摘要
目的:探讨宫腔中放置左炔诺孕酮宫内节育系统(levonorgestrel releasing intrauterine system,LNG-IUS)联合桂枝茯苓丸对年轻子宫内膜息肉切除术(transcervical resection of polyp,TCRP)后患者月经情况、宫腔灌洗液炎症指标及复发率的影响。方法:将接受TCRP治疗的年轻子宫内膜息肉(endometrial polyps,EMP)患者104例以随机数字表法分为研究组、对照组各52例。对照组术后于宫腔中放置LNG-IUS,研究组在对照组基础上服用桂枝茯苓丸3个月。比较两组患者临床疗效、治疗后1年复发情况、不良反应及治疗前后月经量评分(pictorial blood loss assessment chart,PBAC)、中医证候积分、宫腔灌洗液中炎症指标[干扰素γ(interferonγ,IFN-γ)、白细胞介素6(interleukin-6,IL-6)、白细胞介素1β(interleukin-1β,IL-1β)]水平、腺上皮与间质孕激素受体(progesterone receptor,PR)、雌激素受体(estrogen receptor,ER)表达分级。结果:研究组治疗后总有效率为96.15%(50/52),高于对照组的80.77%(42/52)(P<0.05);研究组治疗1、3个月PBAC评分、中医证候积分、ER表达分级及宫腔灌洗液中IFN-γ、IL-1β水平均低于对照组(P<0.05),IL-6水平、腺上皮与间质PR表达分级均高于对照组(P<0.05);不良反应发生率研究组为7.69%(4/52),与对照组5.77%(3/52)相比,差异无统计学意义(P>0.05);研究组治疗后1年复发率为3.92%(2/51),低于对照组的18.00%(9/50)(P<0.05)。结论:宫腔中放置LNG-IUS联合桂枝茯苓丸可提高TCRP术后患者疗效,调整子宫内膜PR、ER表达水平,减轻宫腔炎症反应,改善患者月经情况,降低疾病复发率,且安全性良好。
Objective:To discuss the influence of intrauterine placement of levonorgestrel-releasing intrauterine device(LNG-IUS)joined with Guizhi Fuling pills on menstrual status,inflammatory indexes of uterine lavage fluid and the relapse rate in young patients with transcervical resection of polyp(TCRP).Methods:All 104 young patients with endometrial polyps who accepted TCRP were allocated to the study group and the control group in light of random table method,with 52 cases in each group.The control group accepted intrauterine placement of LNG-IUS after the surgery,and the study group took Guizhi Fuling pills for three months based on the therapy the control group received.To compare clinical effects,recurrence one year after the treatment,adverse reaction,menstrual volume scores PBAC before and after the treatment,TCM syndrome integrals,the levels of the inflammatory indexes of uterine lavage fluid(IFN-γ,IL-6 and IL-1β),PR and ER expression grading in glandular epithelium and mesenchyme in the two groups.Results:Total effective rate of the study group after the treatment was 96.15%(50/52),higher than 80.77%(42/52)of the control group(P<0.05);PBAC scores,TCM syndrome integrals,ER expression grading,and the levels of IFN-γand IL-1βof uterine lavage fluid of the study group were lower than these of the control group after one month and three months of the treatment(P<0.05),the levels of IL-6,PR expression grading in glandular epithelium and mesenchyme were higher than these of the control group(P<0.05);the incidence of adverse reaction of the study group was 7.69%(4/52),compared with 5.77%(3/52)of the control group,the difference had no statistical meaning(P>0.05);the recurrence rate one year after the treatment was 3.92%(2/51)in the study group,lower than 18.00%(9/50)of the control group(P<0.05).Conclusion:Intrauterine placement of LNG-IUS combined with Guizhi Fuling pills could raise the patients'clinical effects after TCRP,regulate the expression of endometrial PR and ER,relieve uterine inflammatory reaction,improv
作者
古衡芳
肖雁冰
赵菁
牟萌
蒋成素
GU Hengfang;XIAO Yanbing;ZHAO Jing;MOU Meng;JIANG Chengsu(Zunyi Maternal and Child Health Care Hospital,Zunyi 563000,China)
出处
《西部中医药》
2023年第9期115-119,共5页
Western Journal of Traditional Chinese Medicine
基金
国家自然科学基金(81660293)。
