加味温经汤治疗寒凝血瘀型原发性痛经的疗效及对子宫动脉血流动力学的影响

Effect of Jiawei Wenjing Decoction(温经汤)on Primary Dysmenorrhea of Cold Coagulation and Blood Stasis Type and Its Influence on Uterine Artery Hemodynamics

目的探讨加味温经汤对寒凝血瘀型原发性痛经的疗效及对子宫动脉血流动力学的影响。方法选取2021年1月—2022年12月在濮阳市妇幼保健院就诊的原发性痛经患者120例,按随机数字表法分为试验组和对照组,各60例。对照组给予布洛芬缓释胶囊口服,试验组给予加味温经汤进行干预。比较两组治疗前后中医症状评分及疗效;外周血疼痛介质(前列腺素F2α[PGF2α]、β-内啡肽[β-EP]、5-羟色胺[5-HT]、前列腺素E_(2)[PGE_(2)])水平;子宫动脉血流动力学指标(子宫动脉搏动指数[API]、阻力指数[RI])。结果治疗后,两组中医症状总评分较治疗前明显下降,试验组总评分低于对照组(P<0.05);试验组干预总有效率为95.00%高于对照组65.00%(P<0.05);试验组β-EP、PGE_(2)水平高于对照组(P<0.05),PGF2α、5-HT低于对照组(P<0.05);试验组API及RI低于对照组(P<0.05)。结论加味温经汤能够有效减轻患者痛经症状,调节子宫内分泌环境,降低疼痛介质水平,减少提高疗效,还可以改善子宫动脉血流动力学指标。

Objective To explore the effect of Jiawei Wenjing Decoction(温经汤)on primary dysmenorrhea of cold coagula-tion and blood stasis type and its influence on uterine artery hemodynamics.Methods 120 patients with primary dysmenorrhea who were treated in Puyang Maternal and Child Health Hospital from January 2021 to December 2022 were randomLy divided into observation group and control group,with 60 patients in each group.The control group was given ibuprofen sustained-release capsule orally,and the observation group was given Jiawei Wenjing Decoction.Observe and compare the TCM symptom score and curative effect of the two groups before and after the intervention;Peripheral blood pain mediator(prostaglandin F2α〔PGF2α〕,β-Endorphin〔β-EP〕,5-hydroxytryptamine〔5-HT〕,prostaglandin E_(2)〔PGE_(2)〕)levels;Uterine artery hemo-dynamic indexes(uterine artery pulsatility index〔API〕,resistance index〔RI〕).Results After the intervention,the total score of TCM symptoms in the two groups was significantly lower than that before the intervention,and the total score in the observation group was lower than that in the control group(P<0.05),the total effective rate of intervention in the observation group was 95.00%,which was significantly higher than that in the control group of 65.00%(P<0.05);observation groupβ-The levels of EP and PGE 2 were higher than those of the control group(P<0.05),PGF2α,5-HT was significantly lower than that of the control group(P<0.05),the API and RI of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).Conclusion Jiawei Wenjing Decoction can effectively relieve the symptoms of dysmenor-rhea,regulate the endocrine environment of the uterus,reduce the level of pain medium,and improve the curative effect.It can also improve the hemodynamic indexes of the uterine artery,which is worthy of clinical application.