[1]赵 娜,周灵雪,杨向荣.桂枝茯苓胶囊联合戈舍瑞林对子宫内膜异位症患者子宫动脉血流动力学及Th1/Th2细胞因子的影响[J].陕西中医,2022,(4):446-449.[doi:DOI:10.3969/j.issn.1000-7369.2022.04.008]
　ZHAO Na,ZHOU Lingxue,YANG Xiangrong.Effects of Guizhi Fuling capsule combined with goserelin on uterine artery hemodynamics and Th1/Th2 cytokines in endometriosis patients[J].,2022,(4):446-449.[doi:DOI:10.3969/j.issn.1000-7369.2022.04.008]
点击复制

桂枝茯苓胶囊联合戈舍瑞林对子宫内膜异位症患者子宫动脉血流动力学及Th1/Th2细胞因子的影响
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2022年4期
页码:
446-449
栏目:
临床研究
出版日期:
2022-04-05

文章信息/Info

Title:
Effects of Guizhi Fuling capsule combined with goserelin on uterine artery hemodynamics and Th1/Th2 cytokines in endometriosis patients
作者:
赵 娜; 周灵雪; 杨向荣
(张家口市第一医院妇科,河北 张家口 075000)
Author(s):
ZHAO Na; ZHOU Lingxue; YANG Xiangrong
(Department of Gynecology,Zhangjiakou First Hospital,Zhangjiakou 075000,China)
关键词:
子宫内膜异位症;  桂枝茯苓胶囊;  戈舍瑞林;  子宫动脉血流动力学;  复发率
Keywords:
Endometriosis;  Guizhi Fuling capsule;  Goserelin;  Uterine artery hemodynamics;  Recurrence rate
分类号:
R 711.71
DOI:
DOI:10.3969/j.issn.1000-7369.2022.04.008
文献标志码:
A
摘要:
目的:探讨桂枝茯苓胶囊联合戈舍瑞林对子宫内膜异位症(EMs)患者子宫动脉血流动力学及辅助性T细胞1/辅助性T细胞2(Th1/Th2)细胞因子的影响。方法:选择192例EMSs患者作为研究对象,随机分为观察组和对照组,各96例。对照组皮下注射戈舍瑞林治疗,观察组采用戈舍瑞林与桂枝茯苓胶囊联合治疗,均治疗3个月,并随访6个月。比较两组治疗后的治疗总有效率,治疗前和治疗后的中医证候积分、搏动指数(PI)、收缩期最大流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)、血清白介素-2(IL-2)、白介素-4(IL-4)、干扰素-γ(INF-γ)和血清卵泡刺激素(FSH)、黄体生成素(LH)及雌二醇(E2)水平,统计随访期间的复发率、受孕率以及治疗期间的不良反应发生率。结果:治疗后,观察组的治疗总有效率93.75%明显高于对照组的81.25%(P<0.05); 同时,观察组腰部酸胀、经期腹痛、月经异常和神疲乏力的中医证候积分均比对照组低(P<0.05); 且观察组PI、RI、E2、IL-4水平均低于对照组(P<0.05); 观察组PSV、EDV和血清IL-2和INF-γ水平均高于对照组(P<0.05)。随访期间,观察组患者的复发率低于对照组(P<0.05),受孕率高于对照组(P<0.05); 治疗期间,两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论:将桂枝茯苓胶囊与戈舍瑞林联合应用于EMSs的治疗中,可有效减轻中医证候,降低血清Th1/Th2细胞因子水平,改善雌激素紊乱和子宫动脉血流动力学,减少术后复发并提高受孕率,具有较好的临床疗效。
Abstract:
Objective:To investigate the effects of Guizhi Fuling capsule combined with goserelin on uterine artery hemodynamics and helper T cell 1/helper T cell 2(Th1/Th2)cytokines in patients with endometriosis(EMs).Methods:A total of 192 patients with EMs were randomly divided into observation group and control group,96 cases in each group.The control group was subcutaneously injected with goserelin,while observation group was additionally treated with Guizhi Fuling capsules.All were treated for 3 months and then followed up for 6 months.The total response rate after treatment,scores of TCM syndromes,pulsatility index(PI),peak systolic velocity(PSV),end diastolic velocity(EDV),resistance index(RI),levels of serum interleukin-2(IL-2),interleukin-4(IL-4),interferon-γ(INF-γ),follicle stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)before and after treatment in the two groups were compared.The recurrence and fertilization rates during follow-up,and the incidence of adverse reactions during treatment were statistically analyzed.Results:After treatment,total response rate of treatment was significantly higher in observation group than control group(93.75% vs 81.25%)(P<0.05),scores of TCM syndromes(waist soreness,menstrual abdominal pain,abnormal menstruation,fatigue)were lower in observation group(P<0.05),PI,RI,E2 and IL-4 levels were lower in observation group(P<0.05),PSV,EDV,serum IL-2 and INF-γ levels were higher in observation group(P<0.05).During follow-up,recurrence rate was lower in observation group than control group(P<0.05),while fertilization rate was higher in observation group(P<0.05).During treatment,difference in the total incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion:The application of Guizhi Fuling capsule combined with goserelin can effectively relieve TCM syndromes,reduce levels of serum Th1/Th2 cytokines,improve estrogen disorders and uterine artery hemodynamics,reduce postoperative recurrence and increase fertilization rate in EMs patients,with significant clinical curative effect.

参考文献/References:

[1] 林莉妃,覃英梅,王冰冰.彩色多普勒超声评估卵巢子宫内膜异位囊肿子宫动脉血流动力学结果观察[J].中国性科学,2019,28(5):62-65.
[2] 吴 颖,陈燕娥,葛 菲,等.小金胶囊联合戈舍瑞林缓释植入剂治疗子宫内膜异位症腹腔镜术后的临床研究[J].中华中医药学刊,2019,37(3):703-706.
[3] 许宝珍,薛 芸.子宫内膜异位症腹腔镜手术后醋酸亮丙瑞林联合坤泰胶囊对子宫内膜受容性的影响[J].中国计划生育学杂志,2018,26(12):1183-1188.
[4] 苏燕燕,瘳 琪,王来平.中西医结合疗法对子宫内膜异位症患者激素水平及炎性因子的影响[J].长春中医药大学学报,2018,34(1):95-98.
[5] 黄志欣,李 隽,黄 博,等.腹腔镜联合促性腺激素释放激素激动剂治疗子宫内膜异位症伴不孕症的疗效观察[J].现代生物医学进展,2017,17(1):70-72.
[6] 卢 娜,张 丹,苑文娜.桂枝茯苓胶囊联合地诺孕素治疗子宫内膜异位症的临床研究[J].现代药物与临床,2020,35(6):1117-1121.
[7] 张惜阴.实用妇产科学[M].2版.北京:人民卫生出版社,2003:245.
[8] 中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症的诊治指南[J].中华妇产科杂志,2015,50(3):161-169.
[9] 陈 能,康佳丽,刘晓俊,等.促性腺激素释放激素激动剂联合加味桂枝茯苓汤对子宫内膜异位症不孕患者血清细胞因子的影响[J].中国药业,2017,26(15):27-29.
[10] 国家中医药管理局.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:212.
[11] 马西文.孕三烯酮联合GnRH-a辅助腹腔镜手术治疗中重度子宫内膜异位症临床研究[J].陕西医学杂志,2018,47(4):439-441.
[12] 张海燕,赵得雄.曼月乐保守治疗子宫内膜异位症的疗效及对子宫动脉血流动力学、血清EMAb及激素水平的影响[J].贵州医药,2019,43(1):34-37.
[13] 罗 健.八珍汤联合醋酸戈舍瑞林缓释植入剂治疗子宫内膜异位症的疗效及安全性分析[J].辽宁中医杂志,2019,46(8):1676-1679.
[14] 杨艳琳,王屹雯,颜望碧.化瘀消癥汤结合醋酸亮丙瑞林微球治疗子宫内膜异位症的临床疗效及对血清CA125和CA199的影响[J].四川中医,2019,37(12):162-165.
[15] 茅 菲.温经汤对子宫内膜异位症患者血清前列腺素E2、白介素17、血管内皮生长因子及子宫动脉血流参数的影响[J].中国妇幼保健,2020,35(21):3959-3962.
[16] 胡晓燕.腹腔镜联合GnRH-a对子宫内膜异位症患者VEGF、IL-18及TNF-α的影响[J].湖南师范大学学报:医学版,2018,15(4):86-88.
[17] 田 颖,高晓俐.桂枝茯苓胶囊联合西药治疗多囊卵巢综合征及对内分泌代谢和排卵的影响[J].陕西中医,2017,38(4):444-445.
[18] 区家茵.腹腔镜手术联合肌内注射GnRH-a治疗子宫内膜异位症效果及其对Th1/Th2漂移的影响[J].山东医药,2018,58(2):88-91.
[19] 孙秀丽,李亚凤,苏欠欠,等.桂枝茯苓丸联合达那唑、孕三烯酮胶囊对子宫内膜异位症患者免疫炎性反应和血管生成的影响[J].河北医药,2019,41(12):1788-1792.
[20] 路燕红,杜印娟,王 颖.桂枝茯苓胶囊联合孕三烯酮治疗卵巢子宫内膜异位囊肿的临床研究[J].现代药物与临床,2019,34(11):215-219.

相似文献/References:

[1]胡贞君,刘笑梅△,曹保利.复方莪术散治疗子宫内膜异位症疗效及其分子学研究进展*[J].陕西中医,2019,(9):1315.
[2]张 莉,金 晶,季 菲△.丹莪妇康煎膏联合孕三烯酮治疗子宫内膜异位症疗效及对患者CA125、TNF-α和IL-6水平的影响*[J].陕西中医,2020,(10):1370.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.007]
[3]李承秋,吕文艺,金 凡,等.活血消异汤联合米非司酮对子宫内膜异位症患者血清MMP-3、CA125、EMAb水平的影响[J].陕西中医,2021,(3):297.[doi:DOI:10.3969/j.issn.1000-7369.2020.03.006]
　LI Chengqiu,LV Wenyi,JIN Fan,et al.Effect of Huoxue Xiaoyi decoction combined with mifepristone on the serum levels of MMP-3,CA125 and EMAb in patients with endometriosis[J].,2021,(4):297.[doi:DOI:10.3969/j.issn.1000-7369.2020.03.006]
[4]陈亚杰,闻 姬.子宫内膜异位症中西医认识及治疗研究进展[J].陕西中医,2021,(10):1486.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.043]
[5]余 震,柳 洲.消瘤方对子宫内膜异位症大鼠盆腔粘连的影响[J].陕西中医,2022,(1):13.[doi:DOI:10.3969/j.issn.1000-7369.2022.01.003]
　YU Zhen,LIU Zhou.Effect and the mechanism of Xiaoliu decoction on pelvic adhesion in rats with endometriosis[J].,2022,(4):13.[doi:DOI:10.3969/j.issn.1000-7369.2022.01.003]
[6]董秀娟,曹若愚,于洪基,等.大蒜素对子宫内膜异位症大鼠异位病灶及缺氧诱导因子-1α表达的影响[J].陕西中医,2022,(4):432.[doi:DOI:10.3969/j.issn.1000-7369.2022.04.005]
　DONG Xiujuan,CAO Ruoyu,YU Hongji,et al.Effects of Allicin on the ectopic lesions and the expression of HIF-1α in rats with endometriosis[J].,2022,(4):432.[doi:DOI:10.3969/j.issn.1000-7369.2022.04.005]
[7]刘 叶,赵亚芹.活血通络解毒汤治疗子宫内膜异位症疗效及对患者卵巢功能的影响[J].陕西中医,2022,(4):450.[doi:DOI:10.3969/j.issn.1000-7369.2022.04.009]
　LIU Ye,ZHAO Yaqin.Therapeutic effect of Huoxue Tongluo Jiedu decoction on endometriosis and its influence on ovarian function of patients[J].,2022,(4):450.[doi:DOI:10.3969/j.issn.1000-7369.2022.04.009]
[8]宋梦杨,连 方.连方教授治疗子宫内膜异位症经验[J].陕西中医,2022,(4):511.[doi:DOI:10.3969/j.issn.1000-7369.2022.04.026]
　SONG Mengyang,LIAN Fang.LIAN Fang's experience in treating endometriosis with Quyu Jiedu decoction[J].,2022,(4):511.[doi:DOI:10.3969/j.issn.1000-7369.2022.04.026]
[9]杨润雨,陈 瑶,冯晓玲.中医药治疗子宫内膜异位症致不孕研究进展[J].陕西中医,2023,(5):670.[doi:DOI:10.3969/j.issn.1000-7369.2023.05.032]
　YANG Runyu,CHEN Yao,FENG Xiaoling.Research progress of traditional Chinese medicine in the treatment of infertility caused by endometriosis[J].,2023,(4):670.[doi:DOI:10.3969/j.issn.1000-7369.2023.05.032]
[10]赵佳琪,刘凯莉,李昱帅,等.子宫内膜异位症相关通路及中医药干预研究进展[J].陕西中医,2023,(9):1316.[doi:DOI:10.3969/j.issn.1000-7369.2023.09.038]
　ZHAO Jiaqi,LIU Kaili,LI Yushuai,et al.Research progress on the related pathways of endometriosis and the intervention of traditional Chinese medicine[J].,2023,(4):1316.[doi:DOI:10.3969/j.issn.1000-7369.2023.09.038]

备注/Memo

备注/Memo:
基金项目:河北省中医药管理局课题(20211441)
更新日期/Last Update: 2022-04-08