目的 探討桂枝茯苓丸聯(lián)合地諾孕素片治療子宮內(nèi)膜異位癥的臨床療效。方法 選取2020年2月—2022年2月在周口市中醫(yī)院就診的90例子宮內(nèi)膜異位癥患者，按照隨機(jī)數(shù)字表法將90例患者分為對照組和治療組，每組各45例。對照組口服地諾孕素片，1片/次，1次/d。治療組在對照組基礎(chǔ)上口服桂枝茯苓丸，9粒/次，2次/d。兩組患者連續(xù)治療3個(gè)月。觀察兩組的臨床療效，比較兩組的病灶最長直徑、疼痛程度以及血清中雌二醇、促黃體生成素、血管細(xì)胞黏附因子-1（VCAM-1）、血管內(nèi)皮生長因子（VEGF）、血清糖類抗原125（CA125）水平。結(jié)果 治療后，治療組的總有效率88.89%高于對照組的總有效率66.67%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組病灶最長直徑、數(shù)字疼痛強(qiáng)度量表（NRS）評(píng)分均明顯減?。?i>P<0.05），治療組的病灶最長直徑、NRS評(píng)分小于對照組（P<0.05）。治療后，兩組雌二醇、促黃體生成素水平較治療前降低（P<0.05），治療組的雌二醇、促黃體生成素低于對照組（P<0.05）。治療后，兩組的血清VCAM-1、VEGF、CA125水平均顯著降低（P<0.05）；且治療組的血清VCAM-1、VEGF、CA125水平均顯著低于對照組（P<0.05）。結(jié)論 桂枝茯苓丸聯(lián)合地諾孕素片可提高子宮內(nèi)膜異位癥的療效，有助于減輕疼痛程度，縮小病灶大小，降低激素水平，調(diào)節(jié)血清VCAM-1、VEGF、CA125水平。

Objective To investigate the clinical effect of Guizhi Fuling Pills combined with Dienogest Tablets in treatment of endometriosis. Methods Patients (90 cases) with endometriosis in Zhoukou Hospital of TCM from February 2020 to February 2022 were divided into control and treatment groups according to random number table method, and each group had 45 cases. Patients in the control group were po administered with Dienogest Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Guizhi Fuling Pills on the basis of the control group, 9 pills/time, twice daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and the longest diameter of the lesion, the degree of pain, and the serum levels of estradiol, luteinizing hormone, VCAM-1, VEGF, and CA125 in two groups were compared. Results After treatment, the total effective rate of the treatment group was 88.89%, which was higher than that of the control group (66.67%), and the difference was statistically significant (P < 0.05). After treatment, the longest diameter of the lesions and the NRS score in two groups were significantly decreased (P < 0.05), and the longest diameter of the lesions and the NRS score in the treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of estradiol and luteinizing hormone in two groups were decreased compared with those before treatment (P < 0.05), and the levels of estradiol and luteinizing hormone in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum levels of VCAM-1, VEGF, and CA125 in both groups were significantly decreased (P < 0.05). The serum levels of VCAM-1, VEGF, and CA125 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Guizhi Fuling Pills combined with Dienogest Tablets has clinical curative effect in treatment of endometriosis, can helps to reduce the degree of pain, reduce the size of lesions, reduce hormone levels, and regulate the serum levels of VCAM-1, VEGF, and CA125.

R984

河南省醫(yī)學(xué)教育研究項(xiàng)目（Wjjx2020115）