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OBJECTIVE@#To observe the clinical efficacy of thunder-fire moxibustion combined with mifepristone for ovarian chocolate cyst dysmenorrhea with kidney deficiency and blood stasis.@*METHODS@#Seventy patients were randomly divided into an observation group and a control group, 35 cases in each group. The patients in the the control group were treated with oral administration of mifepristone, 10 mg each time, once a day; based on the treatment of the control group, the patients in the observation group were treated with thunder-fire moxibustion at Guanyuan (CV 4), Zigong (EX-CA 1), Xuehai (SP 10), once every other day. Both the groups were treated for 3 months. The Cox menstrual symptom scale (CMSS) score, the maximum cross-sectional area of ectopic cyst, and the serum levels of transforming growth factor-β1 (TGF-β1) and interleukin-17 (IL-17) were observed before and after treatment in the two groups. The clinical efficacy was evaluated.@*RESULTS@#Compared before treatment, the severity scores and duration scores of CMSS as well as the serum levels of TGF-β1 were reduced after treatment in the two groups (@*CONCLUSION@#Thunder-fire moxibustion combined with mifepristone could significantly improve dysmenorrhea symptoms, shorten dysmenorrhea time and promote atrophy of ovarian heterotopic cyst in patients with ovarian chocolate cyst dysmenorrhea of kidney deficiency and blood stasis, and the mechanism may be related to the reduction of serum levels of TGF-β1 and IL-17.
Subject(s)
Female , Humans , Acupuncture Points , Chocolate , Cysts , Dysmenorrhea/drug therapy , Kidney , Mifepristone , MoxibustionABSTRACT
Ovarian endometrioma is the most frequent endometriotic lesion, affecting about 55% of patients suffering of endometriosis. It is a marker of severity of the disease, associated with deep endometriotic lesions independently of its size. Its compromise is usually multifocal. Though commonly diagnosed in women of reproductive age, it can develop in adolescent girls and even before menarche. Treatment of the ovarian endometrioma is either medical or surgical. Medical treatment, which aims to relieve pain, is mostly used as an adjuvant following surgery in order to decrease recurrence. Surgical treatment plays a major role, despite its effects on the ovarian reserve; rates of pain relief and spontaneous pregnancy favor this approach. Four conservative surgical techniques can be used, all of them feasible by laparoscopy: pseudo capsule excision (cystectomy), ablation, the two-stage technique and the combined technique. Besides chosen technique, surgery quality and the sensible use of energy during the procedure affect the outcome. In cases of ovarian endometrioma, the best approach is individualized treatment considering the patient's needs and associated factors.
El endometrioma ovárico es la forma más frecuente de lesión endometriósica, que afecta aproximadamente a 55% de las pacientes con endometriosis. Es el marcador de severidad de la enfermedad e, independiente de su tamaño, está asociado con lesiones profundas, siendo habitualmente el compromiso multifocal. Comúnmente diagnosticado en mujeres en edad reproductiva, también puede desarrollarse en niñas adolescentes y aún antes de la menarquia. El tratamiento del endometrioma ovárico puede ser médico o quirúrgico. El tratamiento médico está orientado básicamente a aliviar el dolor, pero sobre todo al tratamiento coadyuvante posquirúrgico, con la finalidad de disminuir la recurrencia. El tratamiento quirúrgico tiene rol fundamental, a pesar de sus efectos sobre la reserva ovárica; los beneficios en términos de alivio del dolor y tasas de embarazo espontáneo favorecen este enfoque. Cuatro técnicas quirúrgicas conservadoras son utilizadas en la actualidad, con sus ventajas y desventajas y todas perfectamente realizables por vía laparoscópica: escisión de la pseudocápsula (quistectomía), ablación, la técnica en dos etapas y la técnica combinada. Más importante que la cirugía en sí misma, es la calidad de la cirugía y el uso juicioso de la energía con la que se trabaja. La mejor visión del manejo es la individualización de cada caso, teniendo en consideración las necesidades de la paciente y los factores asociados.
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Chronic pelvic pain is a common yet difficult problem to manage, plaguing the gynecologist as well as the gastroenterologist and general surgeon. Highlighted by increased visceral hypersensitivity, endometriosis and irritable bowel syndrome (IBS) are the most common causes or chronic unrelenting pelvic pain. Recently, the similarities between the two conditions has begged the question as to whether there is any common denominator between the two conditions and their likely co-existence and mismanagement. Further, the association of polycystic ovary syndrome (PCOS) in this cohort remains definitively uncharacterized. This report details a young female patient with the triad of POCS, IBS and endometriosis presenting with chronic pelvic pain.
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Objective To investigate the efficacy of transabdominal ultrasound interventional puncture combined with medicine in the treatment of ovarian chocolate cysts. Methods According to the different treatment methods will be January 2015 to December 2016 in Yuyao People's Hospital 70 cases of patients with ovarian chocolate cyst group: the control group with washed cysts + ethanol sclerotherapy by transabdominal ultrasound interventional puncture + urokinase solution, the observation group in the control group based on the addition of triptorelin;observed the body hormone before and after E2 two patients in the treatment group, follicle stimulating hormone, serum luteinizing hormone, FSH/LH, antral follicles level changes, complications, clinical treatment, and the relevant data for comparative analysis. Results Abdominal ultrasound interventional puncture and drug treatment (observation group) treatment of ovarian chocolate cyst is better than transabdominal ultrasound interventional treatment (control group), the stability of the body hormone levels of patients than the control group, the complication rate was lower than the control group, the total efficiency of clinical treatment was higher than the control group, the difference was statistically significant (P <0.05). Conclusion The patients with ovarian chocolate cyst transabdominal ultrasound interventional puncture and drug treatment effect significantly, can effectively improve the patients body hormone level, low complication rate, the total effective rate of the treatment is high, it is worthy of widely used treatment of patients with ovarian chocolate cyst.
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Objective To investigate the influence factors of serum CA125 level in patients with ovarian chocolate cysts,and to study the effect on serum CA125 level of interventional therapy.Methods A total of 103 patients with single unilateral chocolate cyst of ovary underwent interventional treatment.According the serum CA125 level before interventional therapy,the patients were divided into normal group (CA125≤35 U/ml) and abnormal group (35 U/ml＜CA125≤200 U/ml).The clinical indexes of patients and ultrasound characteristics of cyst were compared between the two groups.The changes of serum CA125 levels before and after interventional therapy were analyzed.Results The difference of the course of diseases,dysmenorrhea history,diameter of cysts had statistical difference between the two groups (all P＜0.05).There were no statistical differences of age,history of dilivery,abortion history,history of pelvic surgery,cyst location between the two groups (all P＞0.05).In abnormal group,the mean serum level of CA125 reduced at 3 months (P＜0.000 1) and 6 months (P ＜0.000 1) after interventional therapy.In the normal group,there was no significant difference of the mean serum level of CA125 before and after interventional therapy (all P＞0.05).Conclusion Serum CA125 level is influenced by dysmenorrhea history,course of disease,diameter of cysts.Ultrasound-guided interventional therapy has intervention effect on patients with abnormal serum CA125 level before interventional therapy.
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Objective To study the action of enantone in chocolate cyst after laparoscopic surgery. Methods To devide the 76 patients into two groups, study group(50 patients, additional enantone after laparoscopic surgery) and the control group (26 patients, only laparoscopic surgery), to analyse their recurrence rate and pregnancy rate. Results The recurrence rate of study group was obviously lower than control group. In the 48 patients with infertility, the pregnancy rate of study group was higher than control group. Conclusions In chocolate cyst after laparoscopic surgery, enantone can decrease the recurrence rate and increase pregnancy rate.
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0.05). ② The Fo in groups 2 and 3 were (5.0?1.5) and (5.2?1.5) respectively, which were significantly lower than that in group 1 (6.1?1.2)(q=4.690, 3.383, P
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Five cases of chronic encapsulated intracerebral hematomas(so called "chocolate cysts") presented slowly progressive neurological deficits and hence mimicked brain tumors. The median duration of symptoms was 21 days. The first symptoms were severe headache and vomiting. At one case generalized seizure was noted. Computed tomography almost consistently demonstrated ring shaped lesions with central high density and minimal perifocal edema. Cerebral angiographic studies showed avascular mass lesions. All cases had superficial white matter lesions. Soft, well-encapsulated, organized, large intracerebral hematomas were removed surgically. Arteriovenous malformations were detected in two cases. All cases recovered completely but at one case postoperative brain swelling was noted transiently. Increasing awareness of "chocolate cyst" as a clinical and pathological entiry was necessary.