中药外治法治疗妇科慢性盆腔痛(气滞血瘀型)52例

Treating 52 cases of gynecological chronic pelvic pain(qi stagnation and blood stasis type) by herbal penetration therapy

目的:观察中药灌肠、中药外敷治疗气滞血瘀型妇科慢性盆腔痛的临床疗效,探讨其缓解疼痛的作用机理。方法:选择妇科慢性盆腔痛(气滞血瘀型)患者52例,予中药保留灌肠、中药外敷治疗两个疗程,通过观察治疗前后数字疼痛评分(NRS)的变化,评价中药灌肠、外敷对妇科慢性盆腔疼痛的改善情况;通过观察中医证候评分以及汉密尔顿抑郁评分(24项)的变化,评价中药灌肠、外敷对慢性盆腔痛中医证候的改善情况和对抑郁情绪的影响。结果:治疗后与治疗前相比盆腔疼痛症状明显改善,总有效率为88.46%,数字疼痛评分(NRS)与治疗前相比有显著性差异(P<0.01);治疗后慢性盆腔痛患者的抑郁情绪随着疼痛的缓解也得到明显改善,汉密尔顿抑郁评分与治疗前相比有显著性差异(P<0.01)。结论:中药灌肠、外敷具有疏肝行气,温经活血,祛瘀止痛之功,能显著缓解慢性盆腔疼痛症状,改善患者的抑郁情绪,且中药外治操作简便,疗效可靠,副作用小,值得推广。

Objective： To observe the clinical curative effects of herbal enema and herbal penetration therapy in treating gynecological chronic pelvic pains and investigate the mechanism of relieving pains. Methods： 52 cases of patients with gynecological chronic pelvic pains were selected and treated with herbal enema and herbal penetration therapy. The variation of pain scores before and after treatment was observed to evaluate the improvement of chronic pelvic pains by herbal enema and herbal penetration therapy, while the TCM syndromes scores and Hamilton depression scores （24 items） were observed to evaluate the improvement of TCM syndromes of chronic pelvic pain and the affection of depressed emotion by herbal enema and herbal penetration therapy. Results： Syndromes of chronic pelvic pain improved obviously after treatment. The total effective rate was 88.46%. There was a significant difference between the pain scores before and after treatment （P〈0.01）. The depressed emotion of patients improved a lot along with the relieving of pains. There was a significant difference between the Hamilton depressed scores before and after treatment （P〈0.01）. Conclusion： The herbal enema and herbal penetration therapy had an obvious effect in dispersing the depressed liver-energy, promoting Qi, warming meridians, activating blood circulation, removing blood stasis and pains. It was worthy of wide application because it could relieve the syndromes of chronic pelvic pain and improve the depressed emotion of patients, and in addition it was convenient, effective and with little side effects.