傅淑清和肝法对气滞血瘀型原发性痛经患者血清β-内啡肽的影响

Effect of Fushuqing Liver-harmonizing Therapy on Serum Beta-endorphin Levels in Patients with Qi Stagnation and Blood Stasis Type Primary Dysmenorrhea

目的观察自拟和肝止痛汤治疗原发性痛经的近期疗效和远期疗效,探究其作用机制。方法将70例气滞血瘀型原发性痛经患者随机分为治疗组、成药组和西药组。治疗组给予和肝止痛汤,成药组给予痛经宝颗粒,西药组则给予布洛芬缓释胶囊,3组患者均连续治疗3个月经周期,治疗前、治疗后和随访时(治疗后3个月)分别观察两组临床疗效和血清β-内啡肽(β-endorphin,β-EP)水平。结果治疗后,3组临床疗效的差异无统计学意义(P>0.05);随访时,治疗组临床疗效明显优于成药组和西药组(P<0.05)。治疗后和随访时,3组痛经积分均逐渐降低(P<0.05),治疗组随访时痛经积分均显著低于成药组和西药组(P<0.05)。3组治疗后血清β-EP水平均较治疗前显著上升(P<0.05);随访时,成药组和西药组血清β-EP水平较治疗后显著下降(P<0.05),而治疗组血清β-EP水平较治疗后无明显变化(P>0.05),且显著高于成药组和西药组(P<0.05)。结论和肝止痛汤对原发性痛经具有较好的疗效,其远期疗效优于痛经宝颗粒和布洛芬缓释胶囊,其治疗痛经的机制与升高血清β-EP水平有关。

Objective To observe the short-term and long-term efficacy of self-prescribed Hegan Zhitong Decoction （for harmonizing the liver and relieving pain） in patients with primary dysmenorrhea and to in- vestigate its functional mechanism. Methods A total of 70 patients with qi stagnation and blood stasis type primary dysmenorrhea were randomly divided into treatment group given Hegan Zhitong Decoction, proprietary Chinese medicine group given Tongjingbao Granule, and Western medicine group given ibupro- fen sustained-release capsules. All the patients were treated continuously for three menstrual cycles. The clinical efficacy and serum beta-endorphin （β-EP） levels before treatment, after treatment, and at follow- up （3 months after treatment） were compared between the three groups. Results After treatment, no sig- nificant difference in the clinical efficacy was observed between the three groups （P〉0.05）. At follow-up, the clinical efficacy in the treatment group was significantly better than that in the proprietary Chinese medicine group and Western medicine group （P〈0. 05）. Dysmenorrhea score decreased in all the three groups after treatment and at follow-up （P〈0. 05）, and the dysmenorrhea score in the treatment group was significantly lower than those in the other two groups at follow-up （P〈0.05）. All the three groups had significantly increased β-EP levels after treatment （P〈0.05）. In the proprietary Chinese medicine group and Western medicine group, the β-EP levels at follow-up were significantly lower than those after treatment. However, in the treatment group, there was no significant difference between the β-EP levels after treatment and at follow-up （P〉0.05）. The β-EP levels in the treatment group were significantly higher than those in the other two groups at follow-up （P〈0.05）. Conclusion Hegan Zhitong Decoction is effective in the treatment of primary dysmenorrhea and its long-term efficacy is better than Tongjingbao Granule and ibuprofen sustained-release capsules. The functional mechanism of this therapy is related to the upregulation of serum β-EP levels.