清瘀温通法治疗子宫内膜异位症痛经的临床疗效观察  

Clinical study on treatment of endometriosis dysmenorrhea with Qingyu Wentong method

作　　者：曹阳[1] 田露露 翁雷 束兰娣[3] 张婷婷[1] Cao Yang;Tian Lulu;Weng Lei;Shu Landi;Zhang Tingting(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of TraditionalChinese Medicine,Shanghai 200437,China;Shanghai First Maternity and Infant Hospital,Shanghai 200040,China;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,200437 [2]上海同济大学附属第一妇婴保健院,200040 [3]上海中医药大学附属曙光医院,200021

出　　处：《中华生殖与避孕杂志》2019年第2期130-134,共5页Chinese Journal of Reproduction and Contraception

基　　金：上海市中医药事业发展三年行动计划资助项目(ZY3-CCCX-3-3019);上海市科委科技创新行动计划(18401972000);岳阳中西医结合医院院级课题(2018YJ15).

摘　　要：目的探讨清瘀温通法治疗子宫内膜异位症(EMS)痛经的临床疗效。方法将2015年12月—2017年10月期间于上海中医药大学附属岳阳中西医结合医院妇科、曙光医院妇科、上海同济大学第一妇婴保健院妇科就诊的91例EMS术后患者采用随机数字表法分为治疗组(给予清瘀温通方,n=45)和对照组(给予安慰剂,n=46),经连续治疗3个月经周期后观察两组患者治疗前后痛经情况、中医证候疗效及血清CA125、前列腺素E2(PGE2)水平,并采用EMS健康相关质量量表(EHP-30)对患者生存质量进行评估。结果治疗组与对照组痛经缓解率分别为82.2%、23.9%;痛经程度也较治疗前降低(P<0.001),且治疗组优于对照组(P=0.037)。治疗组与对照组中医证候总有效率分别为80.0%、30.4%,中医证候评分亦较治疗前均有显著改善(P<0.001),组间比较差异有统计学意义(P=0.044)。治疗后,治疗组CA125[(41.50±34.85) U/mL]、PGE2水平[(350.52±125.98) ng/L]均显著降低(P<0.001),且治疗组下降幅度优于对照组(P<0.001)。治疗组与对照组患者治疗后生存质量均得到一定改善。在对疼痛的控制力、情绪稳定性、社会支持方面组间差异亦有统计学意义(P<0.001)。结论清瘀温通法可以降低EMS患者的痛经程度,改善临床症状,降低患者血清PGE2、CA125的水平,提高患者生存质量,值得临床推荐。Objective To observe the clinical efficacy of Qingyu Wentong method in treating endometriosis (EMS) dysmenorrhea. Methods Ninty-one cases of EMS patients were randomly divided into two groups, 45 cases in treatment group and 46 cases in control group. The treatment group was given Qingyu Wentong formula and control group was given placebo. All patients were continuously treated for 3 menstrual cycles. The dysmenorrhea, traditional Chinese medicine (TCM) symptom effect, serum CA125 and prostaglandin E2 (PGE2) were observed and analyzed statistically. And the quality of life was assessed by the Endometriosis Health Profile-30 (EHP-30) in two groups. Results The remission rate of dysmenorrhea was 82.2% and 23.9%, respectively (P<0.001). After treatment, dysmenorrhea scale scores of two groups were lower than before treatment (P<0.001), and the treatment group was superior to control group (P=0.037). The total effective rates of TCM syndromes in treatment group and control group were 80.0% and 30.4%, respectively. After treatment, the scores of TCM syndromes in both groups were significantly improved (P<0.001), and there was a significant difference between the two groups (P=0.044). After treatment, the CA125 [(41.50±34.85) U/mL] and PGE2 values [(350.52±125.98) ng/L] in the treatment group decreased (P<0.001), and treatment group was better than control group (P<0.001). Two groups of patients’ quality of life was improved. There was a significant difference in pain control, emotional stability and social support between the two groups (P<0.001). Conclusion Qingyu Wentong method can reduce the degree of dysmenorrhea in EMS patients, reduce the levels of CA125 and PGE2, improve the quality of life and clinical efficacy. It is worthy of recommendation.

关 键 词：子宫内膜异位症 生存质量 清瘀温通法 痛经 

分 类 号：R271.113[医药卫生—中医妇科学]