Observation of Xiaopi-Zhitong-Poyu decoction combined with gosserin sustained-release implant for the treatment of endometriosis after laparoscopy / 国际中医中药杂志

ABSTRACT

Objective To evaluate the efficacy of Xiaopi-Zhitong-Poyu decoction combined with gosserin sustained-release implant for the treatment of endometriosis after laparoscopy. Methods A total of 204 patients with endometriosis who met the inclusion criteria were divided into 2 groups by random number table methods, with 102 cases in each group. On the 5th day after the operation, the control group was subcutaneously injected with Gosserin sustained-release implant in the anterior abdominal wall on the basis of routine treatment, the observation group was added with Xiaopi-Zhitong-Poyu soup on the basis of the control group. Both groups were treated for 24 weeks and followed up for 3 years. The World Health Organization Quality of Life Scale-Brief Form Questionnaire (WHOQOL-BREF) was used to evaluate the quality of life of patients. The TCM symptom scores were used to evaluate the menstrual pain, waist sour bloated, thin stool, dizziness and abnormal menstruation. The FSH, E2 and LH was detected by full automatic serum analyzer, and the endomethal antibody (EMAb), matrix metalloproteinase-3 (mmp-3) and carbohydrate antigen 125(ca-125) were detected by enzyme labeling instrument. Clinical efficacy was evaluated and adverse reactions during treatment were recorded. Results The total effective rate was 93.1% (95/102) in the observation group and 80.4% (82/102) in the control group, with statistically significant differences (χ2=3.871, P=0.039). After treatment, scores in environmental field, life field, physiological field and social relation field in the observation group were all significantly higher than those in the control group (t values were 4.725, 4.930, 4.259, 4.571, all Ps<0.05). Scores of menstrual pain, waist sour bloated, thin stool, dizziness and abnormal menstruation in the observation group were all significantly lower than those of the control group (t values were 3.561, 3.457, 3.421, 3.652, 3.529, all Ps<0.05). After treatment, the serum FSH (1.48 ± 0.15 U/L vs. 2.98 ± 0.29) U/L, t=3.174), E2 (52.17 ± 5.25 pg/ml vs. 88.04 ± 8.23 pg/ml, t=3.141), LH (1.82 ± 0.18 U/L vs. 2.45 ± 0.25 U/L, t=3.372) levels in the observation group were significantly lower ( P<0.05); Serum EMAb (0.23 ± 0.02 vs. 0.32 ± 0.03, t=3.763), MMP-3 (69.69 ± 6.68 μg/L vs. 82.57 ± 8.89 μg/L, t=3.890], the CA-125 (25.89 ± 2.78 U/ml vs. 61.43 ± 6.78 U/ml, t=3.652) levels in the observation group were significantly lower (P<0.05). The recurrence rates of the observation group were 4.2% (4/95), 7.4% (7/95), 12.6% (12/95) at 1, 2, and 3 years respectively, while those of the control group were 13.4% (11/82), 18.3% (15/82), 25.6% (21/82), respectively. The differences were statistically significant ( χ 2 values were 3.309, 3.911, 4.102, all Ps<0.05). Conclusions The Xiaopi-Zhitong-Poyu decoction combined with gosserin sustained-release implant can reduce the hormone level of patients with endometriosis after laparoscopic surgery, improve the content of markers of endometriosis, improve the quality of life and clinical efficacy of patients, and reduce adverse reactions.