自拟温阳活血汤联合孕三烯酮胶囊治疗子宫腺肌病痛经临床研究

Clinical study of self-made Wenyang-Huoxue Decoction combined with gestrinone capsules in the treatment of adenomyosis dysmenorrhea

目的评价自拟温阳活血汤联合孕三烯酮胶囊治疗子宫腺肌病痛经的疗效。方法将符合入选标准的2016年1月-2018年12月青海省大通县中医院子宫腺肌病痛经患者88例,按随机数字表法分为2组,每组44例。对照组采用西医常规疗法治疗,研究组在对照组基础上加用自拟温阳活血汤。2组均连续治疗6个月。分别于治疗前后进行中医证候评分和痛经评分,采用阴道超声检测并计算子宫体积,采用诺丁汉健康调查表(Nottingham Health Poofite, NHP)评估患者生活质量,采用双抗夹心ELISA法检测血清糖类抗原125(carbohydrate antigen 125, CA125)、TNF-α、IL-8水平,评价临床疗效。结果研究组总有效率为93.2%(41/44)、对照组为72.7%(32/44),2组比较差异有统计学意义(χ^2=6.510,P<0.01)。治疗后,研究组中医证候评分、痛经评分及子宫体积均低于对照组(t值分别为7.956、4.959、4.235,P值均<0.01);疼痛、精力、情感、睡眠、社会活动及身体活动评分均低于对照组(t值分别为8.592、9.341、6.652、13.597、4.085、7.858,P值均<0.01)。治疗后,研究组血清CA125[(33.02±5.11)IU/ml比(46.22±6.51)IU/ml,t=10.580]、TNF-α[(41.13±5.03)pg/ml比(55.50±6.15)pg/ml,t=11.997]、IL-8[(38.02±5.50)pg/ml比(49.42±6.51)pg/ml,t=8.873]水平均低于对照组(P<0.01)。结论自拟温阳活血汤联合孕三烯酮胶囊可降低血清CA125、TNF-α、IL-8水平,改善子宫腺肌病痛经患者的临床症状,提高生活质量。

Objective To evaluate the efficacy of self-made Wenyang-Huoxue Decoction combined with gestrinone capsule in the treatment of adenomyosis dysmenorrhea.Methods A total of 88 patients with adenomyosis dysmenorrhea who met the inclusion criteria in Datong Traditional Chinese Medicine Hospital from January 2016 to December 2018 were enrolled and divided into two groups according to random number table method,44 cases in each group.The control group was treated with conventional western medicine and the study group was treated with self-made Wenyang-Huoxue Decoction on the basis of the control group.Two groups were treated continuously for 6 months.The TCM syndrome score and dysmenorrhea score were performed before and after treatment.The vaginal ultrasound was used to detect and calculate uterine volume,Nottingham Health Poofite(NHP)was used to evaluate the quality of life.The ELISA was used to detect serum carbohydrate antigen 125(CA125),TNF-αand IL-8 levels.The clinical efficacy was evaluated.Results The total effective rate of the study group was 93.2%(41/44)and that of the control group was 72.7%(32/44),where the difference between the two groups was statistically significant(χ^2=6.510,P<0.01).After treatment,the TCM syndrome score,dysmenorrhea score and uterine volume of the study group were significantly lower than those in the control group(t values were 7.956,4.959 and 4.235,respectively,all Ps<0.01);the scores of pain,energy,emotion,sleep,social activity and physical activity were significantly lower than those in the control group(t values were 8.592,9.341,6.652,13.597,4.085,7.858,respectively,all Ps<0.01).After treatment,serum CA125(33.02±5.11 IU/ml vs.46.22±6.51 IU/ml,t=10.580),TNF-α(41.13±5.03 pg/ml vs.55.50±6.15 pg/ml,t=11.997)and IL-8(38.02±5.50 pg/ml vs.49.42±6.51 pg/ml,t=8.873)in the study group were significantly lower than those in the control group(P<0.01).Conclusions Self-made Wenyang-Huoxue Decoction combined with gestrinone capsule can reduce the levels of serum CA125,TNF-αand IL-8 in patients with adenomyosis dysmenorrhea,and improve the clinical symptoms,and the quality of life.