补肾活血调经汤联合艾灸治疗人工流产术后月经过少临床研究

Clinical Study on Bushen Huoxue Tiaojing Tang Combined with Moxibustion for Hypomenorrhea after Artificial Abortion

目的:观察补肾活血调经汤联合艾灸治疗人工流产术后的临床疗效及对患者血清血管性血友病因子抗原(vWF)和血栓素A2 (TXA2)的影响。方法:将92例人工流产术后月经过少患者随机分为观察组和对照组,每组46例;对照组采用雌激素和孕激素周期治疗方案,观察组采用补肾活血调经汤联合艾灸进行治疗,疗程均为3个月经周期;观察比较2组临床疗效及不良反应,治疗前后患者月经量、子宫内膜厚度、中医候证积分、性激素水平[卵泡刺激素(FSH)、雌二醇(E2)、促黄体酮生成素(LH)、催乳素(PRL)]、血清vWF和TXA2水平变化。结果:总有效率观察组为95.65%,对照组为60.87%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组患者月经量、子宫内膜厚度均较治疗前均明显增加(P <0.05),且观察组明显高于对照组(P <0.05)。治疗后,2组患者经色经质、乳房胀痛、腰膝酸软积分和总分均较治疗前明显下降(P <0.05);且观察组各项积分明显低于对照组(P <0.05)。治疗后,2组FSH、LH、E2水平较治疗前明显升高(P <0.05),PRL水平较治疗前明显降低(P <0.05);且观察组上述各项指标改善均优于对照组(P <0.05)。治疗后,2组患者血清vWF、TXA2水平均较治疗前明显下降(P <0.05),且观察组两项指标均明显低于对照组(P <0.05)。不良反应发生率观察组为6.52%,对照组为15.22%,2组比较,差异无统计学意义(P>0.05)。结论:补肾活血调经汤联合艾灸能有效改善人工流产术后月经过少症状,增加子宫内膜厚度,同时降低患者血清中vWF和TXA2水平,提高临床疗效,且具有较好的安全性。

Objective: To observe the clinical effect of Bushen Huoxue Tiaojing tang combined with moxibustion for hypomenorrhea after artificial abortion, and its effect on Von Willebrand factor(vWF) and thromboxane A2(TXA2) in serum.Methods: A total of 92 cases of patients with hypomenorrhea after artificial abortion were randomly divided into the observation group and the control group, 46 cases in each group. The control group was treated with cycle treatment scheme of estrogen and progesterone, and the observation group was treated with Bushen Huoxue Tiaojing tang combined with moxibustion. Both groups were treated for three menstrual cycles. The clinical effect and adverse reactions in the two groups were observed and compared. Before and after treatment, the changes of menstrual amount, endometrial thickness, Chinese medicine syndrome scores, levels of sex hormones including follicle stimulating hormone(FSH),estradiol(E2), luteinizing hormone(LH) and prolactin(PRL), and levels of vWF and TXA2 in serum were observed and compared. Results: The total effective rate was 95.65% in the observation group and 60.87% in the control group, the difference being significant(P < 0.05). After treatment, menstrual amount and endometrial thickness in the two groups were significantly increased when compared with those before treatment(P < 0.05), and the above indexes in the observation group were significantly higher than those in the control group(P < 0.05). After treatment, the scores of menstrual colour,menstrual property and soreness and weakness of waist and knees as well as the total scores in the two groups were significantly decreased when compared with those before treatment(P < 0.05), and the above scores in the observation group were significantly lower than those in the control group(P < 0.05). After treatment, the levels of FSH, LH and E2 in the two groups were significantly increased when compared with those before treatment(P < 0.05), and the levels of PRL were significantly decreased when compared with those before treatment(P < 0.05);the improvement of the above indexes in the observation group was better than that in the control group(P < 0.05). After treatment, the levels of vWF and TXA2 in serum in the two groups were significantly decreased when compared with those before treatment(P < 0.05), and the above levels in the observation group were significantly lower than those in the control group(P < 0.05). The incidence of adverse reactions was 6.52% in the observation group and 15.22% in the control group, there being no significance in the difference(P > 0.05).Conclusion:The therapy of Bushen Huoxue Tiaojing tang combined with moxibustion can effectively improve the symptoms of hypomenorrhea after artificial abortion and clinical effect, increase endometrial thickness and lower the levels of vWF and TXA2 in serum, with good safety.