目的 探究止痛化癥胶囊联合亮丙瑞林治疗子宫内膜异位症的临床疗效。方法 选取2014年1月-2014年7月鄂州市中医医院妇产科收治的子宫内膜异位症患者98例,随机分为对照组和治疗组,每组各49例。对照组皮下注射注射用醋酸亮丙瑞林微球,3.75 mg/次,4周/次,若患者体质量<50 kg,则注射剂量减少50%。治疗组在对照组基础上口服止痛化癥胶囊,4粒/次,2次/d,月经期间停止服用。3个月为1个疗程,连续治疗2个疗程。观察两组的临床疗效,同时比较两组治疗前后促卵泡生成素(FSH)、黄体生成激素(LH)、雌二醇(E₂)、子宫体积、CA₁₂₅、Kupperman评分的变化。比较两组患者绝经症状发生情况。结果 治疗后,对照组和治疗组的总有效率分别为77.55%、91.84%,两组比较差异具有统计学意义(P < 0.05)。治疗后,两组FSH、LH、E₂、子宫体积、CA₁₂₅水平、Kupperman评分均显著降低,同组治疗前后差异具有统计学意义(P < 0.05);且治疗组这些指标的降低程度优于对照组,两组比较差异具有统计学意义(P < 0.05)。治疗组潮热出汗、感觉异常、失眠、情绪波动、抑郁、眩晕、疲乏、骨关节痛、头痛、心悸、皮肤蚊走感、泌尿感染、性生活障碍发生例数均显著低于对照组,两组比较差异具有统计学意义(P < 0.05)。治疗后,两组患者痛经、盆腔痛、性交痛的VAS评分均显著降低,同组治疗前后差异具有统计学意义(P < 0.05);且治疗后,治疗组痛经、盆腔痛的VAS评分低于对照组,两组比较差异具有统计学意义(P < 0.05)。结论 痛化癥胶囊联合亮丙瑞林治疗子宫内膜异位症具有较好的临床疗效,可降低患者FSH、LH、E₂水平和VAS评分,改善患者绝经症状,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Zhitong Huazheng Capsules combined with leuprorelin in treatment of endometriosis. Methods Patients (96 cases) with endometriosis in Department of Obstetrics and Gynecology of Ezhou Hospital of Traditional Chinese Medicine from January 2014 to July 2014 were randomly divided into control and treatment groups, and each group had 49 cases. The patients in the treatment group were sc administered with Leuprorelin Acetate Microspheres for injection, 3.75 mg/time, 4 weeks/time. If body quality of patients were low than 50 kg, the dosage was reduced by 50%. The patients in the treatment group were po administered with Zhitong Huazheng Capsules, 4 grains/time, twice daily, and they stopped taking during menstruation. Three months was as one course of treatment, and two groups were treated for two courses. After treatment, the efficacy was evaluated, and the changes of FSH, LH, E₂, uterine volume, CA₁₂₅ level, Kupperman scores in two groups before and after treatment were compared. The occurrences of menopause symptoms in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 77.55% and 91.84%, respectively, and there were differences between two groups (P < 0.05). After treatment, FSH, LH, E₂, uterine volume, CA₁₂₅ level, Kupperman scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). The improved degree of those observation indicators in the treatment group was better than those in the control group, with significant difference between two groups (P < 0.05). The cases of hot flashes sweating, paresthesia, insomnia, mood swings, depression, joint pain, headache, dizziness, fatigue, palpitations, mosquito go feeling skin, urinary infection, and sexual dysfunction in the treatment group were more than those in the control group, and there were differences between two groups (P < 0.05). After treatment, VAS scores of menalgia, pelvic pain, and algopareunia in two groups were decreased, and the difference was statistically significant in the same group (P < 0.05). VAS scores of menalgia and pelvic pain in the treatment group were lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Zhitong Huazheng Capsules combined with leuprorelin has distinct clinical effect in treatment of endometriosis, and can reduce levels of FSH, LH, E₂ and VAS score, and also can improve the clinical symptoms and signs, which has certain clinical application value.