青附柴金丹治疗寒凝血瘀型原发性痛经  

Treatment of Primary Dysmenorrhea of Cold Coagulation and Blood Stasis Type with Qingfu Chaijin Pill

作　　者：李林珏 王浩[1] 丁永芬[1] 徐先敏 朱宜临 王慧鸽 史梅莹[1] 刘晔 赖娟[1] 程玲[1] 郭卫星 LI Linjue;WANG Hao;DING Yongfen;XU Xianmin;ZHU Yilin;WANG Huige;SHI Meiying;LIU Ye;LAI Juan;CHENG Ling;GUO Weixing(Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing China 100102;Beijing University of Chinese Medicine,Beijing China 100029)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]北京中医药大学,北京100029

出　　处：《中医学报》2023年第4期868-873,共6页Acta Chinese Medicine

基　　金：中国中医科学院望京医院院级课题项目(wjyy2020-01)。

摘　　要：目的:观察青附柴金丹治疗寒凝血瘀型原发性痛经的止痛效应及对盆腔血流状态的影响。方法:采取随机对照法将60例符合纳入标准的患者分为观察组和对照组各30例,分别予青附柴金丹和布洛芬缓释胶囊,比较两组治疗前后及疗程结束3个月经周期后随访时疼痛视觉模拟评分法(visual simulation scoring,VAS)评分、COX痛经症状量表(COX dysmenorrhea symptom scale,CMSS)评分,治疗前后子宫动脉血流搏动指数(pulse index,PI)与阻力指数(resistance index,RI)、收缩期流速峰值与舒张期流速峰值的比值(A/B)、子宫静脉与卵巢静脉平均流速峰值、子宫静脉内径与卵巢静脉内径,并进行疗效判定。结果:研究过程中两组均无脱落病例。观察组有效率(86.7%)与对照组有效率(83.3%)相当(P>0.05);随访时,观察组有效率为76.7%,优于对照组(43.3%)(P<0.05)。两组VAS评分治疗后均较治疗前下降(P<0.05),随访时观察组VAS评分仍低于治疗前(P<0.05);观察组CMCC评分治疗后和随访时较治疗前均降低(P<0.05),而对照组较治疗前均无明显差异(P>0.05);观察组治疗后PI、RI、A/B较治疗前与对照组治疗后均下降(P<0.05),而子宫静脉与卵巢静脉平均流速峰值、子宫静脉内径与卵巢静脉内径均较治疗前与对照组治疗后增高(P<0.05);观察组患者治疗期间出现的药物不良反应发生率(3.3%)低于对照组(13.3%)。结论:青附柴金丹可缓解寒凝血瘀型原发性痛经患者临床症状,疗效显著,不良反应少。其可能通过降低PI、RI、A/B,扩大子宫和卵巢静脉内径、增加子宫静脉与卵巢静脉平均流速峰值等,改善盆腔血流状态而起到缓解疼痛的作用。Objective:To observe the analgesic effect of Qingfu Chaijin Pill in treating primary dysmenorrhea(PD)of cold coagulation and Blood stasis type and its effect on pelvic blood flow.Methods:Randomized controlled method was used to divide 60 patients who met the inclusion criteria into observation group and control group,30 cases in each group,and were given Qingfu Chaijin Pill and Ibuprofen Sustained-release Capsules respectively.The visual simulation scoring(VAS)score,the COX dysmenorrhea symptom scale(CMSS)score,the uterine artery blood flow pulse index(PI)and resistance index(RI)before and after treatment,the ratio of the peak systolic flow velocity to the peak diastolic flow velocity(A/B),the average peak flow velocity of the uterine vein and ovarian vein,and the uterine vein diameter and ovarian vein diameter were compared between the two groups before and after treatment and at the follow-up after 3 menstrual cycles.And the curative effect was evaluated.Results:During the study,there were no drop-out cases in the two groups.The effective rate of the observation group(86.7%)was comparable to that of the control group(83.3%)(P>0.05).During follow-up,the effective rate of the observation group was 76.7%,which was better than that of the control group(43.3%)(P<0.05).After treatment,the VAS scores of the two groups were lower than those before treatment(P<0.05),and the VAS scores of the observation group were still lower than those before treatment during the follow-up(P<0.05).After treatment,the CMCC score of the observation group was lower than that before treatment and follow-up(P<0.05),while there was no significant difference in the control group compared with before treatment(P>0.05).After treatment,PI,RI,and A/B in the observation group were lower than those before treatment and lower than those in the control group after treatment(P<0.05).However,the average flow velocity of the uterine vein and ovarian vein,the inner diameter of the uterine vein,and the ovarian vein were all higher than those before treatm

关 键 词：原发性痛经 青附柴金丹 寒凝血瘀证 盆腔血流 止痛 

分 类 号：R271.113[医药卫生—中医妇科学]