目的 探讨桂枝茯苓胶囊联合地诺孕素治疗子宫内膜异位症的疗效。方法 选取2019年4月—2020年1月在郑州大学第二附属医院接受治疗的子宫内膜异位症患者175例，随机分为对照组（n=87）和治疗组（n=88）。对照组口服地诺孕素片，于月经周期第2天开始服用，2 mg/次，1次/d。治疗组患者在对照组基础上口服桂枝茯苓胶囊，3 粒/次，3次/d。两组均连续治疗3个月。观察两组的临床疗效，比较两组血清激素、VAS评分、囊肿直径、血清因子和血清抗原的变化情况。结果 治疗后，对照组患者总有效率是75.86%，显著低于治疗组的95.45%，两组比较差异具有统计学意义（P<0.05）。治疗后，血清中促卵泡雌激素（FSH）、促黄体生成素（LH）、雌二醇（E₂）和孕酮（P）水平明显低于治疗前水平（P<0.05）；治疗组在治疗后血清中E₂和P水平显著低于对照组治疗后的同期水平（P<0.05）。治疗后，视觉模拟评分法（VAS）评分和囊肿直径都明显降低（P<0.05）；治疗组在治疗后VAS评分和囊肿直径显著低于对照组治疗后的同期水平（P<0.05）。治疗后，血清中金属蛋白酶（MMP）-2、MMP-9、半乳糖凝集素-3（Gal-3）和血管内皮生长因子（VEGF）水平明显低于治疗前的水平（P<0.05）；治疗组在治疗后MMP-2、MMP-9、Gal-3和VEGF水平显著低于对照治疗后的同期水平（P<0.05）。治疗后，血清中C_A199和C_A125水平显著低于治疗前的水平（P<0.05）；治疗组在治疗后血清中C_A199和C_A125水平明显低于对照组治疗后的同期水平（P<0.05）。结论 桂枝茯苓胶囊联合地诺孕素治疗子宫内膜异位症具有良好的效果，可有效降低血清因子和血清抗原水平，降低VAS评分和囊肿直径，具有一定的临床推广应用价值。

Objective To investigate the curative effect of Guizhi Fuling Capsules combined with denogest in treatment of endometriosis. Methods 175 Patients with endometriosis who were admitted to the Second Affiliated Hospital of Zhengzhou University from April 2019 to January 2020 were randomly divided into control group (n = 87) and treatment group (n = 88). The control group was po administered with Dienogest Tablets, started on the second day of the menstrual cycle, 2 mg/time, once daily. The treatment group was po administered with Guizhi Fuling Capsules on the basis of the control group, 3 grains/time, 3 times daily. The clinical efficacy of the two groups was observed, and the changes of serum hormones, VAS score, cyst diameter, serum factors and serum antigens were compared between the two groups. Results After treatment, the total effective rate in the control group was 75.86%, significantly lower than 95.45% in the treatment group, and there were differences between two groups (P<0.05). After treatment, serum levels of follicle-stimulating estrogen (FSH), luteinizing hormone (LH), estradiol (E₂) and progesterone (P) were significantly lower than those before treatment (P<0.05). After treatment, the serum E₂ and P levels in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, VAS score and cyst diameter were significantly reduced after treatment (P<0.05). After treatment, VAS score and cyst diameter in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the serum levels of metalloproteinase (MMP-2), MMP-9, galactosin -3 (Gal-3) and vascular endothelial growth factor (VEGF) were significantly lower than those before treatment (P<0.05). After treatment, the levels of MMP-2, MMP-9, Gal-3 and VEGF in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, serum levels of C_A199 and C_A125 were significantly lower than those before treatment (P<0.05). The serum levels of C_A199 and C_A125 in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Guizhi Fuling Capsules combined with denogest has a good effect in treatment of endometriosis, and can effectively reduce the serum factor and serum antigen levels, and also can reduce VAS score and cyst diameter, which has a certain clinical application value.

R984

河南省科技厅基础项目（142300410240）