腹腔镜术后联合蠲痛饮治疗子宫内膜异位症的临床研究
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摘要
目的观察蠲痛饮治疗子宫内膜异位症术后的临床疗效。方法选择2016年1月~12月于右江民族医学院附属医院诊治的子宫内膜异位症术后患者60例,随机分为治疗组和对照组,治疗组口服蠲痛饮,每日100ml,分两次服,对照组给予曲普瑞林肌肉注射,每次3.75mg,每4周1次,比较两组临床疗效、随访1年后观察复发率及妊娠情况。结果治疗3个月后,治疗组临床总有效率为83.33%,对照组为90.00%,两组比较差异无统计学意义(P>0.05)。治疗组痛经复发为12例,腹痛9例,盆腔包块4例;对照组痛经复发为10例,腹痛8例,盆腔包块3例,两组比较差异无统计学意义(P>0.05)。术后7~12个月内,治疗组总妊娠率为26.67%,对照组总妊娠率为6.67%,两组比较差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论蠲痛饮治疗子宫内膜异位症术后明显提高妊娠率,且未出现严重不良反应,值得临床推广。
Objective To observe the clinical curative effects of JUANTONG DECOCTION in the treatment of postoperative endometriosis. Methods Sixty patients with endometriosis cared at Affiliated Hospital of Youjiang Medical University for Nationalities from January to December 2016 were selected as the research objects and were randomly divided into a treatment group and a control group.Patients of the treatment group were given oral JUANTONG DECOCTION 50 ml,twice a day.The control group was given intramuscular injection with Triptorelin 3.75 mg,once every four weeks.Clinical curative effects were compared between the two groups. Results After 3 months of treatment,the total effective rate was 83.33%in the treatment group and 90.00%in the control group,comparison of the results between the two groups showed that there was no statistically significant difference(P >0.05).The treatment group had 12 cases of dysmenorrhea recurrence,9 cases of abdominal pain,4 cases of pelvic mass;and the control group had 10 cases of dysmenorrhea recurrence,8 cases of abdominal pain,3 cases of pelvic mass,comparison of the recurrences between the two groups yielded that there were no statistically significant differences(P >0.05).Within 7~12 months after operation,the total pregnancy rate of the treatment group was 26.67%,and the total pregnancy rate was 6.67%,compared the pregnancy rate between the two group showed that there was a statistically significant difference(P <0.05).There was no statistically significant difference by comparing the side effect rate of the treatment group with that of the control group(P >0.05). Conclusion JUANTONG DECOCTION in the treatment of endometriosis after surgery can significantly improve the pregnancy rate,moreover,no serious adverse reactions occur,which is worthy of clinical promotion.
Objective To observe the clinical curative effects of JUANTONG DECOCTION in the treatment of postoperative endometriosis. Methods Sixty patients with endometriosis cared at Affiliated Hospital of Youjiang Medical University for Nationalities from January to December 2016 were selected as the research objects and were randomly divided into a treatment group and a control group.Patients of the treatment group were given oral JUANTONG DECOCTION 50 ml,twice a day.The control group was given intramuscular injection with Triptorelin 3.75 mg,once every four weeks.Clinical curative effects were compared between the two groups. Results After 3 months of treatment,the total effective rate was 83.33%in the treatment group and 90.00%in the control group,comparison of the results between the two groups showed that there was no statistically significant difference(P >0.05).The treatment group had 12 cases of dysmenorrhea recurrence,9 cases of abdominal pain,4 cases of pelvic mass;and the control group had 10 cases of dysmenorrhea recurrence,8 cases of abdominal pain,3 cases of pelvic mass,comparison of the recurrences between the two groups yielded that there were no statistically significant differences(P >0.05).Within 7~12 months after operation,the total pregnancy rate of the treatment group was 26.67%,and the total pregnancy rate was 6.67%,compared the pregnancy rate between the two group showed that there was a statistically significant difference(P <0.05).There was no statistically significant difference by comparing the side effect rate of the treatment group with that of the control group(P >0.05). Conclusion JUANTONG DECOCTION in the treatment of endometriosis after surgery can significantly improve the pregnancy rate,moreover,no serious adverse reactions occur,which is worthy of clinical promotion.
引文
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[4]Vallerie AM,Hsieh T,Baxi LV.Peritoneal inclusion cyst:effects on fertility and antepartum course[J].Obstet Gynecol,2008,112(2Pt2):498-500.
[5]Guo SW.Recurrence of endometriosis and its control[J].Hum Reprod Update,2009,15(4):441-461.
[6]李楷滨,王立岩,盛敏佳,等.子宫内膜异位症术后复发短期应用促性腺激素释放激素激动剂与达那唑的临床观察[J].中国妇幼保健,2013,18(10):599-601.
[7]李申.子宫内膜异位症的诊治现状及实验研究进展[J].中国校医,2014,28(3):236-237.
[8]齐聪,杨红,钱海墨.中医防治复发性子宫内膜异位症的策略与优势[J].上海中医药大学学报,2011,25(4):9-11.
[9]高琦,蔡霞.袪瘀散结方保留灌肠防治盆腔子宫内膜异位症术后复发疗效观察[J].新疆医科大学学报,2013,36(10):1470-1472.
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[11]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:14.
[12]国家中医药管理局.中华人民共和国卫生部.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,2002:239.
[13]王舒婷,赵瑞华.子宫内膜异位症中医治疗概况及民间疗法总结[J].辽宁中医杂志,2013,40(4):815-818.
[14]张如星.腹腔镜手术治疗子宫内膜异位症疗效观察[J].现代中西医结合杂志,2015,24(32)∶3585-3587.
[15]石少权,李俏敏,姜芳芳,等.腹腔镜手术治疗重型子宫内膜异位症的临床分析[J].中国医药,2013,8(10)∶1442-1444.
[16]黄思毅,李末娟.腹腔镜手术治疗子宫内膜异位症伴不孕178例[J].实用医学杂志,2012,28(10)∶1673-1675.
[17]李斗辉.腹腔镜诊断和治疗子宫内膜异位症的临床观察[J].湖南中医药大学学报,2012,32(10)∶50-51,62.
[18]Lainas TG,Sfontouris IA,Zorzovilis IZ,et al.Flexible GnRH antagonist protocol versus GnRH agonist long protocol in patients with polycystic ovary syndrome treated for IVF:aprospective randomised controlled trial(RCT)[J].Hum Reprod,2010,25(3):683-689.
[19]沈映君.中药药理学[M].北京:人民卫生出版社,2000:629-631.
[20]林艳明,庞广福,卢笛,等.蠲痛饮治疗子宫内膜异位症临床观察[J].实用中医药杂志,2012,28(2):101.
[2]王滢毅,朱长艳,秦莉,等.促性腺激素释放激素在子宫内膜异位症合不孕治疗中的应用[J].亚太传统医药,2013,9(6):135-136.
[3]Marcoux S,Maheux B,Berabe S.Laparoscopic surgery in infertile women with minmal or mild endomtriosis.Canadian Collaborative Group on Endometriosis[J].N Eng J Med,1997,337(4):217-222.
[4]Vallerie AM,Hsieh T,Baxi LV.Peritoneal inclusion cyst:effects on fertility and antepartum course[J].Obstet Gynecol,2008,112(2Pt2):498-500.
[5]Guo SW.Recurrence of endometriosis and its control[J].Hum Reprod Update,2009,15(4):441-461.
[6]李楷滨,王立岩,盛敏佳,等.子宫内膜异位症术后复发短期应用促性腺激素释放激素激动剂与达那唑的临床观察[J].中国妇幼保健,2013,18(10):599-601.
[7]李申.子宫内膜异位症的诊治现状及实验研究进展[J].中国校医,2014,28(3):236-237.
[8]齐聪,杨红,钱海墨.中医防治复发性子宫内膜异位症的策略与优势[J].上海中医药大学学报,2011,25(4):9-11.
[9]高琦,蔡霞.袪瘀散结方保留灌肠防治盆腔子宫内膜异位症术后复发疗效观察[J].新疆医科大学学报,2013,36(10):1470-1472.
[10]谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013:272-273.
[11]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:14.
[12]国家中医药管理局.中华人民共和国卫生部.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,2002:239.
[13]王舒婷,赵瑞华.子宫内膜异位症中医治疗概况及民间疗法总结[J].辽宁中医杂志,2013,40(4):815-818.
[14]张如星.腹腔镜手术治疗子宫内膜异位症疗效观察[J].现代中西医结合杂志,2015,24(32)∶3585-3587.
[15]石少权,李俏敏,姜芳芳,等.腹腔镜手术治疗重型子宫内膜异位症的临床分析[J].中国医药,2013,8(10)∶1442-1444.
[16]黄思毅,李末娟.腹腔镜手术治疗子宫内膜异位症伴不孕178例[J].实用医学杂志,2012,28(10)∶1673-1675.
[17]李斗辉.腹腔镜诊断和治疗子宫内膜异位症的临床观察[J].湖南中医药大学学报,2012,32(10)∶50-51,62.
[18]Lainas TG,Sfontouris IA,Zorzovilis IZ,et al.Flexible GnRH antagonist protocol versus GnRH agonist long protocol in patients with polycystic ovary syndrome treated for IVF:aprospective randomised controlled trial(RCT)[J].Hum Reprod,2010,25(3):683-689.
[19]沈映君.中药药理学[M].北京:人民卫生出版社,2000:629-631.
[20]林艳明,庞广福,卢笛,等.蠲痛饮治疗子宫内膜异位症临床观察[J].实用中医药杂志,2012,28(2):101.