左炔诺孕酮宫内节育系统联合桂枝茯苓胶囊对子宫腺肌症患者性激素、血脂及血清hs-CRP、VEGF水平的影响

摘要 目的：探讨左炔诺孕酮宫内节育系统联合桂枝茯苓胶囊对子宫腺肌症患者超敏C反应蛋白（hs-CRP）、性激素、血管内皮生长因子（VEGF）以及血脂的影响。方法：选取2016年4月~2019年8月期间我院接收的90例子宫腺肌症患者，按照随机数字表法分为对照组（45例，左炔诺孕酮宫内节育系统治疗）和研究组（45例，对照组的基础上联合桂枝茯苓胶囊治疗），比较两组患者疗效、性激素、血脂、血清hs-CRP、VEGF水平、子宫内膜厚度、痛经视觉模拟评分法（VAS）评分以及不良反应。结果：治疗6个月后研究组临床总有效率较对照组高（P<0.05）。两组治疗6个月后卵泡刺激素（FSH）、hs-CRP、黄体生成素（LH）、VEGF水平以及子宫内膜厚度、痛经VAS评分均较治疗前下降，且研究组较对照组低（P<0.05）；雌二醇（E2）水平较治疗前升高，且研究组较对照组高（P<0.05）。两组治疗6个月后总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）水平对比未见统计学差异（P>0.05）。两组不良反应发生率对比无差异（P>0.05）。结论：左炔诺孕酮宫内节育系统联合桂枝茯苓胶囊治疗子宫腺肌症安全有效，可改善机体性激素、血清hs-CRP、VEGF水平及子宫内膜厚度，减轻痛经症状，且对机体血脂情况影响轻微。

The Effect of Levonorgestrel Intrauterine Contraceptive System Combined with Guizhi Fuling Capsule on Sex Hormone, Blood Lipid and Serum hs-CRP, VEGF Levels in Patients with Adenomyosis

ABSTRACT Objective: To investigate the effect of levonorgestrel intrauterine contraceptive system combined with Guizhi Fuling capsule on sex hormone, blood lipid, serum high sensitive C-reactive protein (hs-CRP) and vascular endothelial growth factor (VEGF) levels in patients with adenomyosis. Methods: 90 patients with adenomyosis admitted to our hospital from April 2016 to December 2019 were divided into control group (n=45, treated with levonorgestrel intrauterine contraceptive system) and study group (n=45, treated with Guizhi Fuling capsule on the basis of the control group) according to the random number table. The efficacy, sex hormone, blood lipid and serum hs-CRP, VEGF levels, endometrial thickness, visual analogue scale (VAS) and adverse reactions of the two groups were compared. Results: 6 months after treatment, the total clinical effective rate of the study group was higher than that of the control group (P<0.05). 6 months after treatment, follicle-stimulating hormone (FSH), hs-CRP, luteinizing hormone (LH), VEGF, endometrial thickness, and VAS scores of dysmenorrhea in both groups all decreased compared with those before treatment, and study group was lower than control group (P<0.05). Estradiol (E2) was higher than that before treatment, study group was higher than control group (P<0.05). There was no significant difference in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) in two groups at 6 months after treatment(P>0.05). There was no significant difference in the incidence of adverse reactions in two groups(P>0.05). Conclusion: Levonorgestrel intrauterine contraceptive system combined with Guizhi Fuling capsule is safe and effective in the treatment of adenomyosis, wihch can improve the sex hormone, serum hs-CRP, VEGF levels and endometrial thickness, reduce dysmenorrhea symptoms, and has a slight effect on the body''s blood lipid.