宣郁通经汤联合左炔诺孕酮宫内节育系统治疗子宫腺肌症伴痛经的临床效果

Clinical effect of Xuanyu Tongjing Decoction combined with Levonorgestrel intrauterine system in the treatment of adenomyosis with dysmenorrhea

目的探讨宣郁通经汤联合左炔诺孕酮宫内节育系统治疗子宫腺肌症伴痛经的效果及安全性。方法选取2018年2~8月江西省妇幼保健院收治的120例子宫腺肌症伴痛经患者作为研究对象,按照随机数字表法将其分为对照组和观察组,每组各60例。观察组采用宣郁通经汤联合左炔诺孕酮宫内节育系统治疗,对照组单纯使用左炔诺孕酮宫内节育系统治疗。治疗6个月后,比较两组的痛经症状、疼痛程度、中医证候、子宫体积、血清糖类抗原-125(CA-125)水平及不良反应发生情况。结果治疗6个月后,两组患者的痛经症状积分、视觉模拟量表(VAS)评分、中医证候积分、子宫体积、血清CA-125水平均低于治疗前,差异有统计学意义(P<0.05),观察组患者的痛经症状积分、VAS评分、中医症候积分、子宫体积及血清CA-125水平均低于对照组,差异有统计学意义(P<0.05);两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论宣郁通经汤联合左炔诺孕酮宫内节育系统治疗子宫腺肌症伴痛经患者可有效改善临床症状,效果显著,值得推广应用。

Objective To explore the effect and safety of Xuanyu Tongjing Decoction combined with Levonorgestrel intrauterine system in the treatment of adenomyosis with dysmenorrhea.Methods A total of 120 adenomyosis patients with dysmenorrhea recruited in Jiangxi Provincial Maternal and Child Health Hospital from February to August 2018 were selected as the study objects and divided into control group and observation group,with 60 cases in each group based on random number table method.The observation group was treated with Xuanyu Tongjing Decoction combined with Levonorgestrel intrauterine system,and the control group was only treated with Levonorgestrel intrauterine system.The symptoms of dysmenorrhea,the degree of pain,traditional Chinese medicine(TCM)syndrome integral,the volume of uterus,the level of serum carbohydrate antigen-125(CA-125)and the occurrence of the adverse reaction were compared after 6 months of treatment.Results The symptom score of dysmenorrhea,visual analogue scale(VAS)score,TCM syndrome integral score,uterine volume and the level of serum CA-125 level in both two groups after 6 months of treatment were higher than those before treatment,and the differences were statistically significant(P<0.05).The symptom score of dysmenorrhea,VAS score,TCM syndrome integral score,uterine volume and the level of serum CA-125 level in observation group after 6 months of treatment were lower than those in control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group and the control group had no statistically significant difference(P>0.05).Conclusion Xuanyu Tongjing Decoction combined with Levonorgestrel intrauterine system can effectively improve the clinical symptoms of adenomyosis with dysmenorrhea,and worthy to be promoted and applicated in clinical.