本文選題：子宮內(nèi)膜異位癥 + 氣滯血瘀證��； 參考：《中國實(shí)驗(yàn)方劑學(xué)雜志》2017年21期

【摘要】：目的:探討宮瘤消膠囊治療子宮內(nèi)膜異位癥(EMs)氣滯血瘀證的臨床療效及對(duì)血管內(nèi)皮生長因子(VEGF),基質(zhì)金屬蛋白酶(MMP),堿性成纖維細(xì)胞生長因子(b FGF),轉(zhuǎn)化生長因子-β1(TGF-β1)和腫瘤壞死因子-α(TNF-α)等促血管生成因子水平的影響。方法:將128符合EMs氣滯血瘀證患者,采用SAS軟件生成的,隨機(jī)按數(shù)字表法分為對(duì)照組和觀察組各64例。兩組患者均服用孕三烯酮膠囊,2.5 mg/次,2次/周,于月經(jīng)第1天開始,每周固定時(shí)間服藥。觀察組加服宮瘤消膠囊,4粒/次,3次/d。兩組療程均連續(xù)治療6個(gè)月經(jīng)周期。經(jīng)期疼痛情況采用視覺模擬評(píng)分(VAS)評(píng)分,進(jìn)行治療前后非月經(jīng)期的盆腔痛、性交疼痛、盆腔壓痛、骶韌帶觸痛結(jié)節(jié)和氣滯血瘀證評(píng)分;檢測治療前后血清癌抗原125(CA125),CA199,VEGF,MMP-2,MMP-9,b FGF,TGF-β1和TNF-α水平。結(jié)果:觀察組臨床總有效率為91.67%,高于對(duì)照組的76.27%(χ2=5.255,P0.05);觀察組在第4,5,6個(gè)月經(jīng)周期VAS評(píng)分均低于對(duì)照組(P0.01);治療后觀察組非月經(jīng)期的盆腔痛、性交疼痛、盆腔壓痛、骶韌帶觸痛結(jié)節(jié)評(píng)分均低于對(duì)照組(P0.01),觀察組氣滯血瘀證評(píng)分低于對(duì)照組(P0.01);觀察組患者血清CA125和CA199水平均低于對(duì)照組(P0.01);觀察組患者血清VEGF,MMP-2,MMP-9,b FGF,TGF-β1和TNF-α水平均低于對(duì)照組(P0.01)。結(jié)論:宮瘤消膠囊治療子宮內(nèi)膜異位癥氣滯血瘀證患者,能顯著緩解患者的疼痛相關(guān)癥狀,提高臨床療效,并能降低VEGF等促血管生成因子水平,從不同靶點(diǎn)抑制新生血管的形成,起到控制病情的作用。
[Abstract]:Objective: to investigate the clinical effect of Gongliuxiao capsule in treating endometriosis with syndrome of Qi stagnation and blood stasis, and to investigate the effects of Gongliuxiao capsule on vascular endothelial growth factor (VEGF), matrix metalloproteinase (MMPP), basic fibroblast growth factor (bFGF), transforming growth factor- 尾 _ (1) (TGF- 尾 _ (1)) and TGF- 尾 _ (1) in endometriosis.Effect of tumor necrosis factor-偽 and TNF- 偽 on the level of angiogenic factors.Methods: the patients with EMs Qi stagnation and Blood stasis Syndrome were randomly divided into control group (n = 64) and observation group (n = 64).The patients in both groups were treated with pregnancy trienone capsule 2. 5 mg/ twice a week, starting on the first day of menstruation and taking medicine at a fixed time every week.The observation group was treated with 4 capsules of Gongliuxiao capsule / 3 times per day.The two groups were treated continuously for 6 menstrual cycles.Visual analogue scale (VASS) was used to evaluate the pain in menstrual period, including pelvic pain, sexual pain, pelvic tenderness, tenderness of sacral ligament and blood stasis of qi before and after treatment, and the levels of serum cancer antigen 125 CA125 / CA199VEGFU MMP-2MMP-9b FGFTGF- 尾 1 and TNF- 偽 were detected before and after treatment.Results: the total clinical effective rate of the observation group was 91.67, which was higher than that of the control group (76.27), the VAS score of the observation group was lower than that of the control group in the 4th week (P 0.05), 6 menstrual cycles in the observation group was lower than that in the control group (P 0.01), after treatment, the pelvic pain, sexual intercourse pain and pelvic tenderness in the observation group were lower than those in the control group.The score of the sacral ligament tenderness nodule was lower than that of the control group (P 0.01), the score of qi stagnation and blood stasis in the observation group was lower than that of the control group (P 0.01), the levels of serum CA125 and CA199 in the observation group were lower than those in the control group (P 0.01), and the serum levels of VEGF, MMP-2, MMP-9, FGF- 尾 1 and TNF- 偽 in the observation group were lower than those in the control group (P 0.01).Conclusion: Gongyuxiao capsule in treating endometriosis patients with Qi stagnation and blood stasis syndrome can significantly relieve the pain related symptoms, improve the clinical efficacy, and reduce the level of angiogenic factors such as VEGF.From different targets inhibit the formation of neovascularization, play a role in controlling the disease.
【作者單位】： 鄭州大學(xué)第一附屬醫(yī)院;
【基金】：河南省醫(yī)藥科技攻關(guān)項(xiàng)目(2016020103)
【分類號(hào)】：R271.9

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