中医Ⅱ期疗法治疗湿热瘀结型子宫腺肌病的疗效

The clinical effect of traditional Chinese medicine phase Ⅱ therapy on adenomyosis of dampness heat stasis type

目的探讨中医Ⅱ期疗法治疗湿热瘀结型子宫腺肌病疗效及对免疫指标CA125和抗子宫内膜抗体(EMAb)的影响。方法湿热瘀结型子宫腺肌病患者100例,随机分为观察组与对照组各50例,观察组采用经期腺肌汤联合痛经1号贴治疗,非经期予消癥汤联合痛经1号灌肠液治疗,对照组采用月经周期第5天服用去氧孕烯炔雌醇(妈富隆)片,1片/d,共服用21 d。两组治疗3个月经周期。观察治疗前后血清CA125、EMAb、子宫体积及临床症状变化等,比较两组治疗效果及相关指标水平。结果两组CA125、子宫体积、月经失血评分(PBAC)、痛经视觉模拟评分(VAS)、中医证候评分治疗后均明显改善(P<0.05);观察组PBAC、VAS、中医证候评分改善均优于对照组(P<0.05)。结论中医Ⅱ期疗法对改善子宫腺肌病患者月经量多、痛经程度疗效确切,可有效改善患者临床症状,缩小子宫体积,降低血清CA125水平,且安全性较高。

Objective To investigate the clinical efficacy of TCM second phase therapy in the treatment of damping-heat stasis adenomyosis and its influence on immune indexes CA125 and EMAb.Methods 100 patients with adenomyosis of dampness heat stasis type were randomly divided into the observation group and the control group,50 cases in each group.The observation group was treated with menstrual adenomyosis decoction combined with Tongjing No.l paste,and the non menstrual period was treated with Xiaozheng decoction combined with Tongjing No.l enema.The control group was treated with desogestrel ethinylestradiol(Marvelon)tablets,1 tablet/D,for 21 days.The two groups were treated for 3 menstrual cycles.The changes of serum CA125,EMAb,uterine volume and clinical symptoms were observed before and after treatment,and the therapeutic effect and the level of related indicators were compared between the two groups.Results During the experiment,6 cases of abscission in the traditional Chinese medicine treatment group and 4 cases of abscission in the Western medicine control group were lost to follow-up,and 90 cases were finally completed,including 44 cases in the treatment group and 46 cases in the control group.There was no statistically significant difference in immune index EMAb between the two groups before and after treatment(P>0.05),while there were statistically significant differences in CA125,uterine volume,menstrual blood loss score(PBAC),visual analogue scale(VAS)and TCM syndrome score between the two groups,which were significantly improved after treatment(P<0.05).After treatment,there were statistically significant differences in PBAC,VAS and TCM syndrome scores between the two groups,and the improvement of the above indexes in the TCM treatment group was better than that in the control group(P<0.05).Conclusion The second phase of TCM therapy is effective in improving the menstrual volume and dysmenorrhea in patients with adenomyosis,and effectively improves the clinical symptoms of patients,effectively reduces the uterine volume,reduces the level of serum CA125,and is relatively safe.