中药辨证治疗痛经139例临床观察

A Clinical Observation on Chinese Medication for 139 Cases of Dysmenorrhea

目的观察中药辨证治疗痛经的临床疗效。方法将231例患者随机分为中药组139例、中成药组45例及西药组47例。中药组患者按照气滞血瘀证、寒湿凝滞证、湿热瘀阻证、气血虚弱证及宿瘀内结证给予中药辨证治疗,西药组给予散利痛片,中成药组给予血府逐瘀颗粒。各组均连续用药3个月经周期为1个疗程。观察各组中医证候及临床疗效,并分别于治疗前后对患者痛经及其他主要临床症状、生活质量进行评分。结果中药组、中成药组、西药组中医证候总有效率分别为91.37%、75.56%、40.43%,临床疗效总有效率分别为82.01%、71.11%、8.51%,中药组及中成药组疗效均优于西药组(P<0.01)。治疗后各组患者痛经程度及生活质量评分均较治疗前明显改善(P<0.01);中药组其他主要临床症状评分均较治疗前明显降低(P<0.05或P<0.01),中成药组仅乳房胀痛、冷汗淋漓评分较治疗前降低(P<0.05),西药组仅冷汗淋漓评分较治疗前降低(P<0.05)。结论中药辨证治疗痛经有较好疗效,且具有较好的远期疗效。

Objective To observe the efficacy and safety of Chinese medication for dysmenorrhea. Methods Totally 231 ca- ses of dysmenorrhea were randomized into the Chinese medication group （139 cases）, Chinese patent medicine group （45 cases） and western medication group （47 cases）. The patients in the Chinese medication group were classified into qi stagnation blood stasis syndrome, congealing cold damp stagnation syndrome, damp-heat stasis obstruction syndrome, qi-blood deficiency syn- drome and abiding stasis binding internally syndrome and given the corresponding therapy. The western medication group was given Saridon. The Chinese patent medicine group was given Xuefu Zhuyu Granules. One treatment course lasted for 3 men- strum cycles. The degree of dysmenorrhea, accompanied symptoms and quality of life （QOL） after treatment were observed and evaluated with Dysmenorrhea Degree Scale （DDS）, Visual Analog Scale （VAS）, Chinese Medicine Syndrome Scale and SF- 36 QOL Scale. Results The scores of DDS and VAS were significantly improved in all groups after treatment （P〈0.01）. The scores of DDS and VAS were significantly improved in the Chinese patent medicine group and western medicine group 3 months after withdrawal （P〈0. 05）. The Chinese medication group was significantly improved in breast tenderness, limb cold, lumbosacral pain, anal bulge, nausea, vomiting and cold sweat dripping after treatment （P〈0.05）. The Chinese patent medb cine group was significantly improved in breast tenderness and cold sweat dripping after treatment （P〈0.05）. The western medication group was significantly improved in cold sweat dripping after treatment （P〈0.05）. The efficacy of Chinese medi- cine syndrome and total efficacy in the Chinese patent medicine group （75. 56%,71. 11%）and Chinese medication group （91.37 %, 82.01 % ） were superior to those in the western medication group （40.43 %, 8.51%） （P〈0.01 ）. The QOL scores were significantly increased in all groups after treatment （P〈0.01）. The QOL scores in the Chinese medication group were significantly higher than those in the western medication group after treatment （P〈0. 05）. Conclusion Chinese medication is effective for dysmenorrhea with a better long-term efficacy.