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目的观察内异灌肠方对子宫内膜异位症(EMS)慢性盆腔疼痛的临床治疗效果,探究治疗EMS的临床机制。方法选择60例EMS患者随机分组,治疗组30例,予内异灌肠方灌肠治疗,比较治疗前后临床症状(经行腹痛、性交痛)评分、治疗前后血清CA125值及卵巢囊肿的变化;中药灌肠连续治疗3个月经周期,于第4次月经干净3~7天行腹腔镜手术。对照组30例直接行腹腔镜手术。比较2组患者腹腔液中的CA125及前列腺素F2α(PGF2α)水平。结果治疗组患者经行腹痛21例、性交痛12例,3个月治疗后症状不同程度改善,治疗前后比较差异有统计学意义(P<0.05)。2组腹腔液CA125及PGF2α水平比较差异有统计学意义(P<0.05),r AFS评分比较差异无统计学意义(P>0.05)。结论内异灌肠方可减轻EMS患者经行腹痛、性交痛程度,可能通过降低患者腹腔液CA125及PGF2α浓度发挥治疗作用。
Objective To observe the therapeutic effect of Nei Yi enema on chronic pelvic pain in patients with endometriosis (EMS) and to explore the clinical mechanism of EMS. Methods Sixty patients with EMS were randomly divided into treatment group (n = 30), internal enema and enema enema treatment, clinical symptoms (abdominal pain, sexual intercourse pain) scores before and after treatment, serum CA125 value and ovarian cyst before and after treatment, Continuous treatment of 3 menstrual cycle, the first 4 menstrual clean 3 to 7 days laparoscopic surgery. Control group of 30 cases directly laparoscopic surgery. The levels of CA125 and prostaglandin F2α (PGF2α) in peritoneal fluid of two groups were compared. Results In the treatment group, 21 cases had abdominal pain and 12 cases had painful intercourse. After 3 months of treatment, the symptoms improved to some extent. The difference was statistically significant before and after treatment (P <0.05). The levels of CA125 and PGF2α in the peritoneal fluid of the two groups were significantly different (P <0.05). There was no significant difference in r AFS scores between the two groups (P> 0.05). Conclusion Enemae enema can reduce the degree of abdominal pain and painful intercourse in patients with EMS, and may play a therapeutic role by decreasing the concentrations of CA125 and PGF2α in peritoneal fluid of patients.