目的 探究止痛化癥膠囊聯(lián)合亮丙瑞林治療子宮內(nèi)膜異位癥的臨床療效。方法 選取2014年1月-2014年7月鄂州市中醫(yī)醫(yī)院婦產(chǎn)科收治的子宮內(nèi)膜異位癥患者98例,隨機(jī)分為對(duì)照組和治療組,每組各49例。對(duì)照組皮下注射注射用醋酸亮丙瑞林微球,3.75 mg/次,4周/次,若患者體質(zhì)量<50 kg,則注射劑量減少50%。治療組在對(duì)照組基礎(chǔ)上口服止痛化癥膠囊,4粒/次,2次/d,月經(jīng)期間停止服用。3個(gè)月為1個(gè)療程,連續(xù)治療2個(gè)療程。觀察兩組的臨床療效,同時(shí)比較兩組治療前后促卵泡生成素(FSH)、黃體生成激素(LH)、雌二醇(E₂)、子宮體積、CA₁₂₅、Kupperman評(píng)分的變化。比較兩組患者絕經(jīng)癥狀發(fā)生情況。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為77.55%、91.84%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。治療后,兩組FSH、LH、E₂、子宮體積、CA₁₂₅水平、Kupperman評(píng)分均顯著降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05);且治療組這些指標(biāo)的降低程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。治療組潮熱出汗、感覺異常、失眠、情緒波動(dòng)、抑郁、眩暈、疲乏、骨關(guān)節(jié)痛、頭痛、心悸、皮膚蚊走感、泌尿感染、性生活障礙發(fā)生例數(shù)均顯著低于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。治療后,兩組患者痛經(jīng)、盆腔痛、性交痛的VAS評(píng)分均顯著降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05);且治療后,治療組痛經(jīng)、盆腔痛的VAS評(píng)分低于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。結(jié)論 痛化癥膠囊聯(lián)合亮丙瑞林治療子宮內(nèi)膜異位癥具有較好的臨床療效,可降低患者FSH、LH、E₂水平和VAS評(píng)分,改善患者絕經(jīng)癥狀,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Zhitong Huazheng Capsules combined with leuprorelin in treatment of endometriosis. Methods Patients (96 cases) with endometriosis in Department of Obstetrics and Gynecology of Ezhou Hospital of Traditional Chinese Medicine from January 2014 to July 2014 were randomly divided into control and treatment groups, and each group had 49 cases. The patients in the treatment group were sc administered with Leuprorelin Acetate Microspheres for injection, 3.75 mg/time, 4 weeks/time. If body quality of patients were low than 50 kg, the dosage was reduced by 50%. The patients in the treatment group were po administered with Zhitong Huazheng Capsules, 4 grains/time, twice daily, and they stopped taking during menstruation. Three months was as one course of treatment, and two groups were treated for two courses. After treatment, the efficacy was evaluated, and the changes of FSH, LH, E₂, uterine volume, CA₁₂₅ level, Kupperman scores in two groups before and after treatment were compared. The occurrences of menopause symptoms in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 77.55% and 91.84%, respectively, and there were differences between two groups (P < 0.05). After treatment, FSH, LH, E₂, uterine volume, CA₁₂₅ level, Kupperman scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). The improved degree of those observation indicators in the treatment group was better than those in the control group, with significant difference between two groups (P < 0.05). The cases of hot flashes sweating, paresthesia, insomnia, mood swings, depression, joint pain, headache, dizziness, fatigue, palpitations, mosquito go feeling skin, urinary infection, and sexual dysfunction in the treatment group were more than those in the control group, and there were differences between two groups (P < 0.05). After treatment, VAS scores of menalgia, pelvic pain, and algopareunia in two groups were decreased, and the difference was statistically significant in the same group (P < 0.05). VAS scores of menalgia and pelvic pain in the treatment group were lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Zhitong Huazheng Capsules combined with leuprorelin has distinct clinical effect in treatment of endometriosis, and can reduce levels of FSH, LH, E₂ and VAS score, and also can improve the clinical symptoms and signs, which has certain clinical application value.