消癥杀胚煎剂治疗未破裂型输卵管异位妊娠的疗效及对产妇卵巢功能、生育结局的影响
|
摘要
目的消癥杀胚煎剂治疗未破裂型输卵管异位妊娠的疗效及对产妇卵巢功能、生育结局的影响。方法选择2015年9月至2017年9月荆门市第二人民医院接诊的74例未破裂型输卵管异位妊娠患者,按随机数表法分为观察组及对照组各37。对照组使用抑那通进行治疗,观察组在此基础上,加用消癥杀胚煎剂进行治疗。比较两组的卵泡刺激素(FSH)、雌二醇(E2)、促黄体生成素(LH)、抗子宫内膜抗体(EMAb)。结果治疗后,观察组FSH、LH水平低于对照组[(20. 44±1. 74) U/Lvs (28. 55±1. 93) U/L,(21. 28±2. 13) U/L vs(25. 25±2. 18) U/L],差异具有统计学意义(P <0. 05);观察组E2水平高于对照组[(250. 12±7. 77) pmol/L vs(174. 78±8. 16) pmol/L](P <0. 05);观察组血清EMAb阳性率低于对照组[10(27. 03%) vs 22(59. 46%)],差异具有统计学意义(P <0. 05);经治疗2周后,观察组的血清β-HCG、孕酮水平明显低于对照组,差异具有统计学意义(P <0. 05),正常妊娠率明显高于对照,差异具有统计学意义(P <0. 05)。结论消癥杀胚煎剂联合抑那通治疗未破裂型输卵管异位妊娠可有效改善内异症患者卵巢功能,疗效安全可靠,值得应用推广。
Objective To study the efficacy of xiaozhengshapei decoction in treating unruptured tubal ectopic pregnancy and its effect on maternal ovary function and fertility outcome. Methods 74 patients with unruptured tubal ectopic pregnancy admitted into our hospital from September 2015 to September 2017 were divided into observation group and control group according to random number table method. The control group was treated with enantone. The observation group was treated with xiaozhengshapei decoction and enantone. The follicle stimulating hormone( FSH),estradiol( E2),luteinizing hormone( LH) and anti-endometrial antibodies( EAMb) of the twogroups were compared. Results After treatment,the levels of FSH and LH in observation group were lower than those in control group [( 20. 44 ± 1. 74) U/L vs( 28. 55 ± 1. 93) U/L,( 21. 28 ± 2. 13) U/L vs( 25. 25 ± 2. 18)U/L]( P < 0. 05). The levels of E2 in observation group were higher than those in control group [( 250. 12 ±7. 77) pmol/L vs( 174. 78 ± 8. 16) pmol/L]( P < 0. 05). The positive rate of serum EMAb in observation group was lower than that in control group [10( 27. 03%) vs 22( 59. 46%) ]( P < 0. 05). Conclusions Xiaozhengshapei decoction combined with enantone in the treatment of unruptured tubal ectopic pregnancy can effectively improve the ovarian function of patients,safe and reliable,which is worthy of promotion.
Objective To study the efficacy of xiaozhengshapei decoction in treating unruptured tubal ectopic pregnancy and its effect on maternal ovary function and fertility outcome. Methods 74 patients with unruptured tubal ectopic pregnancy admitted into our hospital from September 2015 to September 2017 were divided into observation group and control group according to random number table method. The control group was treated with enantone. The observation group was treated with xiaozhengshapei decoction and enantone. The follicle stimulating hormone( FSH),estradiol( E2),luteinizing hormone( LH) and anti-endometrial antibodies( EAMb) of the twogroups were compared. Results After treatment,the levels of FSH and LH in observation group were lower than those in control group [( 20. 44 ± 1. 74) U/L vs( 28. 55 ± 1. 93) U/L,( 21. 28 ± 2. 13) U/L vs( 25. 25 ± 2. 18)U/L]( P < 0. 05). The levels of E2 in observation group were higher than those in control group [( 250. 12 ±7. 77) pmol/L vs( 174. 78 ± 8. 16) pmol/L]( P < 0. 05). The positive rate of serum EMAb in observation group was lower than that in control group [10( 27. 03%) vs 22( 59. 46%) ]( P < 0. 05). Conclusions Xiaozhengshapei decoction combined with enantone in the treatment of unruptured tubal ectopic pregnancy can effectively improve the ovarian function of patients,safe and reliable,which is worthy of promotion.
引文
[1]蒋德菊,黄碧萍.活血化瘀中药对腹腔镜手术治疗未破裂型输卵管异位妊娠疗效的影响[J].广州中医药大学学报,2012,29(1):13-14,18.
[2]林艳明,马卓飞,卢笛.蠲痛饮对未破裂型输卵管异位妊娠血清抗子宫内膜抗体(EmAb)的影响[J].现代预防医学,2012,39(3):586-587.
[3] Guo H,Wang Y,Chen Q,et al. Use of medroxyprogesterone acetate in women with ovarian endometriosis undergoing controlled ovarian hyperstimulation for in vitro fertilization[J]. Sci Rep,2017,7(1):11927.
[4]刘姣,贺克,李清.少腹逐瘀丸对未破裂型输卵管异位妊娠大鼠MMP-9和TIMP-1 mRNA表达的影响[J].中成药,2012,34(4):610-613.
[5]冷金花,史精华.未破裂型输卵管异位妊娠及其相关手术对卵巢功能和生育的影响[J].实用妇产科杂志,2012,28(6):426-429.
[6] Leone RMU,Scala C,Tafi E,et al. Spontaneous fertility after expectant or surgical management of rectovaginal endometriosis in women with or without ovarian endometrioma:A retrospective analysis[J].Fertil Steril,2017,107(4):969-976. e5.
[7]陈碧晖,刘奇志,柴洪佳,等.补肾活血化瘀中药三联疗法在未破裂型输卵管异位妊娠合并不孕患者腹腔镜术后的应用[J].实用医学杂志,2012,28(21):3651-3653.
[8]赵瑞华,杨艳环,李敏,等.活血消异方对未破裂型输卵管异位妊娠大鼠ICAM-1、MMP-9及VEGF的影响[J].北京中医药大学学报,2012,35(12):826-829,872.
[9] Burghaus S,Fasching PA,Hberle L,et al. Genetic risk factors for ovarian cancer and their role for endometriosis risk[J]. Gynecol Oncol,2017,145(1):142-147.
[10]张丽霞,季士顺.补肾活血化瘀方联合米非司酮治疗未破裂型输卵管异位妊娠的效果[J].中国妇幼保健,2014,29(19):3117-3120.
[11] López de la Torre MA,Abrao HM,Fernandes LF,et al. Ten principles for safe surgical treatment of ovarian endometriosis[J]. J Minim Invasive Gynecol,2017,24(2):203-204.
[12]郝长宏,田永会,刘正玲,等.未破裂型输卵管异位妊娠患者血清CA_(125)、HE4、EMAb的表达及其临床意义[J].实用妇产科杂志,2014,30(11):855-857.
[13]王灵彬,李辞妹.腹腔镜术后药物治疗未破裂型输卵管异位妊娠周期及疗效的临床探讨[J].中国妇幼保健,2013,28(07):1084-1088.
[14] de Lima CB,Cordeiro FB,Camargo M,et al. Follicular fluid lipid peroxidation levels in women with endometriosis during controlled ovarian hyperstimulation[J]. Hum Fertil(Camb),2017,20(1):48-54.
[15]申学华,王本东.活血逐瘀汤治疗未破裂型输卵管异位妊娠的临床疗效观察[J].中国妇幼保健,2013,28(30):5050-5051.
[16] Goodman LR,Goldberg JM,Flyckt RL,et al. Effect of surgery on ovarian reserve in women with endometriomas,endometriosis and controls[J]. Am J Obstet Gynecol,2016,215(5):589e1-589e6.
[17]尹洁.腹腔镜术联合抑那通治疗中重度卵巢巧克力囊肿的临床疗效[J].中国妇幼保健,2013,28(32):5381-5382.
[18]冯燕,张婕.未破裂型输卵管异位妊娠中西医结合治疗对患者孕育功能疗效因素研究[J].中华中医药学刊,2016,34(3):605-608.
[19] Bai H,Cao D,Yuan F,et al. Prognostic value of endometriosis in patients with stage I ovarian clear cell carcinoma:Experiences at three academic institutions[J]. Gynecol Oncol,2016,143(3):526-531.
[20]张海霞,李萍,李楠,等.复宫宁颗粒对未破裂型输卵管异位妊娠卵巢功能及血清细胞因子的影响[J].中药材,2016,39(1):197-199.
[2]林艳明,马卓飞,卢笛.蠲痛饮对未破裂型输卵管异位妊娠血清抗子宫内膜抗体(EmAb)的影响[J].现代预防医学,2012,39(3):586-587.
[3] Guo H,Wang Y,Chen Q,et al. Use of medroxyprogesterone acetate in women with ovarian endometriosis undergoing controlled ovarian hyperstimulation for in vitro fertilization[J]. Sci Rep,2017,7(1):11927.
[4]刘姣,贺克,李清.少腹逐瘀丸对未破裂型输卵管异位妊娠大鼠MMP-9和TIMP-1 mRNA表达的影响[J].中成药,2012,34(4):610-613.
[5]冷金花,史精华.未破裂型输卵管异位妊娠及其相关手术对卵巢功能和生育的影响[J].实用妇产科杂志,2012,28(6):426-429.
[6] Leone RMU,Scala C,Tafi E,et al. Spontaneous fertility after expectant or surgical management of rectovaginal endometriosis in women with or without ovarian endometrioma:A retrospective analysis[J].Fertil Steril,2017,107(4):969-976. e5.
[7]陈碧晖,刘奇志,柴洪佳,等.补肾活血化瘀中药三联疗法在未破裂型输卵管异位妊娠合并不孕患者腹腔镜术后的应用[J].实用医学杂志,2012,28(21):3651-3653.
[8]赵瑞华,杨艳环,李敏,等.活血消异方对未破裂型输卵管异位妊娠大鼠ICAM-1、MMP-9及VEGF的影响[J].北京中医药大学学报,2012,35(12):826-829,872.
[9] Burghaus S,Fasching PA,Hberle L,et al. Genetic risk factors for ovarian cancer and their role for endometriosis risk[J]. Gynecol Oncol,2017,145(1):142-147.
[10]张丽霞,季士顺.补肾活血化瘀方联合米非司酮治疗未破裂型输卵管异位妊娠的效果[J].中国妇幼保健,2014,29(19):3117-3120.
[11] López de la Torre MA,Abrao HM,Fernandes LF,et al. Ten principles for safe surgical treatment of ovarian endometriosis[J]. J Minim Invasive Gynecol,2017,24(2):203-204.
[12]郝长宏,田永会,刘正玲,等.未破裂型输卵管异位妊娠患者血清CA_(125)、HE4、EMAb的表达及其临床意义[J].实用妇产科杂志,2014,30(11):855-857.
[13]王灵彬,李辞妹.腹腔镜术后药物治疗未破裂型输卵管异位妊娠周期及疗效的临床探讨[J].中国妇幼保健,2013,28(07):1084-1088.
[14] de Lima CB,Cordeiro FB,Camargo M,et al. Follicular fluid lipid peroxidation levels in women with endometriosis during controlled ovarian hyperstimulation[J]. Hum Fertil(Camb),2017,20(1):48-54.
[15]申学华,王本东.活血逐瘀汤治疗未破裂型输卵管异位妊娠的临床疗效观察[J].中国妇幼保健,2013,28(30):5050-5051.
[16] Goodman LR,Goldberg JM,Flyckt RL,et al. Effect of surgery on ovarian reserve in women with endometriomas,endometriosis and controls[J]. Am J Obstet Gynecol,2016,215(5):589e1-589e6.
[17]尹洁.腹腔镜术联合抑那通治疗中重度卵巢巧克力囊肿的临床疗效[J].中国妇幼保健,2013,28(32):5381-5382.
[18]冯燕,张婕.未破裂型输卵管异位妊娠中西医结合治疗对患者孕育功能疗效因素研究[J].中华中医药学刊,2016,34(3):605-608.
[19] Bai H,Cao D,Yuan F,et al. Prognostic value of endometriosis in patients with stage I ovarian clear cell carcinoma:Experiences at three academic institutions[J]. Gynecol Oncol,2016,143(3):526-531.
[20]张海霞,李萍,李楠,等.复宫宁颗粒对未破裂型输卵管异位妊娠卵巢功能及血清细胞因子的影响[J].中药材,2016,39(1):197-199.