散结镇痛胶囊联合地屈孕酮治疗子宫内膜异位症痛经患者的临床疗效及对其炎症介质、生活质量的影响  

Efficacy of Sanjie Zhentong Capsule Combined with Dydrogesterone for Patients with Dysmenorrhea of Endometriosis and Its Impact on Inflammatory Mediators and Quality of Life

作　　者：丁兰芳 曹剑[1] 齐丹[2] 寇青[1] DING Lan-fang;CAO Jian;QI Dan;KOU Qing(Department of Gynecology,Woman′s Hospital of Nanjing Medical University,Nanjing Woman and Children′s Healthcare Hospital,Nanjing Jiangsu 210004;Department of traditional Chinese medicine,Woman′s Hospital of Nanjing Medical University,Nanjing Woman and Children′s Healthcare Hospital,Nanjing Jiangsu 210004)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)妇科,江苏南京210004 [2]南京医科大学附属妇产医院(南京市妇幼保健院)中医科,江苏南京210004

出　　处：《世界中西医结合杂志》2025年第3期574-579,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：南京市卫生科技发展专项资金项目(YKK18158)。

摘　　要：目的观察散结镇痛胶囊联合地屈孕酮治疗子宫内膜异位症(Endometriosis,EMs)痛经患者的临床疗效及对其血清炎症介质、生活质量的影响。方法选取2021年1月—2023年1月期间于南京医科大学附属妇产医院(南京市妇幼保健院)就诊的EMs痛经患者90例,按数字随机表法分为对照组和观察组,每组各45例。对照组采取地屈孕酮治疗,观察组在对照组基础上联合散结镇痛胶囊治疗,治疗3个月后,观察比较两组患者临床疗效、安全性,治疗前后中医证候评分、痛经数字评价量表(Numeric rating scale,NRS)评分,中文版COX痛经症状评分量表(Cox menstrual symptom scale,CMSS)评分、盆腔包块直径、子宫内膜厚度及子宫体积变化、血清炎症介质[清肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白介素-1β(Interleukin-1β,IL-1β)、白介素-6(Interleukin-6,IL-6)和细胞间黏附分子-1(Intercellular adhesion molecule-1,ICAM-1)]水平。结果治疗后两组患者中医证候评分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组中医证候评分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者NRS及CMSS评分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组NRS及CMSS评分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者盆腔包块直径、子宫内膜厚度及子宫体积均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组盆腔包块直径、子宫内膜厚度及子宫体积低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者TNF-α、IL-1β、IL-6、ICAM-1水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组血清炎症各项指标低于对照组,差异有统计学意义(P<0.05)。治疗后观察组治愈率及总有效率44.44%(20/45)、97.78%(44/45)高于对照组28.89%(13/45)、82.22%(37/45),差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应类型及发生率比较,差异无统Objective To observe the efficacy of Sanjie Zhentong capsule combined with dydrogesterone for patients with dysmenorrhea of endometriosis(EMs)and its impact on serum inflammatory mediators and quality of life.Methods From January 2021 to January 2023,a total of 90 patients with EMs treated in our hospital were collected as the subjects of this study.They were randomly divided into a control group and an observation group by the random number table method,with 45 cases in each group.The control group received treatment with dydrogesterone,while the observation group received treatment with Sanjie Zhentong capsule combined with dydrogesterone.After 3 months of treatment,the therapeutic effect was observed and compared in the following aspects before and after treatment:the Traditional Chinese Medicine(TCM)syndrome score,the dysmenorrhea Numeric Rating Scale(NRS)score,the Chinese version of the Cox Menstrual Symptom Scale(CMSS),the diameter of the pelvic mass,changes in endometrial thickness and uterine volume,the serum inflammatory mediators including Tumor Necrosis Factor-α(TNF-α),Interleukin-1β(IL-1β),Interleukin-6(IL-6),and Intercellular Adhesion Molecule-1(ICAM-1).Results After treatment,the TCM syndrome score of both groups was decreased significantly,with statistical significance(P<0.05)while the TCM syndrome score was lower in the observation group(P<0.05).The NRS and CMSS scores of both groups were decreased significantly(P<0.05)while the NRS and CMSS scores were lower in the observation group(P<0.05).The diameter of pelvic masses,endometrial thickness,and uterine volume in both groups were significantly reduced(P<0.05).The levels of TNF-α,IL-1β,IL-6,and ICAM-1 in both groups were significantly reduced(P<0.05),and the serum inflammation indicators were lower in the observation group(P<0.05).The cure rate and total effective rate of the observation group were 44.44%(20/45)and 97.78%(44/45),respectively,higher than those of the control group,which were 28.89%(13/45)and 82.22%(37/45),respectively(P<0.05)

关 键 词：子宫内膜异位症 痛经 散结镇痛胶囊 地屈孕酮 生活质量 炎症 

分 类 号：R271.113[医药卫生—中医妇科学] R711.71[医药卫生—中医学]