化瘀散结法对宫腔镜子宫内膜息肉切除术后复发的预防作用  

Study on prevention of recurrence after transcervical resection of polyp by Huayu Sanjie therapy

作　　者：张宜群 赵珊琼 ZHANG Yi-qun;ZHAO Shan-qiong(Department of Gynaecology,Ningbo Hospital of Traditional Chinese Medicine,Ningbo,Zhejiang 315000,China)

机构地区：[1]宁波市中医院妇科,浙江宁波315000

出　　处：《中华全科医学》2020年第3期442-445,共4页Chinese Journal of General Practice

基　　金：浙江省中医药科技计划项目(2015ZB101)。

摘　　要：目的探讨化瘀散结法对宫腔镜子宫内膜息肉切除术(TCRP)后患者子宫内膜孕激素受体(PR)、增殖细胞核相关抗原Ki-67(Ki-67)、B细胞淋巴瘤/白血病-2基因(Bcl-2)表达的影响。方法将宁波市中医院2016年5月-2018年5月间收治的216例行宫腔镜子宫内膜息肉切除术的患者根据随机数字法分为A、B、C 3组,每组72例。A组给予化瘀散结方中药口服加外敷,B组给予妈富隆,C组不给予药物。比较3组治疗前后中医症候积分、雌二醇(E2)、孕酮(P)、雌激素受体(ER)、PR及Ki-67、Bcl-2表达的变化。结果治疗后,3组中医症候积分降低,治疗前后为A组(10.33±2.07)、(5.17±1.02)分(t=18.973,P=0.001)、B组(10.38±2.12)、(6.85±1.13)分(t=12.468,P=0.001)与C组(10.29±2.16)、(7.03±1.25)分(t=11.084,P=0.001),且A组低于B组与C组。A组、B组PR表达水平升高(均P<0.05),A组、B组Ki-67、Bcl-2表达水平降低(均P<0.05),且A组改善优于B组与C组(均P<0.05)。结论化瘀散结法可降低子宫内膜息肉宫腔镜切除术后患者的临床症状,有效预防子宫内膜息肉术后复发,其作用机制可能与化瘀散结法可提高子宫内膜PR表达,抑制子宫内膜Ki-67与Bcl-2过度表达有关。Objective To investigate the effect of Huayu Sanjie therapy on the expression of progesterone receptor(PR), proliferating cell nuclear associated antigen Ki-67(Ki-67), B-cell lymphoma/leukemia-2 gene(Bcl-2) in endometrium of patients after transcervical resection of polyp(TCRP). Methods A total of 216 patients admitted by Ningbo Hospital of Traditional Chinese medicine from May 2016 to May 2018 were divided into A, B and C groups according to the random number method, with 72 case each group. Group A was given Huayu Sanjie prescription oral plus external application, group B was given marvelon, group C was not given any drugs. The changes of TCM syndrome score, serum estradiol(E2), progesterone(P), estrogen receptor(ER), progesterone receptor(PR), ki-67 and Bcl-2 before and after treatment were compared in the three groups. Results After treatment, the scores of TCM syndromes in the three groups were reduced, and group A was lower than group B and C. In group A and B, the expression of PR were increased(all P<0.05), the expression of Ki-67 and Bcl-2 were decreased(all P<0.05). The improvement of group A was better than that of group B and C(all P<0.05). Conclusion Huayu Sanjie therapy can reduce the clinical symptoms of patients with endometrial polyps after hysteroscopic resection and effectively prevent recurrence of endometrial polyps. Its mechanism may be related to that this method can improve the expression of endometrial PR and inhibit the over-expression of endometrial Ki-67 and Bcl-2 in endometrium.

关 键 词：子宫内膜息肉 宫腔镜术 化瘀散结法 作用机制 

分 类 号：R711.32[医药卫生—妇产科学] R616.5[医药卫生—临床医学]