| Objective To compare the clinical outcomes and quality of life of patients with ovarian endometriosis（OEM）after laparoscopic ovarian endometriosis cyst removal with dienogest alone or in combination with dienogest and Dane Fukang Decoction,thus providing a new diagnostic basis for the long-term management of patients after OEM.Methods A randomized controlled experimental study was conducted to collect 68 OEM patients who visited the gynecology department of our hospital from September 2020 to June 2022 and met the inclusion and exclusion criteria as study subjects,and were divided into a test group（32 cases）and a control group（36 cases）using the random number table method,and the control group was given dienogest 2 mg/day postoperatively,and the test group was treated with Dane Fukang Decoction on top of this 10g/day was added to this treatment in the experimental group.The changes of Estradiol（E2）,Luteinizing Hormone（LH）and Follic stimulating hormone（FSH）values were observed before surgery and 6 months after taking the medication,and the Endometriosis Health Profile-5（EHP-5）score and Biberoglu&Behrman（B&B）scores were used to assess patients’psychological and quality of life.Results 1 Comparing patients in the test and control groups the differences in age before treatment,E2,LH,FSH,EHP-5 score and B&B score,and time of onset were not significant（P>0.05）{33.31±2.83years,34.58±2.80 years,P>0.05;3.25±1.67 years,3.07±1.46years,P>0.05;52.93±2.10 pg·ml-1,52.46±2.49 pg·ml-1,P>0.05;6.34±0.71 m IU·ml-1,6.43±0.76 m IU·ml-1,P>0.05;6.72±0.98 m IU·ml-1,6.77±1.08 m IU·ml-1,P>0.05;16.69±1.42 points,16.89±1.41 points,P>0.05;5.13±1.36 points,5.03±1.46 points,P>0.05}.2 Comparing patients in the test and control groups after 6 months of medication,respectively,E2,LH and FSH showed different degrees of decrease in the test and control groups compared with the preoperative period（P<0.05）,and the differences were significant.The E2values before and after the test group(52.93±2.10 vs 32.96±1.69 pg·ml-1)and the E2values before and after the control group(52.46±2.49 vs 39.93±1.61pg·ml-1);the LH values before and after the test group(6.34±0.71 vs5.35±0.55 m IU·ml-1)and the LH values before and after the control group(6.43±0.76 vs.5.73±0.65 m IU·ml-1);FSH values before and after the test group(6.72±0.98 vs.5.36±0.48 m IU·ml-1)and before and after the control group(6.77±1.08 vs.5.75±0.68 m IU·ml-1).3 EHP-5 scores showed that the five aspects of pain,control and powerlessness,emotional well-being,social support,and self-image were lower in both groups after treatment than before treatment,and the differences were statistically significant（P<0.05）.The total score of EHP-5 scale before and after the treatment was lower in the observation group（16.69±1.42 vs.7.53±0.92 points）and the total score of EHP-5 scale before and after the treatment was lower in the control group（16.89±1.41vs.9.89±1.55 points）.In the observation group,the percentages of"rarely"in pain,control and powerlessness,emotion,and social support were higher than those in the control group,and the percentages of"often"were lower than those in the control group（P<0.05）.There was no difference in self-image scores（P=0.229）.4 The Biberoglu&Behrman scale（B&B scale）scores of"pelvic pain dysmenorrhea,dyspareunia"decreased in both groups before and after treatment,and the difference between the groups was significant（P<0.05）.The total B&B scale scores were lower in the test group（5.13±1.36 vs.1.00±0.67）and in the control group（5.03±1.46 vs.2.08±0.65）,and the total B&B scale scores were lower in the test group than in the control group after treatment.There was a difference in the proportion of non-menstrual pelvic pain and painful intercourse in each dimension of the B&B scale scores between the two groups after treatment（P<0.05）.The proportion of patients with"no"pelvic pain and"no"dyspareunia after treatment was higher in the test group than in the control group,and the proportion of"mild"pain was lower than in the control group（P<0.05）.There was no difference in the percentage of"moderate and severe"and no difference in the score of dysmenorrhea（P=0.223）.5 The difference in the incidence of side effects of"irregular vaginal bleeding,headache and hot flash"between the two groups was not significant（P>0.05）,but the difference in the incidence of total adverse reactions was significant（P<0.05）,3.1%in the test group and 25.0%in the control group.Conclusion 1 The ovarian endometriosis patients with laparoscopic ovarian cyst removal after the single application of dienogest or dienogest combined with Dane Fukang Decoction has a good therapeutic effect.2 Both dienogest and dienogest in combination with Dane Fukang Decoction can decrease EHP-5 and B&B scores,and improve their quality of life,But Dane Fukang Decoction and dienogest are more effective than dienogest alone.3 Adverse effects were less in the case of dienogest combined with Dane Fukang Decoction than in the case of dienogest alone. |
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