自拟温经疏肝活血通络汤对原发性痛经患者血清前列腺素、β-内啡肽水平的影响研究

Study on the Effect of Wenjing Shugan Huoxue Tongluo Decoction on the Level of Prostaglandin andβ-endorphin in Primary Dysmenorrhea

目的探讨温经疏肝活血通络汤治疗原发性痛经对血清前列腺素、β-内啡肽水平的影响。方法选取我院(2017年2月至2019年11月)收治的发性痛经患者108例,均表现为不同程度的经前或经期下腹阵发性或持续性疼痛,根据不同治疗分为两组,对照组(n=54)接受益母草冲剂治疗,观察组(n=54)接受温经疏肝活血通络汤治疗,两组患者均连续治疗3个月经周期。对比两组患者临床疗效和治疗前后血清前列腺素[前列腺素F2α(PGF2α)、前列腺素E2(PGE2)]、β-内啡肽(β-EP)水平、痛经情况以及不良反应(消化不良、厌食、恶心呕吐)发生情况。结果观察组患者总有效率为94.44%(51/54),对照组患者总有效率为77.78%(42/54),两组患者临床疗效对比差异明显(χ^2=11.6028,P<0.05)。治疗后观察组患者β-EP、PGE2水平为(190.58±74.50)pg/mL、(410.66±123.07)pg/mL,对照组为(170.53±54.06)pg/mL、(452.57±132.14)pg/mL,两组较治疗前均明显提升,治疗后观察组PGF2α水平为(294.42±106.03)pg/mL,对照组为(260.52±103.80)pg/mL,两组均明显降低,观察组患者改善更明显(t=1.7603、2.7055、3.6789,P<0.05)。治疗后观察组患者痛经持续时间(0.92±0.31)h,对照组为(1.55±0.57)h,两组与治疗前比较均明显缩短,观察组痛经症状评分(1.60±1.40)分,对照组为(4.48±1.17)分,两组与治疗前比较均明显降低,观察组患者改善更明显(t=7.1350、11.5995,P<0.05)。观察组消化不良、厌食、恶心呕吐等不良反应的总发生率为12.96%(7/54),对照组为14.81%(8/54),两组患者不良反应对比无差异(χ^2=0.1431,P>0.05)。结论温经疏肝活血通络汤治疗原发性痛经对血清前列腺素、β-内啡肽水平具有显著的改善作用,可有效缓解痛经症状,该方还具有较高安全性,值得临床推广。

Objective To explore the effect of Wenjing Shugan Huoxue Tongluo Decoction on serum prostaglandin andβ-endorphin in the treatment of primary dysmenorrhea.Methods 108 patients with dysmenorrhea who were treated in our hospital from February 2017 to November 2019 were divided into two groups according to the different treatment.The control group(n=54)was treated with Yimucao granules,the observation group(n=54)was treated with Wenjing Shugan Huoxue Tongluo Decoction,and the two groups were treated for three consecutive menstrual weeks Period.The clinical effect and the serum levels of prostaglandins(PGF2α,PGE2),β-endorphin(β-EP),dysmenorrhea and adverse reactions(dyspepsia,anorexia,nausea and vomiting)were compared before and after treatment.Results The total effective rate was 94.44%(51/54)in the observation group and 77.78%(42/54)in the control group.There was a significant difference between the two groups(χ^2=11.6028,P<0.05).After treatment,the levels ofβ-EP and PGE2 were(190.58±74.50)pg/mL,(410.66±123.07)pg/mL in the observation group,(170.53±54.06)pg/mL and(452.57±132.14)pg/mL in the control group,which were significantly higher than those before treatment.After treatment,the level of PGF2αin the observation group was(294.42±106.03)pg/mL and(260.52±103.80)pg/mL in the control group It was more obvious(t=1.7603,2.7055,3.6789,P<0.05).After treatment,the duration of dysmenorrhea in the observation group was(0.92±0.31)h,and that in the control group was(1.55±0.57)h.The dysmenorrhea symptom score in the observation group was(1.60±1.40)(P<0.05),and that in the control group was(4.48±1.17)(P<0.05).The total incidence of dyspepsia,anorexia,nausea and vomiting was 12.96%(7/54)in the observation group and 14.81%(8/54)in the control group.There was no difference between the two groups(χ2=0.1431,P>0.05).Conclusion Wenjing Shugan Huoxue Tongluo Decoction can significantly improve the level of serum prostaglandin andβ-endorphin in the treatment of primary dysmenorrhea,and it can effectively alleviate the symptoms of dysmenorrhea.The prescription is also of high safety and is worthy of clinical promotion.