左炔诺孕酮宫内节育系统联合少腹逐瘀汤加减治疗子宫腺肌病痛经临床研究  

Clinical Study on Levonorgestrel Intrauterine System Combined with Modified Shaofu Zhuyu Tang for Dysmenorrhea due to Adenomyosis

作　　者：裴凤霞 徐贞淑[1] 严丽慧 PEI Fengxia;XU Zhenshu;YAN Lihui

机构地区：[1]海宁市中医院,浙江海宁314400

出　　处：《新中医》2020年第8期55-57,共3页New Chinese Medicine

摘　　要：目的:观察左炔诺孕酮宫内节育系统联合少腹逐瘀汤加减治疗子宫腺肌病痛经患者的临床疗效。方法:选取120例子宫腺肌病痛经患者,按随机数字表法分为西药组和联合组各60例,西药组给予左炔诺孕酮宫内节育系统治疗,联合组给予左炔诺孕酮宫内节育系统联合少腹逐瘀汤加减治疗。分析2组临床疗效、中医证候积分、痛经程度评分、血清学指标及治疗安全性。结果:联合组总有效率为93.3%(56/60),明显高于西药组的75.0%(45/60),差异有统计学意义(P<0.05)。治疗后,2组中医证候积分、痛经程度评分、血清学各指标水平均较治疗前降低(P<0.05);联合组中医证候积分、痛经程度评分及血清糖类抗原(CA)125、肿瘤坏死因子-α、白细胞介素-8水平明显低于西药组(P<0.05)。联合组用药不良反应发生率为1.7%(1/60),西药组为3.3%(2/60),2组比较,差异无统计学意义(χ^2=0.342,P=0.559)。结论:对子宫腺肌病痛经患者实施左炔诺孕酮宫内节育系统联合少腹逐瘀汤加减治疗,可有效减轻症状,改善炎症及子宫内膜浸润生长情况,安全性高。Objective:To observe the clinical effect of levonorgestrel intrauterine system combined with modified Shaofu Zhuyu tang for patients with dysmenorrhea due to adenomyosis and its mechanism.Methods:A total of 120 cases of patients with dysmenorrhea due to adenomyosis were included and divided into the western medicine group and the combination group according to the random number table method,60 cases in each group.The western medicine group was treated with levonorgestrel intrauterine system,and the combination group was additionally treated with modified Shaofu Zhuyu tang.The clinical effect,the Chinese medicine syndrome scores,the scores of dysmenorrhea,the indexes of serology and treatment safety in the two groups were analyzed.Results:The total effective rate was 93.3%(56/60)in the combination group,significantly higher than that of 75.0%(45/60)in the western medicine group,the difference being significant(P<0.05).After treatment,the Chinese medicine syndrome scores,the scores of dysmenorrhea and the indexes of serology in the two groups were decreased when compared with those before treatment(P<0.05);the Chinese medicine syndrome score,the score of dysmenorrhea and the levels of carbohydrate antigen(CA)125,tumor necrosis factor-α and interleukin-8 in the combination group were significantly lower than those in the western medicine group(P<0.05).The incidence of adverse reactions was 1.7%(1/60)in the combination group,and 3.3%(2/60)in the western medicine group,there being no significance in the difference(χ^2=0.342,P=0.559).Conclusion:For patients with dysmenorrhea due to adenomyosis,the therapy of levonorgestrel-releasing intrauterine system combined with modified Shaofu Zhuyu tang can effectively relieve symptoms,inflammation and infiltrative growth of endometrium,with high safety.

关 键 词：子宫腺肌病 痛经 寒凝血瘀证 左炔诺孕酮宫内节育系统 少腹逐瘀汤 糖类抗原125 肿瘤坏死因子-α 白细胞介素-8 

分 类 号：R711.71[医药卫生—妇产科学]