首页|扶正通络方预防子宫内膜异位症术后复发及对免疫稳态影响的研究

扶正通络方预防子宫内膜异位症术后复发及对免疫稳态影响的研究

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目的 探讨扶正通络方预防子宫内膜异位症术后复发的临床疗效及对免疫稳态的影响。方法 纳入2018 年9 月—2019 年12 月就诊于苏州市中医医院且腹腔镜已证实为子宫内膜异位症(ASRM分期为Ⅱ～Ⅲ期)患者85 例，随机分为2 组，对照组予促性腺激素释放激素激动剂(GnRH-a)治疗3 个月，观察组在对照组治疗基础上给予扶正通络方口服3 个月。比较2 组患者治疗前后痛经VAS评分及血清肿瘤指标(CA125、CA199)、炎症因子[白细胞介素-10(IL-10)、白细胞介素-17(IL-17)、白细胞介素-32(IL-32)]水平，统计2 组停药6 个月、12 个月后复发及妊娠情况。结果 治疗后2 组痛经VAS评分及血清CA125、CA199、IL-10、IL-17 水平均较治疗前明显下降(P均＜0。05)，且观察组均明显低于对照组(P均＜0。05);治疗后观察组血清IL-32 水平明显低于治疗前及对照组(P 均＜0。05)，对照组治疗后 IL-32 水平无明显变化(P＞0。05)。停药后6 个月，2 组复发率及妊娠率比较差异均无统计学意义(P均＞0。05);停药后12 个月，观察组复发率明显低于对照组[10。0%(4/40)比32。5%(13/40)，P＜0。05]，妊娠率明显高于对照组[40。0%(16/40)比12。5%(5/40)，P＜0。05]。结论 GnRH-a联合扶正通络方可以更好地减轻子宫内膜异位症术后患者痛经症状，降低血清CA125、CA199 水平，纠正术后持续存在的免疫稳态失衡，可有效减少复发，提高妊娠率，为临床预防子宫内膜异位症术后复发提供了新思路。
Decoction for reinforce healthy Qi and unblocking collaterals prevents postoperative recurrence of endometriosis and its effect on immune homeostasis
Objective It is to investigate the clinical efficacy of decoction for reinforce healthy Qi and unblocking col-laterals in preventing postoperative recurrence of endometriosis and its effect on immune homeostasis.Methods Eighty-five patients who visited Suzhou Hospital of Traditional Chinese Medicine from September 2018 to December 2019 with endome-triosis(ASRM stageⅡ-Ⅲ)confirmed by laparoscopy were included,and were randomly divided into 2 groups:the control group was treated with gonadotropin-releasing hormone agonist(GnRH-a)for 3 months,and the observation group was treated with decoction for reinforce healthy Qi and unblocking collaterals by oral use based on on the treatment of the control group.The VAS score of dysmenorrhea,serum levels of tumor indexes(CA125,CA199)and inflammatory factors[inter-leukin-10(IL-10),interleukin-17(IL-17),interleukin-32(IL-32)]before and after treatment were compared between the two groups,and the recurrence of dysmenorrhea and pregnancy were counted in the two groups at 6 months and 12 months after drug discontinuance.Results The VAS score of dysmenorrhea and serum levels of CA125,CA199,IL-10 and IL-17 of the two groups were decreased significantly after treatment compared with those before treatment(all P＜0.05),and they were all significantly lower in the observation group than those in the control group(all P＜0.05);the serum lev-els of IL-32 in the observation group were significantly lower than those before treatment and in the control group(both P＜0.05),and no significant change in the levels of IL-32 was found in the control group after treatment(P＞0.05).At 6 months after drug discontinuance,there was no statistically significant difference in the recurrence rate and pregnancy rate between the two groups(both P＞0.05);at 12 months after drug discontinuance,the recurrence rate of the observation group was significantly lower than that of the control group[10.0%(4/40)vs.32.5%(13/40),P＜0.05],and the pregnancy rate was significantly higher than that of the control group[40.0%(16/40)vs.12.5%(5/40),P＜0.05].Conclusion GnRH-a combined with decoction for reinforce healthy Qi and unblocking collaterals can better alleviate dys-menorrhea symptoms,reduce serum levels of CA125 and CA199,correct the persistent imbalance of immune homeostasis after surgery in patients with endometriosis,and can effectively reduce recurrence and improve the pregnancy rate,which provides new ideas for the prevention of postoperative recurrence of endometriosis in the clinic.

decoction for reinforce healthy Qi and unblocking collateralsendometriosispostoperative recurrenceimmune homeostasis

陆黎娟、曾薇薇、刘迎、王斐、张露蓉、王伟、夏亲华

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南京中医药大学附属苏州市中医医院,江苏 苏州 215000

上海中医药大学附属曙光医院,上海 200120

南京中医药大学,江苏 南京 210000

扶正通络方 子宫内膜异位症 术后复发 免疫稳态

国家自然科学基金国家自然科学基金苏州市科技发展计划(医疗卫生科技创新)项目苏州市吴门医派科研专项研究基金科技项目苏州市卫生青年骨干人才"全国导师制"培训项目(2020)

8190423682004398SKY2022205SKYXD2022058苏卫健科教[2020]7号

2024

10.3969/j.issn.1008-8849.2024.05.001

现代中西医结合杂志
中国中西医结合学会河北分会,中华中医药学会

现代中西医结合杂志

CSTPCD
影响因子：1.775
ISSN：1008-8849
年,卷(期)：2024.33(5)
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