目的 探討桂枝茯苓膠囊聯(lián)合地諾孕素治療子宮內(nèi)膜異位癥的療效。方法 選取2019年4月—2020年1月在鄭州大學(xué)第二附屬醫(yī)院接受治療的子宮內(nèi)膜異位癥患者175例，隨機(jī)分為對(duì)照組（n=87）和治療組（n=88）。對(duì)照組口服地諾孕素片，于月經(jīng)周期第2天開(kāi)始服用，2 mg/次，1次/d。治療組患者在對(duì)照組基礎(chǔ)上口服桂枝茯苓膠囊，3 粒/次，3次/d。兩組均連續(xù)治療3個(gè)月。觀察兩組的臨床療效，比較兩組血清激素、VAS評(píng)分、囊腫直徑、血清因子和血清抗原的變化情況。結(jié)果 治療后，對(duì)照組患者總有效率是75.86%，顯著低于治療組的95.45%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，血清中促卵泡雌激素（FSH）、促黃體生成素（LH）、雌二醇（E₂）和孕酮（P）水平明顯低于治療前水平（P<0.05）；治療組在治療后血清中E₂和P水平顯著低于對(duì)照組治療后的同期水平（P<0.05）。治療后，視覺(jué)模擬評(píng)分法（VAS）評(píng)分和囊腫直徑都明顯降低（P<0.05）；治療組在治療后VAS評(píng)分和囊腫直徑顯著低于對(duì)照組治療后的同期水平（P<0.05）。治療后，血清中金屬蛋白酶（MMP）-2、MMP-9、半乳糖凝集素-3（Gal-3）和血管內(nèi)皮生長(zhǎng)因子（VEGF）水平明顯低于治療前的水平（P<0.05）；治療組在治療后MMP-2、MMP-9、Gal-3和VEGF水平顯著低于對(duì)照治療后的同期水平（P<0.05）。治療后，血清中C_A199和C_A125水平顯著低于治療前的水平（P<0.05）；治療組在治療后血清中C_A199和C_A125水平明顯低于對(duì)照組治療后的同期水平（P<0.05）。結(jié)論 桂枝茯苓膠囊聯(lián)合地諾孕素治療子宮內(nèi)膜異位癥具有良好的效果，可有效降低血清因子和血清抗原水平，降低VAS評(píng)分和囊腫直徑，具有一定的臨床推廣應(yīng)用價(jià)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

河南省科技廳基礎(chǔ)項(xiàng)目（142300410240）