진단 복강경시 복강내 미슬토 추출물 (Mistletoe Extract) 투여의 자궁내막증의 통증에 대한 치료 효과
The Effect of intraperitoneal instillation of Mistletoe extract during the diagnostic laparoscopy for pain of endometriosis
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=목적: 면역계의 변화는 자궁내막증의 병인과 진행에 중요한 연관이 있다. 미슬토 추출물은 면역작용을 변화시키는 효과가 있다고 알려져 있다. 본 연구에서는 미슬토 추출물을 복강내로 투여할 경우 자궁내막증으로 인한 골반통증을 완화시키는지에 대하여 알아보았다. 연구 방법: 골반통증을 주소로 외래에 내원한 환자 중 통증의 원인으로 자궁내막증이 의심되는 환자 30명을 대상으로 하였다. 자궁내막증을 확진하기 위하여 진단복강경을 시행한 후 시술을 마치기 전 미슬토 추출물을 맹낭에 점적투여 하였다. 통증의 평가는 진단복강경 전과 한 달 후에 통증의 정도를 최저 0점부터 최고 10점까지로 하여 점수를 매겼다. 결과: 미슬토 추출물을 점적 투여한 후 30명 중 11명 (36.7%)의 환자에서 통증의 호전이 있었다. 합병증은 2명 (6.7%)에서 나타났으며, 항히스타민제제와 대증치료로 호전되었다. 결론: 통증의 원인이 자궁내막증인 경우, 확진을 위한 진단복강경 검사를 할 때 미슬토 추출물을 복강내 투여하여 골반통증의 고식적인 치료 외에 보조적인 도움을 줄 수 있을 것으로 생각되며, 향후 이에 대한 많은 연구가 필요할 것이다.
Abstract
Objective: Immune alternation is related to the pathogenesis and progression of endometriosis. Helixor-A, mistletoe extract, has been known that it has immune modulation effect. Therefore the purpose of this study is to determine the effects of Helixor-A for pain of endometriosis by intraperitoneal instillation of mistletoe extract during the diagnostic laparoscopy. Methods: Among the paitients who visited to outpatient clinic due to chronic pelvic pain, 30 patients who had laparoscopically-confirmed endometriosis were included in this study. Helixor-A 5 mg was instilled into the posterior cul-de-sac during the diagnostic laparoscopy. Before diagnostic laparoscopy and one month after laparoscopy, the patients recorded pain scores. Results: In 11 of 30 patients (36.7%), pelvic pain of endometriosis improved after laparoscopy. In 2 of 30 patients, the side-effect of Helixor- A appeared and they were easily controlled by antihistamines. Conclusion: The instillation of Helixor-A during diagnostic laparoscopy, that is essential for confirmation of endometriosis, may be helpful as a supportive treatment for treatment of pelvic pain due to endometriosis with classical treatment such as GnRH agonist therapy.
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