补肾祛瘀方联合丹那唑对子宫内膜异位症患者血清雌/孕激素、前列腺素的影响

孙阿梅 刘长云 刘汉蓉 汪正芳

摘要 目的：探討补肾祛瘀方联合丹那唑对子宫内膜异位症患者血清雌/孕激素、前列腺素的影响。方法：回顾性分析2016年2月至2017年1月应城市人民医院妇科门诊收治的子宫内膜异位症患者122例，根据治疗方法分为观察组和对照组，每组61例，对照组采用丹那唑治疗，观察组在对照组的基础上联合补肾祛瘀方治疗，2组均连续治疗3个月。比较2组临床治疗效果;检测并比较治疗前后2组血清雌/孕激素、体液/细胞免疫指标及前列腺素水平变化;观察并比较治疗过程中2组不良反应发生情况。结果：治疗后观察组临床治疗总有效率为81.97%，较对照组的63.93%显著升高（P<0.05）;治疗后2组P、E2、LH、FSH水平较治疗前显著降低，且观察组低于对照组（P<0.05或P<0.01）;治疗后2组IgA、IgG、IgM水平较治疗前显著降低，C3和C4水平较治疗前显著升高，2组间差异有统计学意义（P<0.05或P<0.01）;治疗后2组CD3+、CD4+细胞比例及CD4+/CD8+较治疗前显著升高，且观察组高于对照组（P<0.05），CD8+细胞比例较治疗前及组间比较差异无统计学意义（P>0.05）;治疗后2组PG E2、PG F2α、TXB2水平较治疗前显著降低，6-k-PG F1α水平较治疗前显著升高，2组间差异有统计学意义（P<0.05或P<0.01）;2组间不良反应发生率比较差异无统计学意义（P>0.05）。结论：补肾祛瘀方联合丹那唑能调节子宫内膜异位症患者机体免疫功能，改善患者雌/孕激素、前列腺素水平，增强患者抵抗力，缓解疼痛，效果显著，安全可行。

关键词 子宫内膜异位症;补肾祛瘀方;丹那唑;雌/孕激素;前列腺素

Effects of Bushen Quyu Decoction Combined with Danazol in the Treatment of Patients with Endometriosis

on the Serum Endocrine Estrogen/Progesterone and Prostaglandin

Sun Amei1， Liu Changyun1， Liu Hanrong1，Wang Zhengfang2

（1 Yingcheng People′s Hospital， Yingcheng 432400， China; 2 Digestive center of Beijing Chinese Medicine

Hospital affiliated to Capital Medical University， Beijing 100010， China）

Abstract Objective：To explore the effects of Bushen Quyu decoction combined with danazol on the serum estrogen/progesterone and prostaglandin in the treatment of patients with endometriosis. Methods：A retrospective analysis of 122 cases of patients with endometriosis in gynecology clinic of our hospital from February 2016 to January 2017 were selected and divided into treatment group （n=61） and control group （n=61） according to therapeutic method. Patients in the control group were treated with danazol， and those in the treatment group were treated with Bushen Quyu decoction on the basis of what was used in the control group. All the patients of the 2 groups were treated continuously for 3 months. The clinical effects of patients in the 2 groups were compared; the serum estrogen/progesterone， humoral/cellular immune indexes and prostaglandin levels of patients in the 2 groups were detected and compared before and after treatment; the adverse reactions of the 2 groups were observed and compared. Results：After treatment， the clinical total effective rate of the treatment group was 81.97%， which was significantly higher than 63.93% of the control group （P<0.05）; after treatment， the levels of P， E2， LH and FSH in the 2 groups were significantly lower than those before treatment， and the levels in the treatment group were lower than those in the control group （P<0.05 or P<0.01）; after treatment， the levels of IgA， IgG and IgM in the 2 groups were significantly lower than those before treatment， and the levels of C3 and C4 were significantly higher than those before treatment. The differences between the 2 groups were significant （P<0.05 or P<0.01）; after treatment， the proportion of CD4+， CD3+ and CD4+/CD8+ in the 2 groups were significantly higher than those before treatment， and the levels in treatment group were higher than those in the control group （P<0.05）. There was no significant difference of the proportion of CD8+ cells compared with before treatment and between the 2 groups （P>0.05）; after treatment， the levels of PG E2， PG F2α and TXB2 in the 2 groups were significantly lower than those before treatment， and 6-k-PG F1 level was significantly higher than that before treatment. The difference between the 2 groups was significant （P<0.05 or P<0.01）; there was no significant difference in the incidence of adverse reactions between the 2 groups （P>0.05）. Conclusion：Bushen Quyu decoction combined with danazol can regulate the immune function in patients with endometriosis， improve the serum estrogen/progesterone levels， enhance resistance of patients， relieve pain， which had significant effects and was safe and feasible.

Key Words Endometriosis; Bushen Quyu decoction; Danazol; Serum estrogen/progesterone; Prostaglandin

中图分类号：R271.11文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.03.035

子宫内膜异位症是指子宫内膜生长在子宫被覆面及其他宫腔外部位引起的一种妇科疾病，临床多表现不孕、痛经、月经不调等，本病为妇科常见多发疾病，多发于20～45岁妇女，且近几年发病率呈逐年上升趋势[1-2]。治疗子宫内膜异位症常用方法分为手术治疗和药物治疗，但手术治疗无法根治，且术后易复发，药物治疗中最常用的药物为丹那唑，但长期服用对肝功能有一定的影响[3-4]。……