补肾活血散瘀汤治疗肾虚血瘀型子宫腺肌症的临床观察  

Treatment of Adenomyosis Patients by Bushen Huoxue Sanyu Decoction:a Clinical Study

作　　者：成臣 桂涛[1] 黄美华[1] 朱利[1] 马小平[1] 荀爱华[1] 杨桂云[1] 万贵平[1] 

机构地区：[1]江苏省中西医结合医院妇产科,南京210028

出　　处：《中国中西医结合杂志》2014年第11期1302-1305,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：江苏省名老中医药专家(杨桂云)传承工作室建设项目基金资助(No.GZS-02);中医科学院江苏分院院级课题(No.JSBY1305)

摘　　要：目的评价补肾活血散瘀汤治疗肾虚血瘀型子宫腺肌症的临床疗效。方法选择70例中医辨证属肾虚血瘀型的子宫腺肌症患者分为中药组(50例)和曼月乐组(20例)。中药组给予补肾活血散瘀汤治疗,每日1剂;曼月乐组给予宫腔放置左炔诺孕酮宫内节育系统(曼月乐)治疗,每日释放左炔诺酮20μg至宫腔;两组疗程均为3个月。观察两组患者治疗前后患痛经、月经量、肾虚血瘀证候、中医证候、子宫体积及血清糖类抗原CA125的变化。结果与本组治疗前比较,两组治疗后痛经症状积分、月经量评分、肾虚血瘀证候评分及中医证候总积分均降低(P<0.01);两组治疗后子宫体积缩小(P<0.05),血清糖类抗原CA125下降(P<0.05,P<0.01)。与曼月乐组比较,治疗后中药组痛经症状积分升高,肾虚血瘀证候评分降低(P<0.01,P<0.05);两组间比较,子宫体积及血清糖类抗原CA125值差异均无统计学意义(P>0.05)。结论补肾活血散瘀汤能有效缓解肾虚血瘀型子宫腺肌症患者痛经、月经量多、子宫体积增大等主要临床症状及降低肾虚血瘀证候评分和中医证候总积分。Objective To observe the clinical efficacy of Bushen Huoxue Sanyu Decoction（ BHSD） in treatment of adenomyosis（ AM） patients. Methods Seventy AM patients of Shen deficiency blood stasis syndrome（ SDBSS） were randomly assigned to two groups,the CM treatment group（ 50 cases） and the Mirena group（ 20 cases）. Patients in the CM treatment group were treated with BHSD,one dose per day. Levonorgestrel intrauterine system（ Mirena） was placed in the uterine cavity of those in the Mirena group. The therapeutic course for all was 3 months. Changes of dysmenorrhea,menstrual quantity,SDBSS,CM syndrome,uterine volume,and serum CA125 levels were observed before and after treatment. Results Compared with before treatment in the same group,scores for dysmenorrhea integral,scores for menstrual quantity,scores for SDBSS,and scores for CM syndrome all decreased in the two groups after treatment（ P 〈0. 01）. Compared with before treatment in the same group,the uterine volume was reduced after treatment in the two groups（ P 〈0. 05） and serum carbohydrate antigen CA125 levels decreased between the two groups（ P 〈0. 05,P 〈0. 01）. Compared with the Mirena group,scores for dysmenorrhea integral increased and scores for SDBSS decreased in the CM treatment group（ P 〈0. 01,P 〈0. 05）. There was no statistical difference in the uterine volume or serum carbohydrate antigen CA125 levels（ P 〉0. 05）. Conclusions BHSD could effectively alleviate main symptoms of AM patients of QSBSS such as dysmenorrhea,profuse menstrual blood volume,and increased uterine volume,and lower scores for QSBSS and the total score for CM syndrome.

关 键 词：子宫腺肌症 补肾活血散瘀汤 肾虚血瘀证 中医证候 

分 类 号：R271[医药卫生—中医妇科学]