目的 探讨小金胶囊联合醋酸戈舍瑞林缓释植入剂治疗子宫内膜异位症的临床疗效。方法 选取2019年3月—2020年6月郑州大学第二附属医院收治的90例子宫内膜异位症患者，按照随机数字表法将所有患者分为对照组和治疗组，每组各有45例。对照组于月经第1天皮下注射醋酸戈舍瑞林缓释植入剂，3.6 mg/次，1次/4周。治疗组在对照组基础上口服小金胶囊，4粒/次，2次/d。两组患者连续治疗6个月。观察两组的临床疗效，比较两组患者治疗前后病灶体积、子宫内膜厚度变化、血清雌二醇（E₂）、黄体生成素（LH）、卵泡刺激素（FSH）、血管内皮生长因子（VEGF）、基质金属蛋白酶3（MMP-3）、转化生长因子-β₁（TGF-β₁）水平。结果 治疗后，治疗组患者的总有效率为93.33%，对照组为77.78%，两组比较差异有统计学意义（P<0.05）。治疗后，两组的病灶体积、子宫内膜厚度显著降低（P<0.05）；且治疗组的病灶体积、子宫内膜厚度比对照组低，差异有统计学意义（P<0.05）。治疗后，两组的E₂、LH、FSH水平显著降低（P<0.05），以治疗组E₂、LH、FSH水平降低的更明显（P<0.05）。治疗后，两组的VEGF、MMP-3、TGF-β₁水平显著降低，差异有统计学意义（P<0.05）；且治疗组的VEGF、MMP-3、TGF-β₁水平比对照组低，差异有统计学意义（P<0.05）。结论 小金胶囊联合醋酸戈舍瑞林缓释植入剂可提高子宫内膜异位症的疗效，缩小异位病灶体积，降低雌激素水平，可能与抑制血管生成有关。

Objective To investigate the clinical effect of Xiaojin Capsules combined with Goserelin Acetate Sustained-Release Depot in treatment of endometriosis. Methods Patients (90 cases) with endometriosis in the Second Affiliated Hospital of Zhengzhou University from March 2019 to June 2020 were randomly divided into control and treatment groups, and each group had 45 cases. Patients in the control group were sc injection administered with Goserelin Acetate Sustained-Release Depot on the first day of menstruation, 3.6 mg/time, once every 4 weeks. Patients in the treatment group were po administered with Xiaojin Capsules on the basis of the control group, 4 grains/time, twice daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and the lesion volume, the endometrial thickness, and the levels of E₂, LH, FSH, VEGF, MMP-3, and TGF-β₁ in two groups were compared. Results After treatment, the total effective rate of the treatment group was 93.33%, and that of the control group was 77.78%, and the difference between the two groups was statistically significant (P<0.05). After treatment, the lesion volume and endometrial thickness of two groups were significantly reduced (P<0.05). Lesion volume and endometrial thickness of the treatment group were lower than those of the control group, and the difference was statistically significant (P<0.05). After treatment, the levels of E₂, LH, and FSH in two groups were significantly decreased (P<0.05), and the levels of E₂, LH, and FSH in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the levels of VEGF, MMP-3,and TGF-β₁ in two groups were significantly decreased (P<0.05), and the levels of VEGF, MMP-3, and TGF-β₁ in the treatment group were lower than those in the control group, and the difference was statistically significant (P<0.05). Conclusion Xiaojin Capsules combined with Goserelin Acetate Sustained-Release Depot can improve the curative effect of endometriosis, reduce the volume of ectopic lesions, and reduce the level of estrogen, which may be related to inhibiting angiogenesis.

R984

河南省医学科技攻关计划项目（LHGJ20190364）