针刺联合米非司酮治疗巧克力囊肿气滞血瘀型痛经临床研究

Clinical Study of Acupuncture Plus Mifepristone for Dysmenorrhea of Qi Stagnation and Blood Stasis Type in Chocolate Cyst of Ovary

目的观察针刺联合米非司酮治疗卵巢巧克力囊肿患者气滞血瘀型痛经的临床疗效。方法将80例卵巢巧克力囊肿患者随机分为对照组和观察组,每组40例。对照组予口服米非司酮,观察组予针刺联合口服米非司酮。比较两组治疗前后COX痛经症状评分量表(CMCC)的严重程度总评分及发作时间总评分、异位囊肿最大截面积、血清转化生长因子(TGF)-β1及白介素(IL)-17水平的变化,并比较两组临床疗效。结果治疗后,观察组总有效率高于对照组,差异具有统计学意义(P<0.05)。两组治疗后CMCC量表痛经症状严重程度总评分、发作时间总评分均较治疗前降低(P<0.05),且观察组治疗后痛经症状严重程度总评分、发作时间总评分低于对照组(P<0.05)。两组治疗后异位囊肿最大截面积均较治疗前缩小(P<0.05),观察组治疗后异位囊肿最大截面积小于对照组(P<0.05)。对照组治疗后血清TGF-β1、IL-17水平与治疗前比较差异无统计学意义(P>0.05);观察组治疗后血清TGF-β1、IL-17水平均较治疗前降低(P<0.05),且均低于对照组治疗后(P<0.05)。结论针刺联合米非司酮治疗卵巢巧克力囊肿患者气滞血瘀型痛经的疗效优于单纯米非司酮治疗,可改善痛经症状,促进异位病灶萎缩,降低血清TGF-β1和IL-17水平。

Objective To observe the clinical efficacy of acupuncture plus Mifepristone for dysmenorrhea of qi stagnation and blood stasis type in chocolate cyst of ovary.Method Eighty patients were randomized to a control group and an observation group,with 40 cases in each group.The control group received oral administration of Mifepristone and the observation group received acupuncture plus oral administration of Mifepristone.The total severity score and the total duration score in the Cox menstrual symptom scale(CMSS),the maximum sectional area of ectopic cyst,and serum transforming growth factor(TGF)-β1 and interleukin(IL)-17 levels were compared between the two groups before and after treatment.The clinical therapeutic effects were also compared between the two groups.Result After treatment,the clinical total efficacy rate was higher in the observation group than in the control group with a statistically significant difference(P<0.05).After treatment,the CMSS total dysmenorrhea severity score and total attack duration score decreased in the two groups compared with before(P<0.05)and were lower in the observation group than in the control group(P<0.05).After treatment,the maximum sectional area of ectopic cyst decreased in the two groups compared with before(P<0.05)and was smaller in the observation group than in the control group(P<0.05).After treatment,serum TGF-β1 and IL-17 levels had no statistically significant differences in the control group compared with before(P>0.05),and decreased in the observation group compared with before(P<0.05)and were lower in the observation group than in the control group(P<0.05).Conclusion Acupuncture plus mifepristone is more effective than Mifepristone alone in treating dysmenorrhea of qi stagnation and blood stasis type in patients with chocolate cyst of ovary.It can relieve the symptoms of dysmenorrhea,promote the atrophy of ectopic lesions and reduce serum TGF-β1 and IL-17 levels.