超声消融结合中药治疗子宫腺肌病继发性痛经的效果

The Effect of Ultrasonic Ablation Combined with Traditional Chinese Medicine in the Treatment of Secondary Dysmenorrhea Caused by Adenomyosis

目的探讨超声消融联合当归芍药散加减治疗子宫腺肌病继发性痛经的临床疗效。方法选取2018年5月-2019年1月我院收治的子宫腺肌病继发性痛经患者124例为研究对象,采用随机数字表法分为对照组和观察组,各62例。对照组采用超声消融联合左炔诺孕酮宫内缓释节育系统治疗,观察组在对照组基础上加服当归芍药散,比较两组治疗后血清雌二醇(E2)、前列腺素F2α(PGF2α)水平、子宫体积、病灶体积、月经量评分、痛经评分(VAS)、痊愈率、不良反应发生率及1年后复发率。结果治疗后6、12个月,观察组E2和PGF2α低于对照组(P<0.05);观察组月经量评分、子宫体积和病灶体积均低于对照组(P<0.05);观察组VAS评分、轻度和重度痛经率均低于对照组(P<0.05);观察组不良反应发生率和1年随访复发率低于对照组,痊愈率高于对照组(P<0.05)。结论当归芍药散可调节子宫腺肌病继发性痛经患者E2和PGF2α等激素水平,加减该方剂可改善超声消融术术后子宫腺肌病继发性痛经的临床症状并降低复发率。

Objective To explore the clinical effect of ultrasonic ablation combined with Danggui Shaoyao San in the treatment of dysmenorrhea secondary to adenomyosis.Methods Totally 124 patients with secondary dysmenorrhea caused by adenomyosis admitted to our hospital from May 2018 to January 2019 were selected as the research objects.Using random number table method,they were divided into control group and observation group,each with 62 cases.The control group was treated with ultrasound ablation combined with levonorgestrel sustained-release intrauterine birth control system,and the observation group was treated with Danggui Shaoyao San on the basis of the control group.Comparison of serum estradiol(E2),prostaglandin F2α(PGF2α)levels,uterine volume,lesion volume,menstrual volume score,dysmenorrhea score(VAS),recovery rate,adverse reaction rate,and recurrence rate after 1 year between the two groups after treatment.Results At 6 and 12 months after treatment,E2 and PGF2αin the observation group were lower than those in the control group(P<0.05);The menstrual volume score,uterine volume and lesion volume of the observation group were lower than those of the control group(P<0.05);The VAS score and the rates of mild and severe dysmenorrhea in the observation group were lower than those in the control group(P<0.05);The incidence of adverse reactions and the recurrence rate of one-year follow-up in the observation group were lower than those in the control group,and the recovery rate was higher than that in the control group(P<0.05).Conclusion Danggui Shaoyao San can adjust the levels of hormones such as E2 and PGF2αin patients with secondary dysmenorrhea of adenomyosis.Adding or subtracting this prescription can improve the clinical symptoms of secondary dysmenorrhea caused by adenomyosis after ultrasonic ablation and reduce the recurrence rate.