加味少腹逐瘀汤联合米非司酮对肾虚血瘀型子宫内膜异位症痛经患者盆腔炎性“瀑布”及血液流变指数的影响  

Effect of Jiawei Shaofu Zhuyu Decoction combined with mifepristone on Pelvic Inflammatory"Waterfall"and Hemorheological Index of Dysmenorrhea Patients with Renal deficiency and Blood Stasis Type Endometriosis

作　　者：黄灿灿 岳斌 武权生[1] 张小花[1] 申剑[1] HUANG Can-can;YUE Bin;WU Quan-sheng;ZHANG Xiao-hua;SHEN Jian(Gansu University of Chinese Medicine,Lanzhou,730000,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730000

出　　处：《时珍国医国药》2024年第4期913-916,共4页Lishizhen Medicine and Materia Medica Research

基　　金：国家自然科学基金(82260949,81700879);甘肃省科技计划项目优秀博士生项目(23JRRA1220);甘肃中医药大学科学研究与创新基金项目(2021KCYB-2);甘肃中医药大学研究生创新创业基金(2022CX-01);西北环境与营养相关疾病中医药防控协同创新中心开放项目(ZYXT-20-06)。

摘　　要：目的探究加味少腹逐瘀汤联合米非司酮对子宫内膜异位症痛位患者的盆腔免疫炎性微环境及血液流变学影响。方法选取2022年1月至2023年3月108名子宫内膜异位症患者按照随机数字表分为两组,对照组54例给予米非司酮,观察组在对照组的基础上再予加味少腹逐瘀汤,治疗3个月经周期。治疗结束后比较两组总有效率、VAS评分、血清指标(CA-125、IL-6、IL-8、TNF-α)、辅助性T淋巴细胞17(Th17)、调节性T淋巴细胞(Treg)细胞数量、全血黏度(ηb),血浆黏度(ηp),红细胞聚集指数(AI)、流动力学(子宫动脉收缩期最大血流速度、PI、RI)的差异;比较两组的不良反应。结果两组治疗均收效,且观察组疗效总有效率高于对照组(Z=-3.621,P<0.05);经治疗,两组患者VAS评分、血清指标、血流动力学指标均有所改善(P<0.05),且观察组更为显著(P<0.05);而血液流变学指数仅观察组明显改善(P<0.05),两组不良反应发生率无统计学差异。结论加味少腹逐瘀汤联合米非司酮对子宫内膜异位症痛经疗效肯定,这可能与缓解盆腔炎症“瀑布”、改善局部微循环及血浆黏度的作用有关。Objective To investigate the effect of Jiawei Shaofu Zhuyu decoction combined with mifepristone on pelvic immunoinflammatory microenvironment and blood rheology in patients with renal deficiency and blood stasis type endometriosis.Methods A total of 108 patients with endometriosis from January 2022 to March 2023 were divided into two groups according to the random number table,54 cases in the control group were given mifepristone,and the observation group was treated with Jiawei Shaofu Zhuyu decoction duing a 3-menstrual cycle on the basis of the control group.After treatment,the total effective rate,VAS score,serum indexes(CA-125,IL-6,IL-8,TNF-α),helper T lymphocyte 17(Th17),number of regulatory T lymphocyte(Treg)cells,whole blood viscosity(ηb),plasma viscosity(ηp),red blood cell aggregation index(AI),and flow dynamics(maximum blood flow velocity during uterine artery systolic,PI,RI)were compared between the two groups.Adverse effects were compared between the two groups.Results Both groups were effective,and the overall effective rate of efficacy in the observation group was higher than that in the control group(Z=-3.621 P<0.05),and the VAS score,serum index,and hemodynamic indexes of the two groups were improved(P<0.05),and the observation group was more significant(P<0.05),while the blood rheological index was only significantly improved in the observation group(P<0.05),and there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The efficacy of Jiawei Shaofu Zhuyu decoction combined with mifepristone in the treatment of endometriosis dysmenorrhea is certain,which may be related to the effect of alleviating local inflammatory response,improving local microcirculation and plasma viscosity.

关 键 词：加味少腹逐瘀汤 米非司酮 子宫内膜异位症 痛经 炎性因子 血流动力学 

分 类 号：R285.6[医药卫生—中药学]