宫瘤消胶囊联合地诺孕素治疗难治/复发性子宫内膜异位症的疗效和机制OA

OBJECTIVE To investigate the clinical efficacy and mechanism of Gongliuxiao capsule combined with dienogest(DNG)in the treatment of refractory/recurrent endometriosis(EMT).METHODS A retrospective analysis was conducted on the clinical data of 94 patients with refractory/recurrent EMT admitted to Qingdao TCM Hospital from January 2022 to January 2025.According to different treatment methods,they were divided into a monotherapy group(47 cases,receiving DNG monotherapy)and a combination group(47 cases,receiving Gongliuxiao capsule combined with DNG).The clinical efficacy,symptom and sign scores[Visual Analog Scale(VAS)and Pictorial Blood Loss Assessment Chart(PBAC)scores],vascular endothelial function indicators[serum transforming growth factor-β1(TGF-β1),vascular endothelial growth factor(VEGF),matrix metalloproteinase-2(MMP-2),MMP-9,basic fibroblast growth factor(bFGF)],serum pathological factors[carbohydrate antigen 125(CA125),CA199,anti-endometrial antibody(EMAb)],and Th1/Th2 drift indicators[interferon-γ(IFN-γ),interleukin-4(IL-4)]were compared between the two groups before and after 6 months of treatment.RESULTS After treatment,the VAS and PBAC scores,serum levels of TGF-β1,VEGF,MMP-2,MMP-9,bFGF,CA125,CA199,EMAb,and IL-4 in both groups were significantly lower than those before treatment,while IFN-γ levels were significantly higher than those before treatment(P＜0.05).Moreover,the magnitude of increase or decrease in the combination group was significantly greater than that in the monotherapy group(P＜0.05).The total effective rate in the combination group was significantly higher than that in the monotherapy group(93.62%vs.76.60%,P＜0.05).CONCLUSIONS The combination of Gongliuxiao capsule and DNG is effective in treating refractory/recurrent EMT,and can effectively improve the degree of dysmenorrhea and abnormal menstrual volume in patients.The mechanism may be related to improving vascular endothelial function,inhibiting the expression of tumor pathological factors,and correcting Th1/Th2 drift.