栝蒌瞿麦方加味联合地诺孕素片治疗痰湿瘀结型子宫腺肌症临床研究  

Clinical Study on Modified Gualou Qumai Prescription Combined with Dienogest Tablets for Adenomyosis of Phlegm Damp Stasis Type

作　　者：闫梅[1] 张珊珊 郭伟光 寇建芳 YAN Mei;ZHANG Shanshan;GUO Weiguang;KOU Jianfang(Zhengzhou Second People's Hospital,Zhengzhou Henan 450062,China;Henan Medical College,Zhengzhou Henan 451191,China;Henan Provincial People's Hospital,Zhengzhou Henan 450003,China)

机构地区：[1]郑州市第二人民医院,河南郑州450062 [2]河南医学高等专科学校,河南郑州451191 [3]河南省人民医院,河南郑州450003

出　　处：《新中医》2025年第2期24-29,共6页New Chinese Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191011)。

摘　　要：目的:观察栝蒌瞿麦方加味联合地诺孕素片治疗痰湿瘀结型子宫腺肌症(AM)的临床疗效。方法:选取2021年8月—2024年2月在郑州市第二人民医院就诊的86例痰湿瘀结型AM患者,按随机数字表法分为对照组、研究组各43例。对照组给予地诺孕素片治疗,研究组给予栝蒌瞿麦方加味联合地诺孕素片治疗,2组均治疗6个月经周期。比较2组临床疗效、视觉模拟评分法(VAS)评分、月经失血图(PBAC)评分、子宫体积、子宫内膜厚度、性激素[雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)]、血管生成因子[前列腺素F2α(PGF2α)、血管生成素-2(Ang-2)、血管内皮生长因子(VEGF)]、氧化应激指标[丙二醛(MDA)、沉默信号调节蛋白6(Sirt6)、超氧化物歧化酶(SOD)]及不良反应发生率。结果:治疗后,总有效率研究组83.72%(36/43),高于对照组65.12%(28/43),差异有统计学意义(P<0.05)。2组VAS、PBAC评分均较治疗前降低,子宫体积均较治疗前缩小,子宫内膜厚度均较治疗前变薄,差异均有统计学意义(P<0.05);研究组VAS、PBAC评分均低于对照组,子宫体积小于对照组,子宫内膜厚度薄于对照组,差异均有统计学意义(P<0.05)。2组LH、FSH、PGF2α、VEGF、Ang-2、MDA水平均较治疗前降低,E2、Sirt6、SOD水平均较治疗前升高,差异均有统计学意义(P<0.05);研究组LH、FSH、PGF2α、VEGF、Ang-2、MDA水平均低于对照组,E2、Sirt6、SOD水平均高于对照组,差异均有统计学意义(P<0.05)。不良反应发生率研究组4.65%(2/43),对照组9.30%(4/43),2组比较,差异无统计学意义(P>0.05)。结论:与仅使用地诺孕素片治疗比较,栝蒌瞿麦方加味联合地诺孕素片治疗痰湿瘀结型AM可提高临床疗效,有效调节性激素水平、减轻机体氧化应激反应,促使子宫内膜厚度变薄,抑制血管新生,改善痛经等临床症状,安全性高。Objective:To observe the clinical effects of modified Gualou Qumai Prescription combined with Dienogest Tablets in the treatment of adenomyosis(AM)of phlegm damp stasis type.Methods:A total of 86 cases of patients who had AM of phlegm damp stasis type and received treatment at the Zhengzhou Second People's Hospital from August 2021 to February 2024 were selected and divided into the control group and the study group,using a random number table method,with 43 patients in each group.The control group was treated with Dienogest Tablets,and the study group was treated with modified Gualou Qumai Prescription combined with Dienogest Tablets.Both groups were treated for six menstrual cycles.The clinical effects,Visual Analogue Scale(VAS)scores,Pictorial Blood Loss Assessment Chart(PBAC)scores,uterine volume,endometrial thickness,sex hormones[estradiol(E2),follicle-stimulating hormone(FSH),and luteinizing hormone(LH)],angiogenic factors[prostaglandin F2α(PGF2α),angiopoietin-2(Ang-2),and vascular endothelial growth factor(VEGF)],oxidative stress indicators[malondialdehyde(MDA),silencing signal regulatory protein 6(Sirt6),and superoxide dismutase(SOD)],and incidence of adverse reactions were compared between the two groups.Results:After treatment,the total effective rate in the study group was 83.72%(36/43),which was higher than that of 65.12%(28/43)in the control group,with the difference being significant(P<0.05).The VAS and PBAC scores in the two groups were decreased,uterine volume decreased,and endometrial thickness were declined when compared with those before treatment,with significance in differences(P<0.05);when compared with those in the control group,the VAS and PBAC scores in the observation group were lower,the uterine volume was smaller,and the endometrial thickness was thinner,with differences being significant(P<0.05).The levels of LH,FSH,PGF2α,Ang-2,VEGF,and MDA in the two groups were decreased when compared with those before treatment,while the levels of E2,Sirt6,and SOD were increased when compared wi

关 键 词：子宫腺肌症 痰湿瘀结型 栝蒌瞿麦方 地诺孕素片 性激素 血管生成因子 氧化应激 

分 类 号：R271.1[医药卫生—中医妇科学]