暖宫止痛贴联合温经定痛汤治疗原发性痛经临床观察

Clinical Observation on Nuangong Zhitong Plaster Combined with Wenjing Dingtong Decoction in Treating Primary Dysmenorrhea

目的探讨暖宫止痛贴联合温经定痛汤治疗原发性痛经(寒凝血瘀证)的临床疗效。方法随机选取溧阳市中医医院2018年1月—2019年12月诊治的原发性痛经患者68例,随机分为对照组和观察组,每组34例。对照组采用温经定痛汤治疗,观察组在此基础上加用暖宫止痛贴治疗。观察2组临床疗效及不良反应发生情况,观察2组治疗前后中医证候症状、血清前列腺素E_(2)(PGE_(2))、前列腺素F2α(PGF2α)水平的变化。结果观察组总有效率(94.12%)较对照组(76.47%)更高(P<0.05);观察组治疗后中医证候积分较对照组显著减少(P<0.05);观察组治疗后血清PGE_(2)水平较对照组显著降低,PGF2α水平与对照组比较,显著降低(P<0.05),2组治疗期间均未出现严重不良反应,组间不良反应发生率差异无统计学意义(P>0.05)。结论暖宫止痛贴联合温经定痛汤治疗寒凝血瘀型原发性痛经,不仅能有效缓解腹痛以治其标,而且能温经散寒、活血化瘀以治其本,提高治疗效果,改善中医证候积分,调节机体前列腺素表达水平,不增加用药风险。

Objective To explore the clinical efficacy of Nuangong Zhitong plaster combined with Wenjing Dingtong decoction in the treatment of primary dysmenorrhea.Methods A random selection of 68 patients with primary dysmenorrhea diagnosed and treated in Liyang Hospital of Traditional Chinese Medicine from January 2018 to December 2019 were divided into the control group and the observation group,with 34 cases in each group.The control group was treated with Wenjing Dingtong decoction,and on this basis,the observation group was treated with Nuangong Zhitong plaster.The clinical efficacy and adverse reactions of the two groups,the changes of traditional Chinese medicine(TCM)syndromes,serum prostaglandin E_(2)(PGE_(2))and prostaglandin F2α(PGF2α)levels before and after treatment were observed.Results The total effective rate(94.12%)of the observation group was significantly higher than that of the control group(76.47%)(P<0.05).After treatment,the TCM syndrome scores of the observation group were significantly lower than those of the control group(P<0.05).The level of serum PGE_(2)in the observation group was significantly lower than that of the control group,and the level of PGF2αwas significantly lower than that of the control group(P<0.05).There were no serious adverse reactions during the treatment of the two groups,and the difference in the incidence of adverse reactions between the groups was not statistically significant(P>0.05).Conclusion The combination of Nuangong Zhitong plaster combined with Wenjing Dingtong decoction in the treatment of primary dysmenorrhea of cold blood stasis type can not only effectively relieve abdominal pain to treat its symptoms,but also warm the menstruation and dispel cold,promote blood circulation and remove blood stasis to cure its roots and improve the therapeutic effect and TCM syndrome score,adjust the body’s prostaglandin expression level,and do not increase the risk of medication.