肌肉运动疗法配合中药治疗气滞血瘀型原发性痛经的临床疗效观察

Therapeutic Effect of Stretching Therapy Combined with Chinese Herbal Medicine for Primary Dysmenorrhea with Qi Stagnation and Blood Stasis

【目的】评估肌肉运动疗法配合中药痛经散口服治疗气滞血瘀型原发性痛经的疗效。【方法】将入组的60例患者随机分为治疗组和对照组,每组各30例。治疗组给予中药痛经散(由当归、川芎、白芍、香附、九香虫、丹参、蒲黄、五灵脂、莪术、桃仁等中药组成)口服同时配合肌肉运动疗法治疗,对照组单纯给予中药痛经散口服治疗。2组均治疗3个月经周期。观察2组患者治疗期间和治疗结束后随访3个月的痛经视觉模拟评分(VAS)情况及治疗前后子宫动脉血流的搏动指数(PI)、阻力指数(RI)、收缩期峰值/舒张期峰值(A/B)等指标的变化情况,并评价2组患者的临床疗效。【结果】(1)治疗后及治疗结束后第3个月经周期,2组患者的VAS评分均较治疗前明显降低(P<0.05),且治疗组对VAS评分的下降作用均明显优于对照组(P<0.05)。(2)经治疗3个月经周期后,治疗组总有效率为96.7%,对照组为76.7%,治疗组疗效优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组彩色多普勒能量图(CDE)子宫动脉血流PI、RI、A/B等指标均较治疗前明显降低(P<0.05),但治疗后组间比较,差异均无统计学意义(P>0.05)。【结论】肌肉运动疗法联合中药痛经散治疗气滞血瘀型原发性痛经,具有较好的近期、远期疗效及较高的安全性和可行性。

Objective To evaluate the curative effect of stretching therapy combined with oral administration of Chinese herbal medicine Tongjing Powder in treating dysmenorrhea patients with Qi stagnation and blood stasis.Methods Sixty dysmenorrhea patients were randomly divided into two groups,30 cases in each group. Treatment group was given oral use of Tongjing Powder（mainly composed of Radix Angelicae Sinensis,Rhizoma Chuanxiong,Radix Paeoniae Alba, Rhizoma Cyperi, Aspongopus, Radix Salviae Miltiorrhizae, Pollen Typhae, Faeces Trogopterori, Rhizoma Curcumae, and Semen Persicae） combined with stretching therapy. The control group was given oral use of Tongjing Powder alone. Each group was treated for 3 menstrual cycles. Visual Analogue Scale（VAS） scores of dysmenorhea were observed during the treatment and 3-month follow-up after treatment.Before and after treatment, pulse index（PI）, resistance index（RI）, the ratio of systolic peak value to the diastolic peak value（A/B）of uterine artery blood flow in the two groups were detected. And the clinical efficacy of the two groups was evaluated after treatment. Results（1） The VAS scores of the two groups after treatment and at the end of the third menstrual cycle after treatment were significantly lower than those before treatment（P0.05）,and the decrease in the treatment group was superior to that in the control group（P〈0.05）.（2） After treatment for 3 menstrual cycles, the total effective rate was 96.7% in the treatment group, which was higher than that in the control group（76.7%）. And the difference was statistically significant（P〈0.05）.（3） The color Doppler energy（CDE） imaging results showed that PI, RI, A/B of uterine artery blood flow in the two groups were decreased after treatment（P〈0.05 compared with those before treatment）, but the differences between the two groups were insignificantly（P〉0.05）. Conclusion Stretching therapy combined with oral administration of Chinese herbal medicine Tongjing Powder exerts certain short-term and long-term effect in treating dysmenorrhea patients with Qi stagnation and blood stasis,with good safety and feasibility.