目的 探討小金膠囊聯(lián)合醋酸戈舍瑞林緩釋植入劑治療子宮內(nèi)膜異位癥的臨床療效。方法 選取2019年3月—2020年6月鄭州大學(xué)第二附屬醫(yī)院收治的90例子宮內(nèi)膜異位癥患者，按照隨機(jī)數(shù)字表法將所有患者分為對照組和治療組，每組各有45例。對照組于月經(jīng)第1天皮下注射醋酸戈舍瑞林緩釋植入劑，3.6 mg/次，1次/4周。治療組在對照組基礎(chǔ)上口服小金膠囊，4粒/次，2次/d。兩組患者連續(xù)治療6個(gè)月。觀察兩組的臨床療效，比較兩組患者治療前后病灶體積、子宮內(nèi)膜厚度變化、血清雌二醇（E₂）、黃體生成素（LH）、卵泡刺激素（FSH）、血管內(nèi)皮生長因子（VEGF）、基質(zhì)金屬蛋白酶3（MMP-3）、轉(zhuǎn)化生長因子-β₁（TGF-β₁）水平。結(jié)果 治療后，治療組患者的總有效率為93.33%，對照組為77.78%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的病灶體積、子宮內(nèi)膜厚度顯著降低（P<0.05）；且治療組的病灶體積、子宮內(nèi)膜厚度比對照組低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的E₂、LH、FSH水平顯著降低（P<0.05），以治療組E₂、LH、FSH水平降低的更明顯（P<0.05）。治療后，兩組的VEGF、MMP-3、TGF-β₁水平顯著降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組的VEGF、MMP-3、TGF-β₁水平比對照組低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 小金膠囊聯(lián)合醋酸戈舍瑞林緩釋植入劑可提高子宮內(nèi)膜異位癥的療效，縮小異位病灶體積，降低雌激素水平，可能與抑制血管生成有關(guān)。

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

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（LHGJ20190364）