摘要
目的 研究散结镇痛胶囊联合地诺孕素对子宫内膜异位症(EMS)患者性激素水平及血清糖类抗原199(CA199)、半乳糖凝集素3(Gal-3)表达的影响.方法 前瞻性选取2020年2月至2022年2月于邢台市人民医院治疗的EMS患者200例作为研究对象,按照随机数字表法将患者分为对照组(n=100)和观察组(n=100).对照组服用地诺孕素片治疗,观察组服用散结镇痛胶囊+地诺孕素片治疗.两组均连续治疗3个月后评价疗效.比较两组患者的临床疗效,治疗前与治疗3个月后的痛经评分[视觉模拟评分法(VAS)评分]、性激素[雌二醇、孕酮、黄体生成素(LH)和促卵泡刺激素(FSH)]水平及血清CA199、Gal-3水平,以及不良反应发生情况.结果 观察组总有效率为93.00％,明显高于对照组(74.00％),差异有统计学意义(P＜0.05).治疗3个月后,两组痛经评分均较治疗前降低,且观察组患者痛经评分为(1.54±0.53)分,明显低于对照组[(2.21±0.77)分],差异均有统计学意义(P＜0.05).治疗3个月后,两组雌二醇、孕酮、LH及FSH水平均较治疗前明显降低,且观察组患者的雌二醇、孕酮、LH及FSH水平分别为(106.16±20.45)pmol/L、(0.42±0.24)nmol/L、(5.43±1.42)IU/L 及(5.02±1.53)IU/L,均显著低于对照组[(121.88±15.23)pmol/L、(0.63±0.18)nmol/L、(5.92±1.69)IU/L 及(5.61±1.74)IU/L],差异均有统计学意义(P＜0.05).治疗3个月后,两组血清CA199、Gal-3水平均较治疗前有明显降低,且观察组患者的血清CA199、Gal-3水平分别为(28.25±4.45)Um/L、(5.54±2.41)ng/L,均显著低于对照组[(36.37±6.26)Um/L、(6.88±3.35)ng/L],差异均有统计学意义(P＜0.05).两组患者总不良反应发生率比较,差异无统计学意义(P＞0.05).结论 采用散结镇痛胶囊联合地诺孕素对子宫内膜异位症患者进行治疗,可有效提高临床疗效,减轻患者痛经程度,改善性激素水平及血清CA199、Gal-3表达,值得临床推广应用.
Abstract
Objective To study the effects of Sanjie Zhentong Capsules combined with dinorgestrel on sex hormone levels and serum car-bohydrate antigen 199(CA199)and galactoagglutinin 3(Gal-3)expression in patients with endometriosis(EMS).Methods A total of 200 EMS patients treated at Xingtai People's Hospital from February 2020 to February 2022 were prospectively selected as the study subjects.The pa-tients were divided into the control group(n=100)and the observation group(n=100)according to the random number table method.The control group was treated with deinorgestrel tablets,while the observation group was treated with Sanjie Zhentong Capsules combined with deinorg-estrel tablets.Both groups were evaluated for efficacy after continuous treatment for 3 months.The clinical efficacy,dysmenorrhea score[visual analogue scale(VAS)score],sex hormone levels[estradiol,progesterone,luteinizing hormone(LH)and follicle-stimulating hormone(FSH)],serum CA199,Gal-3 before treatment and 3 months after treatment,and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 93.00％,which was significantly higher than that of the control group(74.00％),and the difference was statistically significant(P＜0.05).After 3 months of treatment,the dysmenorrhea score of two groups were lower than those before treatment,and the dysmenorrhea score of the observation group patients was(1.54±0.53)points,which was signifi-cantly lower than that of the control group[(2.21±0.77)points],and the difference was statistically significant(P＜0.05).After 3 months of treatment,the levels of estradiol,progesterone,LH,and FSH in two groups were lower than those before treatment,the levels of estradiol,pro-gesterone,LH,and FSH in the observation group were(106.16±20.45)pmol/L,(0.42±0.24)nmol/L,(5.43±1.42)IU/L,and(5.02±1.53)IU/L,respectively,which were significantly lower than those in the control group[(121.88±15.23)pmol/L,(0.63±0.18)nmol/L,(5.92±1.69)IU/L,and(5.61±1.74)IU/L],the differences were statistically significant(P＜0.05).After 3 months of treatment,the levels of serum CA199 and Gal-3 in two groups were lower than those before treatment,and the levels of serum CA199 and Gal-3 in the obser-vation group were(28.25±4.45)Um/L and(5.54±2.41)ng/L,respectively,which were significantly lower than those in the control group[(36.37±6.26)Um/L and(6.88±3.35)ng/L],the differences were statistically significant(P＜0.05).There was no statistically signifi-cant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Sanjie Zhentong Capsules combined with dinorgestrel in the treatment of endometriosis patients can effectively improve the clinical efficacy,reduce the degree of dysmenorrhea,improve the level of sex hormones and serum CA199,Gal-3 expression levels,and effectively reduce the incidence of adverse reactions.
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