摘要
目的:探讨左炔诺孕酮宫内缓释系统(LNG-IUS)结合促性腺激素释放激素激动剂(gonadotropin-releasing hormone agonist,GnRH-a)辅助治疗对重度子宫内膜异位症(endometriosis,EMT)行腹腔镜术患者卵巢功能及Th1、Th2类细胞因子的影响。方法:选取2018年2月-2019年3月安徽中医药大学第一附属医院收治并确诊的重度EMT患者102例,所有患者均行腹腔镜术,采用随机数字表法将患者分为观察组及对照组,每组51例。对照组患者宫内放置LNG-IUS,观察组在对照组的基础上注射GnRH-a,比较两组患者治疗前后卵巢功能及Th1、Th2类细胞因子水平变化。观察并记录药品不良反应(adverse drug reactions,ADRs)发生情况及复发率。结果:观察组患者治疗后卵泡刺激素(FSH)、雌二醇(E2)、促黄体生成素(LH)、白介素10(IL^(-1)0)、白介素4(IL-4)水平均低于治疗前及对照组(P<0.05),白介素2(IL-2)及γ干扰素(IFN-γ)水平高于治疗前及对照组(P<0.05)。观察组患者ADRs发生率与对照组患者比较,差异无统计学意义(13.73%vs 17.65%,P=0.586);观察组患者术后复发率显著低于对照组(3.92%vs 17.65%,P=0.025)。结论:LNG-IUS联合GnRH-a治疗重度EMT行腹腔镜术患者能有效恢复Th1、Th2类细胞因子平衡,降低生殖激素水平,改善患者卵巢功能。
Objective:To explore the effects of levonorgestrel intrauterine sustained-releasing system(LNG-IUS)combined with gonadotropin-releasing hormone agonist(GnRH-a)adjuvant therapy on the ovarian fuction and Th1 and Th2 cytokines of the patients undergoing laparoscopy for severe endometriosis(EMT).Methods:Totally,102 patients diagnosed as EMT and treated in the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from February 2018 to March 2019 were selected as research subjects,who all underwent laparoscopy.The patients were randomly divided into the observation group and the control group,each consisting of 51.The LNG-IUSs were placed in the womb of the patients of the control group,while the patients in the observation group were injected with GnRH-a on the basis of the treatment as received by the control group.Then,changes in the ovarian function and levels of Th1 and Th2 cytokines were compared between the 2 groups before and after treatment.The rates of adverse drug reactions(ADRs)and recurrence were observed and recorded in the process.Results:The levels of follicle stimulating hormone(FSH),estradiol(E-2),luteinizing hormone(LH),interleukin-10(IL^(-1)0)and IL-4 in the patients of the observation group were all lower than those before treatment and the control group(P<0.05).The levels of IL-2 and interferon-γ(IFN-γ)of the patients in the observation group were higher than those before treatment and the control group(P<0.05).There was no statistical significance in the rate of ADRs when comparisons were made between the observation group and the control group(13.73%vs 17.65%,P=0.586).The recurrence rate of the observation group was significantly lower than that of the control group(3.92%vs 17.65%,P=0.025).Conclusion:LNG-IUS combined with GnRH-a could effectively restore the balance of Th1 and Th2 cytokines in the patients with severe EMT undergoing laparoscopy,reduce the level of reproductive hormones,and improve ovarian function of the patients.
作者
陈顺霞
徐云霞
CHEN Shunxia;XU Yunxia(School of Postgraduate,Anhui University of Traditional Chinese Medicine,Hefei 230012,China;Department of Obstetrics and Gynecology,First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031,China)
出处
《药学服务与研究》
CAS
2021年第4期266-269,共4页
Pharmaceutical Care and Research
