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目的探讨补肾活血方联合促性腺激素释放激素类似物(gonadotropin-releasing hormone analogue,GnRH-a)对卵巢子宫内膜异位囊肿腹腔镜手术后的影响。方法选取2013年2月~2014年5月湖北省中国人民解放军第161医院收治的83例卵巢子宫内膜异位囊肿患者,根据患者意愿分为两组。全部患者采用腹腔镜保守性手术治疗与GnRH-a辅助治疗,研究组同时给予补肾活血方治疗。对比两组患者性激素水平变化,随访1年,对比两组患者复发率、妊娠率、不良反应发生情况。结果研究组总有效率(93.02%)显著高于对照组(72.50%)(P<0.05);两组治疗后雌二醇(estradiol,E_2)、促卵泡素(follicle stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、癌抗原125(cancer antigen 125,CA125)、血管内皮生长因子(vascularendothelia gro wth factor,VEGF)、视觉模拟评分(visual analogue scale,VAS)显著降低(P<0.05);研究组治疗后E_2、FSH、LH、CA125、VEGF、VAS评分较对照组更低,复发率、不良反应发生率低于对照组,妊娠率高于对照组,差异均有统计学意义(P<0.05)。结论补肾活血方联合GnRH-a辅助腹腔镜手术治疗卵巢子宫内膜异位囊肿,能进一步降低患者性激素水平,降低复发率,提高妊娠率。
Objective To investigate the effect of GnRH-a combined with gonadotropin-releasing hormone analogue (GnRH-a) on the post-laparoscopic surgery of ovarian endometriosis. Methods From February 2013 to May 2014, 83 patients with ovarian endometriosis were enrolled in the 161st Hospital of People’s Liberation Army of Hubei Province. Patients were divided into two groups according to their wishes. All patients with laparoscopic conservative surgery and GnRH-a adjuvant therapy, the study group also given Bushenhuoxue Fang treatment. The levels of sex hormones were compared between the two groups, followed up for 1 year. The recurrence rate, pregnancy rate and adverse reactions of the two groups were compared. Results The total effective rate (93.02%) in the study group was significantly higher than that in the control group (72.50%) (P <0.05). The estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone Luteinizing hormone (LH), cancer antigen125 (CA125), vascular endothelial growth factor (VEGF) and visual analogue scale (VAS) The scores of E_2, FSH, LH, CA125, VEGF and VAS in the group after treatment were lower than those in the control group, the recurrence rate and incidence of adverse reactions were lower than those in the control group, and the pregnancy rates were higher than those in the control group (P <0.05 ). Conclusion Bushen Huoxue prescription combined with GnRH-a assisted laparoscopic surgery for ovarian endometriosis cyst can further reduce the level of sex hormone in patients, reduce the recurrence rate and improve the pregnancy rate.