活血通络解毒汤对血瘀蕴毒型子宫内膜异位症患者卵巢功能及血清VEGF、TNF-α、CA125水平的影响  

Effect of Huoxue Tongluo Jiedu decoction on ovarian function and levels of serum VEGF,TNF-α,CA125 in patients with endometriosis of type of blood stasis and toxicity accumulation

作　　者：夏莹 周晓莉 刘杰 李静[2] 吴绪峰[3] 汪黎明[3] XIA Ying;ZHOU Xiaoli;LIU Jie;LI Jing;WU Xufeng;WANG Liming(General Hospital of the Central Theater of PLA, Wuhan 430070, Hubei,China;Wuhan Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei, China;Maternal and Child Health Hospital of Hubei Province, Wuhan 430070, Hubei, China)

机构地区：[1]中国人民解放军中部战区总医院,湖北武汉430070 [2]华中科技大学同济医学院附属协和医院,湖北武汉430022 [3]湖北省妇幼保健院,湖北武汉430070

出　　处：《现代中西医结合杂志》2020年第23期2556-2561,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察活血通络解毒汤对血瘀蕴毒型子宫内膜异位症患者卵巢功能及血清血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)、糖类抗原(CA125)水平的影响。方法将中国人民解放军中部战区总医院2016年5月—2018年5月诊治的92例血瘀蕴毒型子宫内膜异位症患者随机分为2组,对照组46例给予孕三烯酮胶囊口服治疗,观察组46例在对照组基础上另给予活血通络解毒汤治疗,2组均连续治疗3个月经周期,比较2组治疗前后中医症状积分(经行腹痛、非经期下腹痛、性交痛、非经期肛门坠痛)、异位囊肿包块直径、疼痛评分[视觉模拟评分(VAS)]、卵巢功能指标[促卵泡生成激素(FSH)、卵巢体积、窦卵泡数量]、血清生化指标(VEGF、TNF-α、CA125)的改善情况,并统计2组治疗后临床总有效率及治疗期间不良反应发生情况。结果2组治疗后经行腹痛、非经期下腹痛、性交痛、非经期肛门坠痛积分均明显低于治疗前(P均<0.05),且观察组以上积分均明显低于对照组(P均<0.05);2组治疗后异位囊肿包块直径和VAS评分均明显低于治疗前(P均<0.05),且观察组异位囊肿包块直径和VAS评分均明显低于对照组(P均<0.05);2组治疗后FSH均明显低于治疗前(P均<0.05),卵巢体积和窦卵泡数量均明显高于治疗前(P均<0.05),且观察组治疗后以上卵巢功能指标改善状况均明显优于对照组(P均<0.05);2组治疗后血清VEGF、TNF-α、CA125水平均明显低于治疗前(P均<0.05),且观察组治疗后均明显低于对照组(P均<0.05);观察组治疗后总有效率为91.3%(42/46),对照组为73.9%(34/46),观察组明显高于对照组(P<0.05);观察组不良反应发生率为13.0%(6/46),对照组不良反应发生率为19.6%(9/46),2组不良反应发生率比较差异无统计学意义(P>0.05)。结论活血通络解毒汤联合常规西药治疗能够显著缓解血瘀蕴毒型子宫内膜异位症患者临床症状,下调VEGF、TNF-α、CA125表达水�Objective It is to observe the effects of Huoxue Tongluo Jiedu decoction on ovarian function and levels of serum vascular endothelial growth factor(VEGF),tumor necrosis factorα(TNF-α)and carbohydrate antigen(CA125)in patients with endometriosis with syndrome of blood stasis and toxicity accumulation.Methods Ninety-two patients with endometriosis with syndrome of blood stasis and toxicity accumulation diagnosed and treated in the General Hospital of the Central Theater of PLA from May 2016 to May 2018 were randomly divided into 2 groups,46 patients in the control group were treated with gestrinone capsules by oral administration,46 cases in the observation group were treated with Huoxue Tongluo Jiedu decoction based on the control group,both groups were treated for 3 consecutive menstrual cycles.The improvements of scores of TCM symptoms(abdominal pain during menstruation,lower abdominal pain during non-menstrual period,pain during intercourse,anal pain during non-menstrual period),ectopic cyst mass diameter,pain score[visual analogue score(VAS)],ovarian function indicators[follicle stimulating hormone(FSH),ovarian volume,number of antral follicles],serum biochemical indicators(VEGF,TNF-α,CA125)before and after treatment were compared,and the total clinical effective rate after treatment and the occurrence of adverse reactions during treatment were counted in the 2 groups.Results After treatment,the scores of menstrual abdominal pain,non-menstrual lower abdominal pain,dyspareunia,and non-menstrual anal fall pain in the two groups were significantly lower than those before treatment(P<0.05),and the scores of the observation group were significantly lower than those of the control group(P<0.05);the diameter and VAS score of the ectopic cyst after treatment were significantly lower than those before treatment in the two groups(P<0.05),and the diameter and VAS score of the ectopic cyst in the observation group were significantly lower than those in the control group(P<0.05);the level of FSH was significantly lower

关 键 词：子宫内膜异位症 血瘀蕴毒型 活血通络解毒汤 卵巢功能 血管内皮生长因子 肿瘤坏死因子Α 糖类抗原 

分 类 号：R711.71[医药卫生—妇产科学]