatment,pregnancy rate of the group Aand group Cwas both higher than that of the group B（P0.05）. After six and twelve months of treatment,pregnancy rate of the group Aand group Bwas both higher than that of the group C（P0.05）. After treatment,MMP-9 levels and value of MMP-9/TIMP-1 of the three groups were all lower than those before treatment（P0.05）. TIMP-1 levels of group Aand group Bwere higher than those before treatment（P0.05）. The decline of MMP-9 levels and value of MMP-9/TIMP-1 in the group Aand group Bwas more significant than that in the group C,while increase of TIMP-1 levels was higher than that of the group C（P0.05）. Conclusion：The combination treatment of laparoscopy and retention enema with E＇leng Neiyitang can effectively improve postoperative clinical symptoms of patients with infertility,which helps to balance MMP-9 and TIMP-1,and impr

关 键 词：子宫内膜异位症(EMs) 不孕 腹腔镜 莪棱内异汤 保留灌肠 米非司酮片 基质金属蛋白酶-9(MMP-9) 基质金属蛋白酶抑制剂-1(TIMP-1) 

分 类 号：R711.71[医药卫生—妇产科学]