| 摘要: |
| 目的:观察腹腔镜联合莪棱内异汤保留灌肠治疗子宫内膜异位症(EMs)不孕的临床疗效及对患者血清基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)的影响。方法:将85例EMs患者随机分为A、B、C3组,A组30例采用腹腔镜手术联合莪棱内异汤保留灌肠治疗,B组28例采用腹腔镜手术配合米非司酮片口服治疗,C组27例单纯行腹腔镜手术治疗。观察3组治疗前后中医证候积分及血清MMP-9、TIMP-1水平的变化,比较3组术后3、6、12月后的妊娠率。结果:治疗后,A、B2组的中医证候积分均较治疗前下降(P<0.05),A、B2组治疗前后中医证候积分的差值均大于C组(P<0.05)。术后3月,A、C2组的妊娠率均高于B组(P<0.05)。术后6月和术后12月,A、B2组的妊娠率均高于C组(P<0.05)。治疗后,3组MMP-9水平及MMP-9/TIMP-1值均较治疗前下降(P<0.05),A、B2组TIMP-1水平均较治疗前升高(P<0.05)。A、B组2组MMP-9水平及MMP-9/TIMP-1值均较C组下降更明显(P<0.05),TIMP-1水平均较C组上升更明显(P<0.05)。结论:腹腔镜联合莪棱内异汤保留灌肠可有效改善EMs不孕患者的临床症状,使MMP-9和TIMP-1趋于平衡,提高临床妊娠率。 |
| 关键词: 子宫内膜异位症(EMs) 不孕 腹腔镜 莪棱内异汤 保留灌肠 米非司酮片 基质金属蛋白酶-9(MMP-9) 基质金属蛋白酶抑制剂-1(TIMP-1) |
| DOI： |
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| 基金项目:江苏省中医药局科研项目（LZ13130） |
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| Abstract: |
| Objective：To observe the clinical effect of combination treatment of laparoscopy and retention enema with E'leng Neiyi tang for infertility due to endometriosis(EMs)，and its effect on matrix metalloproteinase 9(MMP-9)and tissue inhibitor of metalloproteinase-1(TIMP-1).Methods：Divided 85 EMs patients into the group A，group B and group C.The 30 cases in the group A were treated with combination treatment of laparoscopy and retention enema with E'leng Neiyi tang，while the group B was treated with laparoscopy combined with oral Mifepristone tablets and the group C was treated with laparoscopy only.Observed change of Chinese syndrome score of the three groups before and after treatment，and level of serum MMP-9 and TIMP-1，and compared pregnancy rate of the three groups after three months，six months and twelve months of operation.Results：After treatment，Chinese syndrome scores of the group A and group B were lower than those before treatment(P＜0.05)，and the difference of Chinese syndrome score in the group A and group B before and after treatment was both significant than that in the group C(P＜0.05).After three months of treatment，pregnancy rate of the group A and group C was both higher than that of the group B(P＜0.05).After six and twelve months of treatment，pregnancy rate of the group A and group B was both higher than that of the group C(P＜0.05).After treatment，MMP-9 levels and value of MMP-9/TIMP-1 of the three groups were all lower than those before treatment(P＜0.05).TIMP-1 levels of group A and group B were higher than those before treatment(P＜0.05).The decline of MMP-9 levels and value of MMP-9/TIMP-1 in the group A and group B was more significant than that in the group C，while increase of TIMP-1 levels was higher than that of the group C(P＜0.05).Conclusion：The combination treatment of laparoscopy and retention enema with E'leng Neiyi tang can effectively improve postoperative clinical symptoms of patients with infertility，which helps to balance MMP-9 and TIMP-1，and improve clinical pregnancy rate. |
| Key words: Endometriosis(EMs) Infertility Laparoscopy E'leng Neiyi tang Retention enema Mifepristone tablets Matrix metalloproteinase 9(MMP-9) Tissue inhibitor of metalloproteinase-1(TIMP-1) |
