Curative effect observation of Zishen Liangxue Tiaozhou method in the treatment of endometriosis with infertility patients and effect of VEGF in serum
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摘要: 目的 观察滋肾凉血调周法治疗子宫内膜异位症合并不孕患者的临床疗效,探讨该法提高本病妊娠率的作用机制。 方法 将2015年7月-2016年12月宁波市中医院收治的146例患者,按照r-AFS分期法,分为轻度组64例(按随机数字表法分为中药组、对照组各32例),中重度组82例(按随机数字表法分为中药组、对照组各41例)。轻度组:中药组术后首次月经来潮开始按滋肾凉血调周法服用中药,服药及观察各3个月经周期;对照组术后不用药,观察6个月经周期。中重度组:中药组及对照组均于术后首次月经来潮第1天GnRH-α 3.6 mg皮下注射,每4周1次,共3针,其后治疗同轻度组。比较治疗前后各组患者中医证候的改善情况,血清VEGF水平的变化,以及治疗后半年内的妊娠情况。 结果 ①中医证候积分均较治疗前明显改善(P<0.01),组间比较,中药组均优于对照组(P<0.05)。②血清VEGF水平均较治疗前明显下降(P<0.01),组间比较,中药组下降幅度均优于对照组(P<0.05)。③妊娠率:轻度组的中药组为46.88%,对照组为21.88%;中重度组的中药组为43.90%,对照组为21.95%;组间比较,中药组妊娠率均高于对照组(P<0.05)。 结论 滋肾凉血调周法可以显著改善内异症合并不孕患者的临床症状,明显降低血清VEGF水平,提高患者的妊娠率,其机制可能与抑制VEGF的过度表达、阻断异位病灶的新生血管形成有关。Abstract: Objective To observe the clinical effect of Zishen Liangxue Tiaozhou method in the treatment of endometriosis with infertility patients,and to explore the mechanism of this method to improve the pregnancy rate of patients. Methods According to the r-AFS staging method, 146 patients were divided into the mild group 64 cases (32 cases of the chinese herbal group and the control group) and the moderate to severe group 82 cases (41 cases of the Chinese herbal group and the control group). The mild group:the chinese herbal group were treated with Liangxue Zishen Tiaozhou method from the beginning of the first menstruation for three menstrual cycle, and then observed three menstrual cycle; the control group were observed six menstrual cycles without medication after surgery. The middle to severe group:the Chinese herbal group and the control group were both injected subcutaneously with GnRH-a 3.6 mg on the first day of menstruation, once every four weeks, a total of three needles, and the next treatment were the same as the mild group. Before and after treatment, to compare the improvement of the TCM syndromes, the change of serum levels of VEGF, and the condition of pregnancy within six months after treatment. Results ① The TCM syndrome integral all significantly improved than before in each groups (P<0.01), and between the groups, the Chinese herbal group were both better than the control group (P<0.05). ② The serum of VEGF were all significantly lower than before in each groups (P<0.01), and between the groups, the Chinese herbal group were both better than the control group (P<0.05). ③ The pregnancy rate:the mild group:the chinese herbal group was 46.88%, the control group was 21.88%; the moderate to severe group:the chinese herbal group was 43.90%, and the control group was 21.95%; and between the groups, the Chinese herbal group were both higher than the control group (P<0.05). Conclusion The Liangxue Zishen Tiaozhou method can significantly improve the clinical symptoms of endometriosis with infertility patients, obviously decrease the serum levels of VEGF, and increase the pregnancy rate. The mechanism might be inhibiting excessive expression of VEGF and blocking the formation of neovascularization with ectopic foci.
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Key words:
- Zishen Liangxue /
- Endometriosis /
- Infertility /
- Vascular endothelial growth factor
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