痛经宁汤联合穴位贴敷治疗湿热瘀结型子宫内膜异位症相关性慢性盆腔痛临床观察  

Clinical observation of Tongjingning Decoction combined with acupoint sticking on endometriosis-associated chronic pelvic pain of wet-hot-ecchymosis stases type

作　　者：万怡婷 宋艳华[1] 陈静[1] 孔珏莹 谷灿灿 眭瑾 WAN Yiting;SONG Yanhua;CHEN Jing;KONG Jueying;GU Cancan;SUI Jin(Department of Gynecology,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071)

机构地区：[1]上海中医药大学附属市中医医院妇科,上海200071

出　　处：《河北中医》2022年第6期927-930,992,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：上海市中医诊疗模式创新试点建设项目[编号:ZY(2018-2020)-FWTX-6006];上海申康医院发展中心促进市级医院临床技能与临床创新能力三年行动计划项目(编号:SHDC2020CR4056);上海市卫生健康委员会中医药科研项目(编号:2020LQ001);上海市卫生健康委员会中医药科研项目(编号:2020LP001);上海市卫生和计划生育委员会科研课题(编号:201840163);上海市科学技术委员会科技计划项目(编号:20Y21901400)。

摘　　要：目的观察痛经宁汤联合穴位贴敷治疗湿热瘀结型子宫内膜异位症(EMs)相关性慢性盆腔痛(CPP)的临床疗效。方法将177例湿热瘀结型EMs相关性CPP患者按照随机数字表法分为2组,对照组62例予痛经宁汤治疗,治疗组115例在对照组治疗基础上应用穴位贴敷,2组均于月经结束后治疗14 d,连续治疗3个月经周期。比较2组疗效;比较2组治疗前后中医证候评分变化;比较2组治疗前后下腹部疼痛、腰骶部疼痛情况;比较2组治疗前后抑郁自评量表(SDS)、焦虑自评量表(SAS)评分变化。结果治疗组愈显率75.65%(87/115),对照组愈显率53.33%(32/60),治疗组疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分及总评分均较本组治疗前降低(P<0.05);治疗组治疗后下腹胀痛或刺痛、痛处固定,腰骶胀痛,经期腹痛加重,月经量多或伴经期延长评分及总评分均低于对照组(P<0.05)。2组治疗后下腹部轻中度疼痛患者比例、腰骶部轻中度疼痛患者比例均较本组治疗前降低,且治疗组降低更明显(P<0.05)。2组治疗后SDS、SAS评分均较本组治疗前降低(P<0.05),治疗组治疗后SAS评分低于对照组(P<0.05)。结论痛经宁汤联合穴位贴敷治疗湿热瘀结型EMs相关性CPP,能提高疗效,减轻患者下腹部疼痛、腰骶部疼痛状况,改善抑郁、焦虑状况,进而提高生活质量。Objective To observe the clinical observation of Tongjingning Decoction combined with acupoint sticking on endometriosis(EMs)-associated chronic pelvic pain(CPP)of wet-hot-ecchymosis stases type.Methods A total of 177 patients with EMs-associated CPP(wet-hot-ecchymosis stases type)were randomly divided into two groups.The control group(n=62)was treated with oral Tongjingning Decoction,the treatment group(n=115)was additionally treated with acupoint sticking based on the control group.Both groups were treated for 14 days after menstruation for 3 menstrual cycles.The key observation was the curative effects,traditional Chinese medicine(TCM)syndrome scores;the pain of lower abdominal and lumbosacral portion,Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS)between groups before and after treatment.Results The cured and markedly effective rates were 75.65%(87/115)in the treatment group,higher than those of 53.33%(32/60)in the control group.After treatment,the scores of TCM syndromes in groups were decreased(P<0.05),TCM syndromes scores(lower abdominal pain or pricking pain,fixed pain,lumbosacral pain,increased menstrual pain,excessive menstrual flow,and prolonged menstrual period)in the treatment group were lower than those in the control group(P<0.05);the proportion of patients with pain of mild to moderate lower abdominal and lumbosacral region was all lower than that before treatment,and the reduction in the treatment group was more obvious(all P<0.05).The SDS and SAS scores in groups were decreased(P<0.05),and the SAS score in the treatment group was lower than that in the control group(P<0.05).Conclusion For patients with EMs-associated CPP(wet-hot-ecchymosis stases type),Tongjingning Decoction combined with acupoint sticking can effectively improve the curative effect,reduce lower abdominal pain,lumbosacral pain,improve depression,anxiety,thereby improving quality-of-life of patients.

关 键 词：子宫内膜异位症 慢性病 疼痛 子宫附件疾病 中药疗法 穴位贴敷法 

分 类 号：R711.71[医药卫生—妇产科学] R441.1[医药卫生—临床医学] R289.6R245.9