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目的观察促性腺激素释放激素激动剂(GnRHa)联合中药温肾消癥汤口服辅助治疗腹腔镜子宫内膜异位症术后的有效性和安全性。方法选择腹腔镜手术病理确诊为子宫内膜异位症的患者134例,按照是否接受辅助治疗及中药治疗的原则分为对照组、观察1组及观察2组。对照组22例术后未采用辅助治疗;观察1组42例,术后月经第1~5天开始予GnRHa 3.6 mg皮下注射,每隔28天注射1次;观察2组70例,术后月经第1~5天开始予GnRHa 3.6 mg皮下注射并联合中药温肾消瘢汤7剂口服,每隔28天注射并联合中药温肾消瘢汤口服1次,连续治疗观察3~6个月。观察治疗前后3组患者雌二醇(E_2)、促卵泡刺激素(FSH)及促黄体生成激素(LH)的变化、血清糖类癌抗原125(CA1 25)的变化、临床疗效及药物不良反应。结果与对照组比较,观察1、2组E_2、FSH及LH差异均有统计学意义(P<0.05),而观察1组与观察2组间E、FSH及LH比较,差异无统计学意义(P>0.05),3组间临床疗效比较差异有统计学意义(P<0.05);3组血清CA125的水平术前、术后比较,差异有统计学意义(P<0.01),与对照组比较,观察1、2组术后不同治疗时段差异均无统计学意义(P>0.05)。用药期间未见明显不良反应。结论 GnRHa联合温肾消瘢汤辅助治疗腹腔镜子宫内膜异位症术后临床疗效确切,并可降低E_2、FSH、LH水平,是治疗子宫内膜异位症较为理想的治疗方案。
Objective To observe the effectiveness and safety of GnRHa in combination with traditional Chinese medicine Wenshenxiaozitang in the adjuvant treatment of laparoscopic endometriosis. Methods 134 cases with endometriosis diagnosed by laparoscopic surgery were divided into control group, observation group 1 and observation group 2 according to the principle of receiving adjuvant therapy and Chinese medicine treatment. Twenty-two patients in the control group were treated with adjuvant therapy. In group 1, 42 patients were treated with subcutaneous injection of GnRHa 3.6 mg on the 1st to 5th days after the operation and once every 28 days. 1 to 5 days to GnRHa 3.6 mg subcutaneously and combined with traditional Chinese medicine Wenshenxiaozheng decoction oral, every 28 days and the combination of Chinese medicine Wenshenxiaozheng oral 1, continuous treatment for 3 to 6 months. The changes of estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH), the change of serum carbohydrate antigen 125 (CA1 25), clinical efficacy and adverse drug reaction were observed before and after treatment. . Results Compared with the control group, there were significant differences in E_2, FSH and LH between the observation group 1 and 2 (P <0.05), and there was no significant difference in the E, FSH and LH between the observation group 1 and the observation group 2 P> 0.05). There was significant difference in clinical curative effect between the three groups (P <0.05). The levels of serum CA125 in the three groups were statistically different before and after operation (P <0.01), compared with the control group There was no significant difference between the two groups in different treatment periods (P> 0.05). No significant adverse reactions during treatment. Conclusions GnRHa combined with Wenshenxiao Decoction can effectively reduce the levels of E_2, FSH and LH after laparoscopic endometriosis. It is an ideal treatment for endometriosis.