武彦舒+刘继梅

摘要：目的 探討大黄?虫丸联合复方醋酸棉酚片对子宫内膜异位症（EM）患者腹腔镜术后临床疗效，观察患者血清学指标变化。方法 98例EM腹腔镜术后患者随机分为对照组和观察组各49例。所有患者腹腔镜术后均常规抗感染、抗炎、营养支持、维持电解质及酸碱平衡，连续治疗14 d。对照组术后1 d予复方醋酸棉酚片，每次1片，每日1次，晚餐后口服；观察组在对照组基础上予大黄?虫丸，每次2丸，每日2次，口服。均治疗6个月。观察2组临床疗效及症状评分，检测治疗前后血清基质金属蛋白酶-3（MMP-3）、糖类抗原125（CA-125）、抗子宫内膜抗体（EMAb）、卵泡刺激素（FSH）、雌激素（E2）及黄体生成素（LH）水平。观察2组不良反应。结果 观察组总有效率为87.7%（43/49），对照组为73.4%（36/49），2组比较差异有统计学意义（P<0.05）。与本组治疗前比较，2组治疗后各项症状评分均下降（P<0.05），观察组治疗后各项症状评分低于对照组（P<0.05）。与本组治疗前比较，2组MMP-3、CA-125、EMAb、FSH、E2及LH水平下降（P<0.05）；观察组治疗后MMP-3、CA-125、EMAb、FSH、E2及LH水平低于对照组（P<0.05）。所有患者均未发生严重不良反应。结论 大黄?虫丸联合复方醋酸棉酚片治疗EM腹腔镜术后患者临床疗效显著，可降低患者血清MMP-3、CA-125、EMAb及雌激素水平。

关键词：大黄?虫丸；复方醋酸棉酚片；子宫内膜异位症

DOI：10.3969/j.issn.1005-5304.2017.12.007

中图分类号：R271.91 文献标识码：A 文章编号：1005-5304（2017）12-0026-04

Influence of Dahuang Zhechong Pills Combined with Compound Gosspol Acetate Tablets on Serum Markers of Endometriosis Patiens After Operation with Laparoscopy WU Yan-shu， LIU Ji-mei （Yulin Second Hospital， Yulin 719000， China）

Abstract： Objective To explore the clinical efficacy of Dahuang Zhechong Pills combined with compound gosspol acetate tablets for endometriosis （EM） after operation with laparoscopy； To observe changes in serum markers. Methods Totally 98 EM patients after operation with laparoscopy were divided into the control group （49 cases） and observation group （49 cases）. All patients had laparoscopic conventional anti-infective， anti-inflammatory， nutritional support， maintenance of electrolyte and acid-base balance， for 14 d. The control group treated with compound gosspol acetate tablets， one tablet each time， once a day， orally after dinner； the observation group was given Dahuang Zhechong Pills on the basis of control group， two pills per time， twice a day， orally. The treatment course was 6 months. The clinical efficacy and symptom scores were evaluated in the two groups. The levels of MMP-3， CA-125， EMAb， IgG， FSH， E2 and LH were detected before and after treatment in the two groups. The adverse reaction was observed during the treatment. Results After the treatment， the total effective rate was 87.7% （43/49） in observation group， and 73.4% （36/49） in control group， with statistical significance （P<0.05）. After the treatment， the symptom scores were significantly lower in both groups， and the observation group was lower than the control group （P<0.05）. After the treatment， the levels of MMP-3， CA-125， EMAb， FSH， E2 and LH decreased in both groups （P<0.05）. The levels of MMP-3， CA-125， EMAb， FSH， E2 and LH in the observation group were lower than the control group （P<0.05）. There were no serious adverse reactions in the two groups during the treatment period. Conclusion Dahuang Zhechong Pills combined with compound gosspol acetate tablets in the treatment of EM afterendprint

通讯作者：刘继梅，E-mail：550804971@qq.com

operation with laparoscopy has a good clinical curative effect and can decrease the levels of MMP-3， CA-125， EMAb and estrogen levels.

Key words： Dahuang Zhechong Pills； compound gosspol acetate tablets； endometriosis

子宫内膜异位症（endometriosis，EM）主要表现为性交痛、大便坠胀、痛经、月经过多、不孕及盆腔疼痛等。腹腔镜手术是目前最主要的治疗方法之一，但存在术后复发率较高及难以清除所有病灶等问题，故术后采用合理药物辅助治疗对该病的恢复尤为重要[1-2]。研究表明，中西医结合用于EM术后常较单一西药疗效更佳[3]。大黄?虫丸能通经消痞、活血破瘀，对于EM、继发性不孕症及盆腔包块等妇科疾病具有较好疗效[4]。本研究采用大黄?虫丸联合复方醋酸棉酚片用于EM腹腔镜术后，观察血清基质金属蛋白酶-3（MMP-3）、糖类抗原125（CA-125）及抗子宫内膜抗体（EMAb）等EM发病过程中的重要血清学指标，以期为该病治疗提供依据，现报道如下。……