加味桂枝茯苓汤联合GnRHa治疗子宫内膜异位症的疗效及对患者性激素及体液免疫功能的影响  

Clinical efficacy of modified Guizhi Fuling Decoction combined with GnRHA in the treatment of endometriosis and its effect on sex hormone and humoral immune function in patients

作　　者：胡婷婷 程静 董利平 HU Ting-ting;CHENG Jing;DONG Li-ping(Department of Gynecology,Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710016,Shaanxi,CHINA;Department of Gynecology,Integrated Traditional Chinese and Western Medicine,Xidian Group Hospital,Xi'an 710077,Shaanxi,CHINA;Department of Obstetrics and Gynecology,Xi'an Dongfang Hospital,Xi'an 710043,Shaanxi,CHINA)

机构地区：[1]西安市中医医院妇科,陕西西安710016 [2]西电集团医院中西医结合妇科,陕西西安710077 [3]西安市东方医院妇产科,陕西西安710043

出　　处：《海南医学》2022年第8期1016-1019,共4页Hainan Medical Journal

基　　金：陕西省科学技术研究发展计划项目(编号:S2018YFSF01164)。

摘　　要：目的观察加味桂枝茯苓汤联合促性腺激素释放激素激动剂(GnRHa)治疗子宫内膜异位症(EMS)的疗效,并探讨其对患者性激素及体液免疫功能的影响。方法回顾性分析2019年1月至2021年1月在西安市中医医院妇科经腹腔镜手术治疗的80例EMS患者的临床资料,根据治疗方式不同分为对照组38例(GnRHa治疗)和观察组42例(加味桂枝茯苓汤联合GnRHa治疗),两组均连续治疗3个月。比较两组患者治疗3个月后的临床疗效,以及治疗前及治疗3个月后的性激素(血清卵泡刺激素FSH)、黄体生成素(LH)、血清雌二醇(E2)、孕酮(P)、体液免疫功能(IgG、IgM、补体C3、C4)、骨密度、Kupperman评分和不良反应发生情况。结果观察组患者治疗后的总有效率为90.48%,明显高于对照组的71.05%,差异有统计学意义(P<0.05);两组患者治疗后的FSH、LH、E2、P水平均呈下降趋势,且观察组患者治疗后的上述各项指标明显低于对照组,差异均有统计学意义(P<0.05);两组患者治疗前的体液免疫功能指标比较差异均无统计学意义(P>0.05),而治疗后,两组患者的补体C3、C4均呈下降趋势,且观察组患者的C3和C4分别为0.72±0.42、0.32±0.01,明显低于对照组的0.80±0.32、0.38±0.04,差异均有统计学意义(P<0.05),但治疗前后两组患者的IgG、IgM比较差异均无统计学意义(P>0.05);治疗后两组患者的腰椎骨密度、Kupperman评分均呈下降趋势,而观察组患者的腰椎骨密度为(1.22±0.08)g/cm^(2),明显高于对照组的(1.17±0.05)g/cm^(2),Kupperman评分为(8.26±1.21)分,明显低于对照组的(10.26±1.62)分,差异均有统计学意义(P<0.05);治疗期间观察组和对照组患者的不良反应总发生率分别为19.05%、13.16%,差异无统计学意义(P>0.05)。结论加味桂枝茯苓汤联合GnRHa治疗EMS可调节患者的性激素水平,改善免疫功能,提高临床疗效且安全性高。Objective To observe the effect of modified Guizhi Fuling Decoction combined with gonadotropin releasing hormone agonist(GnRHA)in the treatment of endometriosis(EMS),and to explore its effects on sex hormones and humoral immune function in patients.Methods The clinical data of 80 patients with EMS treated by laparoscopic surgery in Department of Gynecology,Xi'an Hospital of Traditional Chinese Medicine from January 2019 to January 2021 were retrospectively analyzed.According to different treatment methods,they were divided into a control group(treated with GnRHa,38 cases)and an observation group(treated with modified Guizhi Fuling Decoction combined with GnRHa,42 cases).Both groups were treated for 3 months.The clinical efficacy of the two groups after 3 months of treatment,sex hormone[serum follicle stimulating hormone(FSH),luteinizing hormone(LH),serum estradiol(E2),progesterone(P)],humoral immune function(IgG,IgM,complement C3,C4),bone mineral density,Kupperman score,and incidence of adverse reactions before and 3 months after treatment were compared.Results The total effective rate of observation group was 90.48%,which was significantly higher than 71.05%of control group(P<0.05).After treatment,the levels of FSH,LH,E2,and P in the two groups all showed a downward trend,and the above indexes in observation group were significantly lower than those in control group after treatment(P<0.05).There was no significant difference in humoral immune function indexes between the two groups before treatment(P>0.05).But after treatment,complement C3 and C4 in the two groups showed a downward trend,and C3 and C4 in the observation group were 0.72±0.42,0.32±0.01,significantly lower than 0.80±0.32 and 0.38±0.04 in the control group(P<0.05).There was no statistically significant difference in IgG and IgM between the two groups before and after treatment(P>0.05).After treatment,the lumbar bone density and Kupperman score of the two groups decreased;the lumbar bone density of the observation group was(1.22±0.08)g/cm^(2),wh

关 键 词：子宫内膜异位症 加味桂枝茯苓汤 GnRHa 性激素 体液免疫功能 疗效 

分 类 号：R711.71[医药卫生—妇产科学]