散结镇痛胶囊联合左炔诺孕酮宫内节育系统对痰瘀互结证子宫腺肌病患者雌孕激素及血管相关生长因子的影响  

The impact of estrogen progesterone and vascular associated growth factors of Sanjie analgesic capsules combined with levonorgestrel intrauterine birth control system treated for adenomyosis with phlegm-stasis interjunction patients

作　　者：姜丽[1] 于丹军[2] 张冰[3] 林秀丽 张德应 Jiang Li;Yu Danjun;Zhang Bing;Lin Xiuli;Zhang Deying(Department of Gynecology,the First Hospital of Qinhuangdao,Qinhuangdao 066000,China;Department of Inspection,the First Hospital of Qinhuangdao,Qinhuangdao 066000,China;Department of Ultrasonic Diagnosis,the First Hospital of Qinhuangdao,Qinhuangdao 066000,China;Department of Traditional Chinese Medicine,the First Hospital of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院妇科,秦皇岛066000 [2]秦皇岛市第一医院检验二科,秦皇岛066000 [3]秦皇岛市第一医院超声诊断一科,秦皇岛066000 [4]秦皇岛市第一医院中医科,秦皇岛066000

出　　处：《中国医师进修杂志》2024年第6期503-507,共5页Chinese Journal of Postgraduates of Medicine

基　　金：秦皇岛市科学技术局2020年市级科学技术研究与发展计划项目(202004A086)。

摘　　要：目的探讨散结镇痛胶囊联合左炔诺孕酮宫内节育系统治疗痰瘀互结证子宫腺肌病的疗效及作用机制。方法回顾性选择2020年8月至2021年6月在秦皇岛市第一医院治疗的86例痰瘀互结证子宫腺肌病患者,按接受治疗方法的不同分为观察组(44例)和对照组(42例)。对照组给予左炔诺孕酮宫内节育系统进行治疗,观察组在对照组基础上联合散结镇痛胶囊进行治疗。治疗6个月后,比较两组患者的中医症候积分、促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E 2)、孕酮(P)、血管内皮生长因子(VEGF)、血管生成素-2(Ang-2)、胰岛素样生长因子-1(IGF-1)、转化生长因子-β1(TGF-β1)水平及临床疗效和不良反应发生情况。结果观察组治疗后中医症候总分低于对照组[(7.57±1.23)分比(9.32±1.45)分],差异有统计学意义(P<0.05)。观察组治疗后血清FSH、LH、E 2、P水平低于对照组[(5.54±1.21)U/L比(7.62±1.36)U/L、(4.43±1.05)U/L比(6.14±1.15)U/L、(83.54±12.36)μg/L比(92.45±11.56)μg/L、(9.64±1.43)pmol/L比(11.36±1.52)pmol/L],差异有统计学意义(P<0.05)。观察组治疗后血清VEGF、Ang-2、IGF-1、TGF-β1水平低于对照组[(114.32±15.41)ng/L比(162.45±16.32)ng/L、(156.14±20.45)ng/L比(186.53±22.36)ng/L、(135.21±15.52)ng/L比(151.23±16.21)ng/L、(13.43±2.24)ng/L比(16.36±2.51)ng/L],差异有统计学意义(P<0.05)。观察组总有效率高于对照组[84.09%(37/44)比64.29%(27/42)],差异有统计学意义(χ^(2)=4.73,P<0.05)。观察组不良反应发生率低于对照组[13.64%(6/44)比33.33%(14/42)],差异有统计学意义(χ^(2)=4.67,P<0.05)。结论对于痰瘀互结证子宫腺肌病,采用散结镇痛胶囊联合左炔诺孕酮宫内节育系统进行治疗,可改善患者的临床症状,提高治疗效果,降低不良反应的发生,可能与抑制雌孕激素、血管相关生长因子等因素有关。Objective To investigate the clinical efficacy and possible mechanism of Sanjie analgesic capsule combined with levonorgestrel intrauterine birth control system in the treatment of adenomyosis with phlegm-stasis interjunction.Methods Eighty-six cases of adenomyosis with phlegm-stasis interjunction were randomly divided into the observation group(44 cases)and the control group(42 cases).The control group was given levonorgestrel intrauterine birth control system treatment,and the observation group was given Sanjie analgesic capsule combined with levonorgestrel intrauterine birth control system treatment.After 6 months of treatment,the traditional Chinese medicine(TCM)syndrome scores,follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E 2),progesterone(P),vascular endothelial growth factor(VEGF),angiopoietin-2(Ang-2),insulin like growth factor(IGF-1),transforming growth factor-β1(TGF-β1),clinical efficacy,adverse reactions were compared between the two groups.Results After treatment,the TCM syndrome scores in the observation group was lower than that in the control group:(7.57±1.23)scores vs.(9.32±1.45)scores,there was statistical difference(P<0.05).After treatment,the levels of FSH,LH,E 2,P in the observation group were lower than those in the control group:(5.54±1.21)U/L vs.(7.62±1.36)U/L,(4.43±1.05)U/L vs.(6.14±1.15)U/L,(83.54±12.36)μg/L vs.(92.45±11.56)μg/L,(9.64±1.43)pmol/L vs.(11.36±1.52)pmol/L,there were statistical differences(P<0.05).After treatment,the levels of VEGF,Ang-2,IGF-1,TGF-β1 in the observation group were lower than those in the control group:(114.32±15.41)ng/L vs.(162.45±16.32)ng/L,(156.14±20.45)ng/L vs.(186.53±22.36)ng/L,(135.21±15.52)ng/L vs.(151.23±16.21)ng/L,(13.43±2.24)ng/L vs.(16.36±2.51)ng/L,there were statistical differences(P<0.05).After treatment,the clinical efficacy in the observation group was higher than that in the control group and the adverse reactions was lower than that in the control group:84.09%(37/44)vs.64.29%(27/42),13.64%(6/44)vs.33

关 键 词：子宫腺肌病 雌激素类 孕激素类 血管内皮生长因子类 痰瘀互结 散结镇痛胶囊 左炔诺孕酮宫内节育系统 

分 类 号：R711.71[医药卫生—妇产科学]