摘要
目的 探讨自拟盆炎方联合宫腔镜电切术治疗子宫内膜息肉的临床效果,并分析其对患者术后复发的影响。方法 选取2020年3月—2021年3月湖南中医药大学第二附属医院收治的150例子宫内膜息肉患者为研究对象,按照随机数字表法分为中药组、西药组及对照组,每组各50例,均行宫腔镜子宫内膜电切术治疗。西药组患者给予地屈孕酮治疗,中西药组患者给予盆炎方治疗,对照组患者不予任何治疗。比较3组患者术前和治疗后月经状况、子宫内膜厚度、性激素水平及治疗效果,术后1年复发率。结果 术前,3组患者月经量、经期比较,差异均无统计学意义(均P>0.05);术后,中药组和西药组患者月经量减少程度均明显优于对照组,差异均有统计学意义(均P<0.05),且中药组患者优于西药组,但差异无统计学意义(P>0.05);术后,中药组和西药组患者经期缩短程度均明显优于对照组,差异均有统计学意义(均P<0.05),且中药组患者优于西药组,差异有统计学意义(P<0.05)。术前,3组患者子宫内膜厚度比较,差异无统计学意义(P>0.05)。术后3个月、术后6个月,中药组和西药组患者子宫内膜厚度均低于对照组,差异均有统计学意义(均P<0.05),西药组和中药组比较,差异无统计学意义(P>0.05)。术前,3组患者性激素水平比较,差异无统计学意义(P>0.05)。术后,中药组和西药组患者血清雌二醇(E;)、黄体生成素(LH)及卵泡刺激素(FSH)水平均低于对照组,差异均有统计学意义(均P<0.05);中药组患者LH和FSH水平优于西药组,差异均有统计学意义(均P<0.05),两组患者血清E;水平比较,差异无统计学意义(P>0.05)。中药组和西药组治疗总有效率(96.00%、92.00%)明显高于对照组(86.00%),差异有统计学意义(χ^(2)=24.326,P<0.05)。中药组总复发率低于西药组,差异有统计学意义(P<0.05)。治疗期间,西药组患者出现恶心、呕吐等不良反应7例,中药组患者无不良反应发生。结论 子宫内膜息肉宫腔镜电切术后联合使用自拟盆炎方治疗可显著改善患者月经状况,降低子宫内膜厚度,且复发率较低,值得临床推广。
Objective To investigate the clinical effect of self-made Penyan recipe combined with hysteroscopic resection in the treatment of endometrial polyps, and to analyze its effect on postoperative recurrence. Methods From March 2020 to March 2021, 150 patients with endometrial polyps who were admitted to the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine were selected as the research objects, and were divided into a traditional Chinese medicine group, a western medicine group and a control group according to the random number table method. Fifty cases in each group were treated with hysteroscopic endometrial resection. The western medicine group was given dydrogesterone, the Chinese and western medicine group was given Penyan prescription, and the control group was not given any treatment. The menstrual status, endometrial thickness, sex hormone level and treatment effect were compared between the three groups before and after treatment, and the recurrence rate 1 year after surgery. Results Before operation, there was no significant difference in menstrual volume and menstrual period among the three groups(all P>0.05);The degree of less menstrual flow was significantly better than that of the control group, and the difference was statistically significant(all P<0.05), and the traditional Chinese medicine group was better than the western medicine group, but the difference was not statistically significant(P>0.05). The menstrual period shortening degree of patients in both group and western medicine group was significantly better than that in control group, and the difference was statistically significant(both P<0.05). Before surgery, there was no significant difference in endometrial thickness among the three groups(P>0.05). At 3 months and 6 months after the operation, the endometrial thickness of the patients in the Chinese medicine group and the western medicine group was lower than that in the control group, and the difference was statistically significant(both P<0.05). There was no difference between the western medicine group and the Chinese medicine group. Statistical significance(P>0.05). Before surgery, there was no significant difference in the levels of sex hormones among the three groups(P>0.05). After operation, the serum estradiol(E;), luteinizing hormone(LH) and follicle-stimulating hormone(FSH) levels in the traditional Chinese medicine group and the western medicine group were lower than those in the control group, and the differences were statistically significant(all P<0.05);LH and the level of FSH was better than that of the western medicine group, and the difference was statistically significant(all P<0.05). There was no significant difference in the serum E;level between the two groups(P>0.05). The total effective rate(96.00%, 92.00%) of the traditional Chinese medicine group and the western medicine group was significantly higher than that of the control group(86.00%), and the difference was statistically significant(χ^(2)=24.326, P<0.05). The total recurrence rate in the traditional Chinese medicine group was lower than that in the western medicine group, and the difference was statistically significant(P<0.05). During the treatment, 7 cases of adverse reactions such as nausea and vomiting occurred in the western medicine group, and no adverse reactions occurred in the traditional Chinese medicine group. Conclusion Combined use of self-made Penyan recipe after hysteroscopic resection of endometrial polyps can significantly improve menstrual status, reduce endometrial thickness, and have a low recurrence rate, which is worthy of clinical promotion.
作者
谢星
刘梅
匡继林
XIE Xing;LIU Mei;KUANG Ji-Lin(Hunan University of Traditional Chinese Medicine,Changsha,Hunan 410208,China)
出处
《中国妇幼保健》
CAS
2022年第9期1571-1575,共5页
Maternal and Child Health Care of China
基金
湖南省中医药科研计划项目(202012)。
关键词
自拟盆炎方
子宫内膜息肉
宫腔镜
术后
复发
Self-made Penyan recipe
Endometrialpolyps
Hysteroscopic electroresection
Postoperative
Relapse
