热敏灸配合中药治疗寒凝血瘀型子宫腺肌症患者的临床疗效研究

Clinical Efficacy of Heat-sensitive Moxibustion Combined with Chinese Medicine in Treatment of Adenomyosis of Cold Coagulation and Blood Stasis Type

【目的】探讨热敏灸配合中药温经汤加减治疗寒凝血瘀型子宫腺肌症的临床疗效。【方法】将60例寒凝血瘀型子宫腺肌症患者随机分为治疗组和对照组,每组各30例。治疗组给予热敏灸配合中药温经汤加减内服治疗,对照组单纯给予中药温经汤加减内服治疗,共治疗3个月经周期并随访3个月。观察2组患者治疗前后痛经程度评分、子宫体积大小及血红蛋白水平的变化情况,评价2组患者的治疗后即时疗效和治疗后3个月的随访疗效,并观察热敏化穴区的分布情况。【结果】(1)即时疗效方面:治疗后,治疗组的总有效率为90.0%(27/30),对照组为70.0%(21/30),治疗组的即时疗效明显优于对照组(P<0.01)。(2)随访疗效方面:治疗后3个月,治疗组的总有效率为93.3%(28/30),对照组为66.7%(20/30),治疗组的随访疗效明显优于对照组(P<0.01)。(3)治疗后,2组患者的痛经程度评分、子宫体积大小及血红蛋白水平均较治疗前明显改善(P<0.05),且治疗组在改善痛经程度评分和子宫体积方面均明显优于对照组(P<0.05),而在改善血红蛋白水平方面差异无统计学意义(P>0.05)。(4)寒凝血瘀型子宫腺肌症患者的热敏化穴区大部分分布于腹部关元穴及腿部三阴交穴。【结论】热敏灸配合中药温经汤加减口服治疗寒凝血瘀型子宫腺肌症患者的疗效确切,其对痛经的缓解作用和对子宫体积的缩小作用均优于单纯中药温经汤加减口服治疗。

Objective To observe the clinical effect of heat-sensitive moxibustion combined with Wenjing Decoction in the treatment of adenomyosis of cold coagulation and blood stasis type.Methods Sixty cases of adenomyosis with the syndrome type of cold coagulation and blood stasis were randomly divided into treatment group and control group,30 cases in each group.The treatment group was treated with heat-sensitive moxibustion combined with oral use of modified Wenjing decoction,while the control group was treated with oral use of modified Wenjing Decoction alone.The treatment lasted for three menstrual cycles and the follow-up covered 3 months.The changes of dysmenorrhea scores,uterine volume and hemoglobin in the two groups before and after treatment were compared.The immediate efficacy after treatment and the efficacy during the 3-month follow-up in the two groups were evaluated.Meanwhile,the distribution of heat-sensitive acupoint was observed.Results(1)In respect of the immediate efficacy,the total effective rate of the treatment group was 90.0%(27/30)and that of the control group was 70.0%(21/30),and the treatment group had stronger immediate efficacy than the control group(P<0.01).(2)In respect of the follow-up efficacy,the total effective rate of the treatment group was 93.3%(28/30)and that of the control group was 66.7%(20/30),and the treatment group had stronger follow-up efficacy than the control group(P<0.01).(3)After treatment,the scores of dysmenorrhea,uterine volume and hemoglobin level in the two groups were much improved in comparison with those before treatment(P<0.05),and the improvement of the scores of dysmenorrhea and uterine volume in the treatment group was superior to that in the control group(P<0.05),but the difference of the improvement of hemoglobin level was insignificant(P>0.05).(4)The heat-sensitive acupoints of the adenomyosis patients with the syndrome type of cold coagulation and blood stasis were mostly located at Guanyuan(CV4)point in the abdomen and Sanyinjiao(SP6)point in the leg.Conclusion Heat-sensitive moxibustion combined with oral use of modified Wenjing Decoction has certain efficacy for the treatment of adenomyosis with the syndrome type of cold coagulation and blood stasis,and its effect on the amelioration of dysmenorrhea and the reduction of uterine volume is stronger than oral use of modified Wenjing Decoction alone.