温经汤联合中药热奄包外用对痛经患者血清疼痛介质水平的影响  

Wenjing Decoction Combined with Traditional Chinese Medicine Hot Package Regulates Serum Levels of Pain Mediators in Patients with Dysmenorrhea

作　　者：路帅[1] 成秀梅 孙红燕[1] 温志刚[2] LU Shuai;CHENG Xiu-mei;SUN Hong-yan;WEN Zhi-gang(Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang Hebei 050000;Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang Hebei 050000)

机构地区：[1]石家庄市中医院,河北石家庄050000 [2]河北省中医院,河北石家庄050000

出　　处：《世界中西医结合杂志》2023年第4期756-759,766,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2017115)。

摘　　要：目的 探讨温经汤联合中药热奄包外用对痛经患者血清疼痛介质水平的影响。方法 选取2016年1月—2019年12月期间石家庄市中医院痛经患者150例作为研究对象,采用随机数字表法分为对照组、治疗I组、治疗Ⅱ组,每组各50例。对照组给予布洛芬干预,治疗Ⅰ组给予布洛芬+温经汤干预,治疗Ⅱ组给予布洛芬+温经汤+中药热奄包外用治疗。治疗3个月经周期后,观察比较3组患者临床疗效,检测3组患者疼痛介质[一氧化氮(Nitric oxide, NO)、P物质(Substance P,SP)、降钙素基因相关肽(Calcitonin gene related peptide, CGRP)及前列腺素E_(2)(Prostaglandin E_(2),PGE_(2))]和氧化应激指标[超氧化物歧化酶(Superoxide dismutase, SOD)、丙二醛(Malondialdehyde, MDA)及总抗氧化能力(Total antioxidant capacity, T-AOC)]水平。结果 治疗后治疗Ⅱ组总有效率92.00%(46/50)明显高于治疗Ⅰ组84.00%(42/50)和对照组72%(36/50),差异有统计学意义(P<0.05)。治疗后3组患者血清NO、CGRP水平较治疗前升高,血清SP、PGE_(2)水平较治疗前降低,差异有统计学意义(P<0.05);且治疗Ⅱ组血清NO、CGRP水平高于对照组和治疗Ⅰ组,血清SP、PGE_(2)水平低于对照组和治疗Ⅰ组,差异有统计学意义(P<0.05)。治疗后3组患者血清SOD、T-AOC水平较治疗前升高,MDA水平较治疗前降低,差异有统计学意义(P<0.05);且治疗Ⅱ组血清SOD、T-AOC水平高于治疗Ⅰ组和对照组,MDA水平低于治疗Ⅰ组和对照组,差异有统计学意义(P<0.05)。结论 温经汤联合中药热奄包外用能显著提高寒凝血瘀型痛经患者的治疗效果,可能与其改善疼痛介质和氧化应激水平有关。Objective To observe the effects of Wenjing Decoction combined with traditional Chinese medicine(TCM)hot package on the serum levels of pain mediators in the patients with dysmenorrhea.Methods A total of 150 pa-tients with dysmenorrhea(syndrome of cold coagulation and blood stasis)treated in Shijiazhuang Hospital of Traditional Chinese Medicine from January 2016 to December 2019 were selected and randomized into a control group(n=50)and ob-servation groups I(n=50)and observation groups II(n=50).The patients in the control group and observation groups I and II received ibuprofen,ibuprofen+Wenjing Decoction,and ibuprofen+Wenjing Decoction+TCM hot package,respec-tively.The therapeutic effects of the three groups were compared after 3 menstrual cycles of treatment.The serum levels of pain mediators[nitric oxide(NO),substance P(SP),calcitonin gene-related peptide(CGRP),and prostaglandin E_(2)(PGE_(2))],oxidative stress indicators[superoxide dismutase(SOD)and malondialdehyde(MDA)],and total antioxidant ca-pacity(T-AOC)were measured before and after treatment.Results The observation group II(92.00%,46/50)showed higher total effective rate than the observation group I(84.00%,42/50)and the control group(72%,36/50)(P<0.05).The treatment in all the three groups elevated the NO and CGRP levels and lowered the SP and PGE_(2) levels(P<0.05)and observation group II outperformed observation group I and control group(P<0.05).In addition,the treatment in all the three groups increased SOD and T-AOC and decreased MDA(P<0.05),and the changes in observation group II were more significant than those in the other two groups(P<0.05).Conclusion Wenjing Decoction combined with TCM hot package can significantly improve the therapeutic effect on the dysmenorrhea patients with the syndrome of cold coagu-lation and blood stasis by regulating the levels of pain mediators and the oxidative stress response.

关 键 词：温经汤 中药热奄包 痛经 疼痛介质 寒凝血瘀 

分 类 号：R271.113[医药卫生—中医妇科学]