祛瘀解毒方对EM患者血清和腹腔液VEGF的影响.pdfVIP

提 要 目的：观察祛瘀解毒方对血瘀蕴毒型子宫内膜异位症临床表现、相关免疫指标及 血清、腹腔液血管内皮生长因子（VEGF）的影响；探讨祛瘀解毒方对子宫内膜异位症 血管生成的影响；探讨祛瘀解毒方治疗子宫内膜异位症可能的作用机理。方法：70 例子宫内膜异位症患者随机分为两组，即中药祛瘀解毒方治疗组 35 例、散结镇痛胶 囊治疗组35例，另取35例同期在我院因输卵管阻塞行腹腔镜治疗的患者作为对照组。 观察每组患者治疗前后症状、体征改善情况，免疫学指标 CA125 及抗子宫内膜抗体 （EMAb），内分泌E2、P、PRL及血清VEGF的变化，检测治疗后腹腔液VEGF水平，并 统计每组患者的妊娠率。结果：治疗三个月后，祛瘀解毒方组患者月经不调、痛经等 中医血瘀蕴毒证候得到有效改善，EMAb 的阳性率及血清 CA125 的水平均有所降低，内 分泌水平得以改善，血清VEGF水平显著降低，及腹腔液VEGF水平显著降低，提高了 妊娠率，其总体临床疗效优于散结镇痛胶囊组。结论：祛瘀解毒方是治疗血瘀蕴毒型 子宫内膜异位症的理想药物，其作用机理可能是通过改善盆腔局部血液循环，调节下 丘脑-垂体-卵巢性腺轴功能，改善女性激素的分泌功能，并调节紊乱的细胞免疫功能， 降低血清及腹腔液VEGF的水平以减少异位病灶的形成而实现的。 关键词 子宫内膜异位症；祛瘀解毒方；瘀毒；VEGF The Effect of QUYUJIEDU Decoction on VEGF in Serum and Peritoneal Fluid of Patients with EM Speciality: Endometriosis，Gynecology Tutor: Prof Lian Fang Author: Han chunyan Abstract Objective: To observe the effect of QUYUJIEDU(QYJD) decoction on endometriosis and to explore its mechanism. Method: 70 patients with endometriosis were randomly divided into two groups: 35 patients treated with QYJD(QYJD group) and the others treated with SANJIEZHENTONG capsule(SJZT group).In addition,35 women was selected as control group (35cases of infertile women with the disturbance of fallopian tube resort to Laparoscopic). The clinical symptom,physical sign,development of immunity and endocrinology,the concentration of VEGF in peripheral blood and peritoneal fluid were observed before and after treatment. Pregnancy rate was our study,too.Result: QYJD can efficiently improve the stasis toxin symptom ,including irregular menstruation and dysmenorrheal,etc, decrease the positive expression of EMAb and the level of