少腹逐瘀汤加减治疗子宫腺肌病痛经的临床研究

摘要

目的：对少腹逐瘀汤加减治疗子宫腺肌病痛经的临床疗效及作用机制进行研究。方法选取2014年6月－2015年6月我院收治的子宫腺肌病痛经患者80例，将其按照随机数字表法分为观察组和对照组各40例，观察组经前5～7 d 开始服用少腹逐瘀汤加减，对照组经前5～7 d 开始服用痛经宝颗粒，每次1袋，每日2次。2组均治疗3个月经周期。观察治疗前后痛经症状改善情况和中医证候、子宫体积大小的变化及血清 CA125、TNF-α、IL-8含量的变化。结果治疗后2组痛经积分及中医证候积分均显著下降，与治疗前比较，P ＜0．01，且观察组下降更为明显（P ＜0．05）；治疗3个疗程后观察组痛经总有效率为95％，显著高于对照组（67．5％，P ＜0．05），中医证候总有效率95％，显著高于对照组（70％，P ＜0．05）；2组治疗后子宫体积与治疗前比较，P ＞0．05；治疗后2组 CA125、TNF-α、IL-8水平均显著下降，与治疗前比较，P ＜0．05～0．01，且观察组下降更为明显（P ＜0．05～0．01）。2组患者治疗期间均未出现明显的不良反应。结论少腹逐瘀汤加减治疗子宫腺肌病痛经可显著缓解患者痛经症状，改善患者中医证候，其作用机制可能与降低血清中的 CA125、TNF-α、IL-8水平有关。%ABSTRACT:OBJECTIVE To study the curative effects and action mechanism of using Shaofu Zhuyu decoction to treat adeno-myosis dysmenorrhea.METHODS From June 2014 to June 2015 in our hospital 80 cases of patients with uterine adenomyosis dysmenorrhea were chosen and randomly divided into the observation group and the control group (40 cases in each group). The observation group had Shaofu Zhuyu decoction 5~7 d before dysmenorrhea,while the control group had Yueyue shu de-coction,1 bag/time.The two groups all had treatment of three menstrual cycles.Dysmenorrhea symptoms before and after treatment and the changes of TCM symptoms as well as the serum of CA125,TNF-αand IL-8 levels were recorded and com-pared,and ultrasound measurement was used to calculate the size of the uterus before and after the treatment.RESULTS In the two groups after treatment,dysmenorrhea scores and TCM symptoms all declined significantly(P <0.01),but that of the observation group decreased more obviously(P <0.05).And after 3 courses of treatment in the observation group,the total effective rate was 95%,significantly higher than 67.5% in the control group;And TCM symptom in the observation group was 95% higher than 70% in the control group(P <0.05).Compared with the condition before treatment,uterine volume had no significantly changes differences after treatment(P >0.05).After treatment,uterine volume of the observation group com-pared with the control group had no significant differences(P >0.05).In the two groups after treatment CA125,TNF-α,IL-8 all declined significantly(P <0.05~0.01),but that of the observation group decreased more obviously(P <0.05~0.01). During the treatment,heart,liver and kidney were all within the normal range,without obvious adverse reactions.CONCLU-SION Using Shaofu Zhuyu Decoction to treat adenomyosis dysmenorrhea could significantly alleviate symptoms of patients with dysmenorrhea,relieving TCM symptoms.And its mechanism may be related to the lowering of the serum CA125,TNF-α,IL-8 levels.