祛瘀理气汤加减联合针灸对子宫肌瘤术患者的影响

Effect of Modified Quyu Liqi Decoction(祛瘀理气汤)Combined with Acupuncture on Patients Undergoing Hysteromyoma

目的探讨祛瘀理气汤加减联合针灸对腹腔镜下子宫肌瘤术后中医证候积分及激素水平的影响。方法选择2018年10月—2020年10月该院收治的子宫肌瘤患者90例,采用随机数字表法将其分为对照组(45例)与研究组(45例),对照组口服米非司酮,研究组采用祛瘀理气汤加减联合针灸疗法,连续治疗2个月后,比较两组患者临床疗效、中医证候积分(肌瘤结节、子宫增大、小腹刺痛、精神抑郁、脉弦细涩)、炎症因子水平[C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)]、应激素水平[去甲肾上腺素(NE)、皮质醇(COR)]、卵泡刺激素(FSH)、雌二醇(E_(2))、并发症发生率。结果治疗后,对照组总有效率(82.22%,37/45)显著低于研究组(95.56%,43/45),差异有统计学意义(P<0.05);治疗前,两组中医证候积分及TNF-α、CRP、COR、NE、ESH、E_(2)值比较差异无统计学意义(P>0.05);治疗后,两组中医证候积分及E_(2)值较本组治疗前明显下降,TNF-α、CRP、COR、NE、ESH值较本组治疗前明显升高,差异有统计学意义(P<0.05);治疗后,研究组中医证候积分及TNF-α、CRP、COR、NE、ESH值明显低于对照组,差异有统计学意义(P<0.05);治疗后,两组E_(2)值及总并发症发生率比较差异有统计学意义(P<0.05)。结论祛瘀理气汤加减联合针灸对气滞血瘀型子宫肌瘤患者疗效显著,可通过调节炎症因子水平、应激素水平及卵巢功能改善患者临床症状,并无较大术后并发症发生,值得推广。

Objective To investigate the effect of Quyu Liqi Decoction(祛瘀理气汤)combined with acupuncture on postoperative TCM syndrome score and hormone level after laparoscopic myomectomy.Methods Ninety patients with uterine fibroids admitted to the hospital from October 2018 to October 2020 were divided into the control group(45 cases)and the study group(45 cases)by using a random number table method.The control group received oral mifepristone and the study group received Quyu Liqi Decoction combined with acupuncture.After 2 months of continuous treatment,various indicators were compared between groups,including clinical efficacy,TCM symptom scores(myoma nodules,uterus enlargement,lower abdominal tingling,mental depression,pulse string),inflammatory factor levels[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)],hormone levels[norepinephrine(NE),cortisol(COR)],follicle stimulating hormone(FSH),estradiol(E_(2))as well as the incidence rate of complications.Results The total effective rate of the control group was significantly lower than that of the study group[82.22%(37/45)vs 95.56%(43/45)(P<0.05)].TCM syndrome scores,levels of TNF-α,CRP,COR,NE,ESH and E_(2)had no difference between groups before treatment(P>0.05).After treatment,the TCM syndrome scores and E_(2)values were decreased.The levels of TNF-α,CRP,COR,NE and FSH were increased within groups(P<0.05).The TCM syndrome scores,and the levels of TNF-α,CRP,COR,NE and FSH in the study group were significantly lower than those in the control group(P<0.05).The levels of E_(2)and the total complications showed significant difference between groups after treatment(P<0.05).Conclusion The application of Quyu Liqi Decoction combined with acupuncture can effectively ameliorate the clinical symptoms through the regulation of inflammatory factor levels,hormone level and ovarian function for patients with uterine leiomyoma with no obvious complications,and it is worthy of promotion.