1. 山东中医药大学附属医院中西医结合生殖与遗传中心
2. 山东中医药大学
纸质出版:2011
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[1]连方,韩春艳.祛瘀解毒方治疗血瘀蕴毒型子宫内膜异位症患者35例临床观察[J].中医杂志,2011,52(23):2013-2016.
LIAN Fang1, HAN Chunyan2. Clinical Observation on Quyu Jiedu Formula in the Treatment of 35 Endometriosis Cases in TCM Syndrome of Blood Stasis with Toxin Retention[J]. Journal of Traditional Chinese Medicine2011, 52(23): 2013-2016.
[1]连方,韩春艳.祛瘀解毒方治疗血瘀蕴毒型子宫内膜异位症患者35例临床观察[J].中医杂志,2011,52(23):2013-2016. DOI: 10.13288/j.11-2166/r.2011.23.010.
LIAN Fang1, HAN Chunyan2. Clinical Observation on Quyu Jiedu Formula in the Treatment of 35 Endometriosis Cases in TCM Syndrome of Blood Stasis with Toxin Retention[J]. Journal of Traditional Chinese Medicine2011, 52(23): 2013-2016. DOI: 10.13288/j.11-2166/r.2011.23.010.
目的观察祛瘀解毒方对血瘀蕴毒型子宫内膜异位症(EM)的临床疗效及机制。方法将70例EM患者随机分为祛瘀解毒方组、散结镇痛胶囊组各35例
另取35例同期在我院因输卵管阻塞行腹腔镜治疗的患者作为对照组。祛瘀解毒方组予祛瘀解毒方免煎冲剂口服
每日1剂
分2次口服。散结镇痛胶囊组给予散结镇痛胶囊
每次4片
每日3次口服。观察EM患者治疗前后症状、体征判定临床疗效
检测治疗前后患者血清中雌二醇(E2)、孕酮(P)、催乳激素(PRL)及血管内皮生长因子(VEGF)的变化
检测治疗后腹腔液VEGF水平
并统计EM患者1年内的妊娠率。结果祛瘀解毒方组总有效率82.86%高于散结镇痛胶囊组的77.14%(P<0.05)。两组患者治疗前血清E2、P、PRL、VEGF与对照组比较差异均有统计学意义(P<0.05)。两组患者治疗后痛经积分、血清E2、PRL、VEGF与治疗前比较差异均有统计学意义(P<0.01或P<0.05)。祛瘀解毒方组P较治疗前明显升高(P<0.01)。治疗后两组间比较
痛经积分、血清P、VEGF水平、腹腔液VEGF浓度差异均有统计学意义(P<0.05)。治疗后散结镇痛胶囊组血清VEGF水平及腹腔液VEGF浓度与对照组比较差异有统计学意义(P<0.05)。两组治疗后1年后的妊娠率的比较
祛瘀解毒方组不孕症患者15例
妊娠11例占73.33%;散结镇痛胶囊组不孕症患者18例
妊娠5例占27.78%
两组比较差异有统计学意义(P<0.05)。结论祛瘀解毒方治疗血瘀蕴毒型EM患者疗效肯定
其作用机理可能是通过改善盆腔局部血液循环
改善女性激素的分泌功能
降低血清及腹腔液VEGF的水平以减少异位病灶的形成而实现的。
Objective To observe the effect of Quyu Jiedu Formula (Formula for removing stasis and toxins) on endometriosis (EM) patients of blood stasis with toxin retention in TCM syndrome
and to study the possible mechanism. Methods Totally 70 EM patients were randomized into two groups
namely Quyu Jiedu Formula group and Sanjie Zhentong Capsule (Capsule for removing masses and stopping pain) group with 35 in each. And 35 patients treated simultaneously in our hospital accepting abdominoscope therapy for obstruction of oviduct were taken as the control group. The Quyu Jiedu Formula group was administered Quyu Jiedu Formula granules for oral taking
one dose per day and taken in two times. The Sanjie Zhentong Capsule group was given Sanjie Zhentong Capsule for oral taking
4 capsules each time
3 times a day. The improvement of symptoms and signs after treatment and the changes in estradiol (E2)
progesterone (P)
prolactin (PRL)
and the serum vascular endotheial growing factor (VEGF) were observed
the VEGF level of peritoneal fluid was determined
and the pregnancy rate of each group within one year was statistically calculated. Results The total effective rate in the Quyu Jiedu Formula group was 82.86%
while that in the Sanjie Zhentong Capsule group was 77.14%. The difference was statistically significant (P<0.05). Before treatment
there was significant difference in serum E2
P
PRL and VEGF between the two treatment groups and the control group. After treatment
the change in the scores of dysmenorrhea serum E2
PRL and VEGF of two groups were significant (P<0.01 or P<0.05). In the Quyu Jiedu Formula group
the P level was significantly increased after treatment (P<0.01). And after treatment
there was significant difference in scores of dysmenorrhea
serum P and VEGF
and peritoneal fluid VEGF between Quyu Jiedu Formula group and Sanjie Zhentong Capsule group (P<0.05). After treatment
VEGF in serum and peritoneal fluid of Sanjie Zhentong Capsule group showed statistical difference as compared with the control group (P<0.05). The comparison of pregnancy rate within one year showed that
there were 15 cases of infertility in the Quyu Jiedu Formula group
11 cases were pregnant
being 73.33%; there were 18 cases of infertility in the Sanjie Zhentong Capsule group
5 cases were pregnant
being 27.78%. The difference was statistically significant (P<0.05). Conclusion Quyu Jiedu Formula is an effective prescription for endometriosis patients in TCM syndrome of blood stasis with toxin retention
the possible mechanism is that it reduces the ectopic foci through improving the pelvic blood circulation
promoting the female hormone secretion
and decreasing the VEGF level of serum and abdominal fluid.
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