中药内服与外敷分期治疗子宫腺肌病35例临床观察

Clinical Observation on Chinese Medical Therapy for 35 Cases of Adenomyo sis with Oral and Topical Medication by Stage

目的观察活血消癥胶囊、化瘀止痛胶囊联合敷脐止痛散分期治疗子宫腺肌病的临床疗效。方法选取66例子宫腺肌病患者随机分为两组。治疗组35例,于非经期服用活血消癥胶囊,每次3粒,每日3次;于月经前3～5天开始外用敷脐止痛散,隔日1次,月经干净后停药;经期口服化瘀止痛胶囊,每次3粒,每日3次。对照组31例,非经期口服桂枝茯苓胶囊,每次3粒,每日3次;经期口服元胡止痛软胶囊,每次2粒,每日3次。两组均治疗3个月。观察两组患者治疗后痛经与月经改善情况及治疗前后检测患者子宫体积、血清糖链抗原125(CA125)、血栓素B2(TXB2)及一氧化氮(NO)的变化。结果治疗后治疗组痛经改善有效率为91.4%,月经不调改善有效率为88.6%;对照组痛经改善有效率为74.2%,月经不调改善有效率为67.7%,两组比较差异均有统计学意义(P<0.05)。两组患者治疗后子宫体积缩小,血清CA125、TXB2及NO含量明显下降(P<0.05或P<0.01),组间比较子宫体积、血清CA125及NO含量差异有统计学意义(P<0.05或P<0.01)。结论活血消癥胶囊、化瘀止痛胶囊合敷脐止痛散能明显改善患者痛经及月经失调症状,其机理可能与降低血清CA125、TXB2及NO的含量有关。

Objective To observe the therapeutic effect and mec ha nism of Huoxue Xiaozheng Capsule（Capsule for Blood-Quic kening and Concretions-Dispersing）,Huayu Zhitong Capsule（Capsule for StasisTransforming and Pain-Relieving） combined with Fuqi Zhitong Powder（UmbilicusCompressing and Pain-Relieving Powder） for adenomyosis by stage.Totally 66 ade nomyosis patients were randomized into treatment group a nd control group.The treatment group（35 cases） accepted Huoxue Xiaozheng Capsu le 3 pills each time,three times a day duri ng non-menstrual period.Fuqi Zhitong Powder was topically applied once every o ther day from 3 or 5 days before the menstruation to the end.Huayu Zhitong Capsule was taken orally 3 pills each ti me,three times a day during the menstruation.The control group accepted Guizhi Fuling Capsule [Capsule of Guizhi（Ramulus Cinnamomi） and Fuling（Poria）] 3 pil ls each time,three times a day during non-menstrual period.Yuanhu Zhitong Sof t Gelatin Capsule [capsule of Yuanhu（Rhizoma Corydalis） for relieving pain ] wa s taken orally 2 pills each time,three times a day during the menstruation. Both groups were treated for 3 months.The relief of menstrual colic and disorde r was observed.The size of uterus,carbohydrate antigen 125（CA125）,thromboxane B2（TXB2） and NO were detected.Results After treat m ent,the improvement rate of dysmenorrhea and menstruation was 91.4% and 88.6% in the treatment group,wh ile that in the control group was 74.2% and 67.7% respectively,the difference b etween was statistical ly significant（P0.05）.The size of uterus was reduced and the content of CA125,TXB2 and NO was decreased significantly in both groups（P0.05 or P 0.01）.The size of uterus and the content of CA125 and NO were significantly different bet ween groups（P0.05 or P0.01）.Conclusion The combination of Huoxue Xiaozheng Capsule,Huayu Zhitong Capsule and Fuqi Zhit ong Powder could relieve the menstrual colic and disorder,which maybe relevant to reducing the content of CA125,TXB2 and NO.