中西医结合治疗对腹腔镜下子宫平滑肌瘤剔除术后患者卵巢功能及应激激素影响

Effect of ovarian function and stress hormone by the methods of Chinese and Western medicine combined therapy for the patient after laparoscopic myomectomy

关键词:  腹腔镜下子宫肌瘤剔除术  中西医结合  卵巢功能  应激激素

Key words:  laparoscopic myomectomy  integration of traditional Chinese and Western medicine  ovarian function  stress hormone

摘要:

[目的]评价中西医结合对腹腔镜下子宫肌瘤剔除术后患者卵巢功能与应激激素的影响。[方法]将符合纳入标准的88例腹腔镜下子宫肌瘤剔除术（LM）患者随机分为治疗组和对照组各44例，研究中脱落3例，脱落率为3.4%，最终完成85例患者，治疗组43例，对照组42例。对照组LM后给予米非司酮片，治疗组在对照组基础上给予益气化瘀中药，两组均1个月为1个疗程，连续口服3个疗程，并随访1 a；观察两组术后3、6个月卵巢功能、应激激素指标及术后两组子宫肌瘤复发率，并进行对比分析。[结果]两组术后6月肾上腺素（NE）、皮质醇（Cor）、多巴胺（DA）均较术后3个月降低（P<0.05）；术后同时间点两组比较治疗组在NE、Cor、DA均低于对照组（P<0.05）；两组术后6个月黄体生成素（FSH）、促黄体生成素（LH）、雌二醇（E₂）均较术后3月降低（P<0.05）；术后同时间点两组比较：治疗组FSH、LH低于对照组，而E₂水平高于对照组（P<0.05）；治疗组术后6个月、术后12个月复发率及总复发率明显低于对照组（P<0.05）。[结论]中西医有机结合对LM患者能够明显改善卵巢功能，降低复发率，降低应激激素水平。

Abstract:

[Objective] In order to evaluate the effect of ovarian function and stress hormone by the methods of Chinese and western medicine combined therapy for the patient after laparoscopic myomectomy.[Methods] Select 88 cases LM patients that accorded with the inclusion criteria were randomly divided into the treatment group and control group(n=44); in the study,3 cases were lost,and the lost rate was 3.4%. In the end,85 case patients were completed,43 cases were treated in the treatment group and 42 in the control group. The control group was given Mifepristone tablets after laparoscopic myomectomy,the treatment group was given Traditional Chinese medicine of benefiting qi and dispersing blood stasis on the basis of the control group; one months for one course and oral 3 courses continuous of both groups,then followed up for one year. To observe postoperative 3 months,6 months ovarian function,index of stress hormones,postoperative uterine fibroid recurrence rate of both groups,and comparison analysis.[Results] In the two groups,6 months after the operation were lower than 3 months after surgery in the NE,Cor and DA (P<0.05). At the same time after operation,the treatment group was lower than the control group in NE,Cor and DA (P<0.05). In the two groups,6 months after the operation were lower than 3 months after surgery in the SH,LH and E₂ (P<0.05). Two groups were compared at the same time,the FSH and LH levels in the treatment group were lower than those in the control group,while the E₂ level was higher in the treatment group than in the control group (P<0.05).The recurrence rate and total recurrence rate were significantly lower in the treatment group than in the control group (P<0.05).[Conclusion] Chinese and western medicine combined therapy for LM patients can significantly improve the clinical syndromes of traditional Chinese medicine,reduce the recurrence rate,improve the level of stress hormone and improve the improvement of ovary function.