中药熏蒸疗法对原发性痛经子宫血流动力学的影响

Efficacy of fumigating therapy on hemodynamics in patients with primary dysmenorrhea

目的:观察中药熏蒸疗法对因气滞血瘀所致原发性痛经的临床效果和子宫血流动力学的影响,分析其影响机制。方法:将63例患者按就诊顺序随机分为试验组32例和对照组31例,试验组采用膈下逐瘀汤中药熏蒸治疗,对照组采用丹莪妇康煎膏口服治疗,两组均治疗3个月经周期,观察比较两组患者临床疗效,并通过彩色多普勒超声检测两组治疗前后子宫动脉搏动指数(Pulsatility Index,PI)、阻力指数(Resistance Index,RI)值的变化。结果:经治疗,试验组和对照组总有效率比较差异无统计学意义(P> 0.05),疗效相近;两组显愈率比较差异有统计学意义(P <0.05),试验组优于对照组。治疗前后痛经程度评分比较,试验组优于对照组(P <0.05)。中医证候积分比较,差异无统计学意义(P> 0.05)。治疗后子宫动脉血流指数与治疗前相比,两组PI、RI均下降,且试验组优于对照组(P <0.05)。结论:中药熏蒸疗法对气滞血瘀型原发性痛经疗效肯定,能够有效改善痛经患者的临床症状;操作简便,易于患者接受,较丹莪妇康煎膏治疗更具有优势,其作用机制可能是通过改善盆腔血液循环,减少子宫动脉血流阻力而实现的。

Objective:To observe the clinical efficacy of fumigation therapy on primary dysmenorrhea of the Qizhi Xueyu type(气滞血瘀).Methods:63 patients were randomly divided into the experimental group(32 cases)and control group(31 cases).The experimental group was treated by fumigation with the Gexia Zhuyu decoction(膈下逐瘀汤).The control group was treated with the Dan’e Fukang condensed decoction(丹莪妇康煎膏).Results:After treatment,difference in the total efficiency between groups is not significant(P﹥0.05).The improvement rate in the experimental group was better than the control group(P﹤0.05).Dysmenorrhea symptom scores in the experimental group was better than the control group(P﹤0.05).TCM syndrome scores showed no statistically significant difference between groups(P﹥0.05).PI and RI of uterine artery were decreased after treatment,and those in the experimental group were better than the control group(P﹤0.05).Conclusion:Fumigation therapy on primary dysmenorrhea of the Qizhi Xueyu type was effective,by improving the clinical symptoms.The mechanism may be related with improving pelvic blood circulation and reducing blood flow resistance of uterine artery.