CAJ | 학술논문

目的：基于免疫平衡,探讨丹赤饮抑制气滞血瘀型子宫内膜异位症(EMs)保守术后复发的作用机理。方法采用区组随机方法,将EMs保守术后患者分为中药组(20例)和西药组(10例),分别予丹赤饮、促性腺激素释放激素(GnRH-a)或孕三烯酮治疗3个月,分别于术前、用药3个月、停药3个月时检测血清白细胞介素(IL)-2、IL-6含量及IL-2/IL-6变化,并与卵巢单纯性囊肿(对照组)5例进行比较。结果术前中药组、西药组患者血清 IL-2水平低于对照组(P＜0.05),IL-6水平高于对照组(P＜0.05),IL-2/IL-6低于对照组(P＜0.05)。用药3个月及停药3个月,2组患者IL-2水平较术前均明显升高(P＜0.05),IL-6水平较术前均明显下降(P＜0.05),IL-2/IL-6较术前均明显升高(P＜0.05)；中药组患者 IL-2/IL-6较对照组无明显变化(P＞0.05),西药组停药3个月时IL-2/IL-6水平显著低于对照组(P＜0.05)。结论免疫失衡与EMs的发生、发展密切相关。丹赤饮、GnRH-a或孕三烯酮治疗均可通过纠正EMs患者免疫失衡状态,达到预防EMs保守术后复发的作用,且丹赤饮的长远效果更为明显。
목적：기우면역평형,탐토단적음억제기체혈어형자궁내막이위증(EMs)보수술후복발적작용궤리。방법채용구조수궤방법,장EMs보수술후환자분위중약조(20례)화서약조(10례),분별여단적음、촉성선격소석방격소(GnRH-a)혹잉삼희동치료3개월,분별우술전、용약3개월、정약3개월시검측혈청백세포개소(IL)-2、IL-6함량급IL-2/IL-6변화,병여란소단순성낭종(대조조)5례진행비교。결과술전중약조、서약조환자혈청 IL-2수평저우대조조(P＜0.05),IL-6수평고우대조조(P＜0.05),IL-2/IL-6저우대조조(P＜0.05)。용약3개월급정약3개월,2조환자IL-2수평교술전균명현승고(P＜0.05),IL-6수평교술전균명현하강(P＜0.05),IL-2/IL-6교술전균명현승고(P＜0.05)；중약조환자 IL-2/IL-6교대조조무명현변화(P＞0.05),서약조정약3개월시IL-2/IL-6수평현저저우대조조(P＜0.05)。결론면역실형여EMs적발생、발전밀절상관。단적음、GnRH-a혹잉삼희동치료균가통과규정EMs환자면역실형상태,체도예방EMs보수술후복발적작용,차단적음적장원효과경위명현。
Objective Based on the immunologic balance, to investigate the mechanisms of Danchi decoction for controlling the recurrence of endometriosis (EMs) of qi stagnation and blood stasis after conservative operation. Methods A multi-center and randomized clinical trial was adopted. EMs patients were divided into Chinese medicine group (CG, 20 cases) and western medicine group (WG, 10 cases). The two groups were given Danchi decoction and GnRH-a or gestrinone respectively for 3 months. The serum IL-2, IL-6 and IL-2/IL-6 were detected before operation, after 3 months of treatment and 3 months after withdrawal, and compared with the control group (5 cases of simple ovarian cysts). Results Before operation, the serum IL-2 level of CG and WG was lower than control group (P<0.05), IL-6 was higher than control group (P<0.05), the ratio of IL-2/IL-6 was lower than control group (P<0.05). After treatment and 3 months after withdrawal, IL-2 level of CG and WG was increased than before operation (P<0.05), IL-6 was decreased (P<0.05), IL-2/IL-6 ratio was increased (P<0.05). There was no significant difference in IL-2/IL-6 between CG and control group (P>0.05), but 3 months after withdrawal, IL-2/IL-6 of WG was significantly lower than that of control group (P<0.05). Conclusion Immune imbalance is closely related to the occurrence and development of EMs. Danchi Decoction or GnRH-a or gestrinone can prevent the recurrence of EMs by adjusting the disorder of immune response, and Danchi Decoction has better effect on long-term result.