地屈孕酮联合桂枝茯苓丸加味治疗子宫内膜息肉的疗效观察  

Efficacy of DydrogesteroneCombined with Supplemented GuizhiFuling Pills onEndometrial Polyps

作　　者：吉丽 万朝霞[1] 陈甦 唐艳 任青玲[2] JI Li;WAN Zhao-xia;CHEN Su;TANG Yan;REN Qing-ling(Nantong Hospital of Traditional Chinese Medicine,Nantong Jiangsu 226001;Jiangsu Province Hospital of Chinese Medicine,Nanjing Jiangsu 210029)

机构地区：[1]南京中医药大学南通附属医院,江苏南通226001 [2]江苏省中医院,江苏南京210029

出　　处：《世界中西医结合杂志》2022年第6期1159-1163,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：2019年度江苏省中医药科技发展计划项目——重点项目(ZD201905)。

摘　　要：目的探讨地屈孕酮与桂枝茯苓丸加味联合治疗子宫内膜息肉(Endometrial Polyps,EP)的临床疗效。方法选取2019年4月—2020年4月期间南京中医药大学南通附属医院收治的92例行宫腔镜下子宫内膜息肉电切术(Transcercal Resection of Polyp,TCRP)治疗的EP患者,采用前瞻性研究方法,随机分为观察组和对照组,每组各46例。对照组给予地屈孕酮治疗,观察组给予桂枝茯苓丸加味联合地屈孕酮治疗。治疗3个月经周期后,观察比较两组患者临床疗效,记录患者治疗前后中医证候积分、子宫内膜厚度、月经失血图(Pictorial Blood Assessment Chart,PBAC)评分、血清血红蛋白(Hemoglobin,Hb)、生殖激素[卵泡刺激素(Follicle Stimulating Hormone,FSH)、孕酮(Progesterone,P)、雌二醇(Estradiol,E_(2))]水平,记录治疗前后腺皮脂和间质的子宫内膜组织的雌激素受体(Estrogen Receptor,ER)和孕激素受体(Progesterone Receptor,PR)水平,并统计不良反应和复发情况。结果治疗后,观察组痊愈率65.22%(30/46)明显高于对照组45.65%(21/46),差异有统计学意义(P<0.05)。两组患者治疗后中医证候积分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组经期延长、月经量多、月经黏稠、经期疼痛、月经血块、面色晦暗、倦怠乏力积分均较对照组明显降低,差异有统计学意义(P<0.05)。两组患者治疗后子宫内膜厚度、PBAC评分均较治疗前明显降低,Hb水平均较治疗前明显升高,差异有统计学意义(P<0.05);且观察组子宫内膜厚度、PBAC评分较对照组明显降低,Hb水平较对照组明显升高,差异有统计学意义(P<0.05)。两组患者治疗后生殖激素FSH、P、E_(2)水平均较治疗前明显降低,差异有统计学意义(P<0.05)。两组患者治疗后腺皮脂ER,间质ER水平均较治疗前明显降低,腺皮脂PR,间质PR水平均较治疗前明显升高,差异有统计学意义(P<0.05);且观察组腺皮脂PR,间质PR水平较对照组明显�Objective To explore the clinical efficacy ofdydrogesteronecombined withSupplemented GuizhiFulingPills on endometrial polyps(EP).Methods A total of 92 patients with EP of blood stasis type who underwent transcervical resection of polyps(TCRP)in Nantong Hospital of Traditional Chinese Medicine from April 2019 to April 2020 were randomized into control group(dydrogesterone,3 menstrual cycles)and observation group(GuizhiFuling Pills+dydrogesterone,3 menstrual cycles),with 46 in either group.The clinical efficacy of the two groups was compared and the traditional Chinese medicine(TCM),endometrial thickness,pictorial bloodassessmentchart(PBAC)score,serum hemoglobin(Hb),levels of reproductive hormones[follicle stimulating hormone(FSH),progesterone(P),estradiol(E_(2))],and levels of estrogen receptor(ER)and progesterone receptor(PR)of glandular sebum and interstitial endometrial tissue before and after treatment were recorded.The incidence of adverse reactions and recurrence were observed.Results The cure rate in the observation group(65.22%,30/46)was higher than that in the control group(45.65%,21/46)(P<0.05).The TCMsyndrome score was lower than that before treatment in both groups(P<0.05),and the scores of menostaxis,menorrhagia,viscousmenstruation,dysmenorrheal,menstrual blood clots,dull complexion,and fatigue in the observation werelower than those in the control group(P<0.05).The endometrial thickness and PBAC score were lower and the Hb level was higher in both groups after treatment than before treatment(P<0.05)and in the observation group than in the control group(P<0.05).The levels ofFSH,P,and E_(2) werelower in both groups after treatment than before treatment(P<0.05).The level ofER in the glandular sebum and interstitium was reduced(P<0.05),and that of PR in glandular sebum and interstitium was raised after treatment in both groups(P<0.05).The PR in glandular sebum and interstitium was higher in the observation group than in the control group(P<0.05).No adverse reaction occurred in either group during the tre

关 键 词：子宫内膜息肉 雌激素受体 桂枝茯苓丸加味 地屈孕酮 血瘀型 孕激素受体 

分 类 号：R711.7[医药卫生—妇产科学]