世界中医药

目的：探究归脾丸加减对围绝经期功血患者免疫功能、白细胞介素2（IL-2）、可溶性白细胞介素-2受体（sIL-2R）的影响。方法：选取2019年3月至2018年6月山东省济南市中西医结合医院收治的符合纳入条件的围绝经期功血患者118例作为研究对象，按照就诊顺序编号随机分为对照组和观察组，每组59例。对照组常规西医治疗，观察组加用归脾丸加减治疗，均治疗3个月。观察2组治疗前、完成治疗后T淋巴细胞亚群、IL-2、sIL-2R、凝血功能、子宫内膜厚度、激素水平、症状积分变化；完成治疗后统计治疗过程中的不良反应。结果：1）完成治疗后，2组CD3+、CD4+、CD4+/CD8+、IL-2较治疗前均显著升高，CD8+、sIL-2R则显著下降（P<0.05）；完成治疗后观察组CD8+、sIL-2R显著低于于对照组，余均高于对照组（P<0.05）。2）完成治疗后2组凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、子宫内膜厚度较治疗前均显著下降（P<0.05），完成治疗后观察组以上指标均显著低于对照组（P<0.05）。3）完成治疗后2组黄体生成素（LH）、促排卵生成素（FSH）、雌二醇（E2）、孕酮（P）、血管内皮生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）较治疗前均显著下降（P<0.05），完成治疗后观察组以上指标均显著低于对照组（P<0.05）。4)完成治疗后2组月经周期、阴道出血量、阴道出血天数、神疲乏力积分较治疗前均显著下降（P<0.05），完成治疗后观察组以上指标均显著低于对照组（P<0.05）。5)完成治疗后观察组胃肠道反应、体质量增加、肝功能异常、乳房胀痛发生率均显著低于对照组，2组比较差异有统计学意义（P<0.05）。结论：归脾丸加减能提高围绝经期功血患者免疫功能，抑制IL-2、sIL-2R，改善凝血功能，从而改善症状，提高疗效。

English Summary:

To explore the influence of modified Guipi Pill on immune function，interleukin-2(IL-2)and soluble interleukin-2 receptor(sIL-2R)in patients with perimenopausal dysfunctional uterine bleeding.Methods:A total of 118 cases of perimenopausal dysfunctional uterine bleeding were enrolled in Laiwu Hospital of Traditional Chinese Medicine from Mar 2017 to June 2018 and were randomly divided into a control group(59 cases)and an study group，with 59 cases in each group.The control group was treated with conventional Western medicine，while the study group was treated with modified Guipi Pill for 3 months.The changes of T lymphocyte subsets，L-2，sIL-2R，coagulation function，endometrial thickness，hormone level and symptom scores before and after treatment were observed and compared between the 2 groups.RESULTS:After treatment，CD3+，CD4+，CD4+/CD8+，IL-2 in the 2 groups increased significantly，while CD8+，sIL-2R decreased significantly(P<0.05).After treatment，CD8+，sIL-2R in the study group were significantly lower than those in the control group，and the rest were higher than those in the control group(P<0.05).2)After treatment，the prothrombin time(PT)，activated partial thromboplastin time(APTT)，thrombin time(TT)and endometrial thickness in both groups decreased significantly compared with those before treatment(P<0.05).After treatment，the above indexes in the study group were significantly lower than those in the control group(P<0.05).3)After treatment，the levels of luteinizing hormone(LH)，ovulation stimulating hormone(FSH)，estradiol(E2)，progesterone(P)，vascular endothelial growth factor(VEGF)，basic fibroblast growth factor(bFGF)in the 2 groups were significantly lower than those before treatment(P<0.05)，and the above indexes in the study group were significantly lower than those in the control group(P<0.05).4)The menstrual cycle，vaginal bleeding volume，days of vaginal bleeding and the scores of mental fatigue in the 2 groups decreased significantly after treatment(P<0.05)，and the above indexes in the study group were significantly lower than those in the control group(P<0.05).5)After treatment，the incidence of gastrointestinal reaction，weight gain，liver dysfunction and breast pain in the study group were significantly lower than those in the control group(P<0.05).Conclusion:Modified Guipi Pill can improve the immune function of patients with perimenopausal dysfunctional uterine bleeding，inhibit IL-2 and sIL-2R，improve coagulation function，thereby improving symptoms and curative effects.

查看全文查看/发表评论下载PDF阅读器