暖宫消癥散结汤联合中药灌肠治疗子宫腺肌症疗效及对患者痛经症状积分、子宫内膜厚度和血清CA_(125)水平的影响

Efficacy of Nuangong Xiaozheng Sanjie decoction combined with traditional Chinese medicine enema on adenomyosis and its effects on dysmenorrhea symptom score,endometrial thickness and serum CA_(125)level

目的:探究暖宫消癥散结汤联合中药灌肠治疗子宫腺肌症的临床疗效,以及对患者痛经、子宫内膜厚度和血清糖类抗原125(CA_(125))水平的影响。方法:选取70例子宫腺肌症患者,且中医证型为寒凝血瘀证,按照随机数字表法分为观察组和对照组各35例。对照组患者予口服优思明片联合中药灌肠治疗,观察组患者在对照组基础上加予暖宫消癥散结汤,两组均治疗21 d。比较两组患者临床有效率、中医症状积分、子宫内膜厚度、子宫体积、子宫压触痛、血清CA_(125)。记录治疗期间不良反应。结果:治疗后,观察组临床有效率88.57%高于对照组68.57%(P<0.05);治疗后,两组中医症状各主症及次症积分均降低(P<0.05),且观察组治疗后积分低于对照组(P<0.05);治疗后,两组子宫内膜厚度、子宫体积、子宫压触痛评分均降低(P<0.05),且观察组治疗后上述指标均低于对照组(P<0.05);治疗后,两组血清CA_(125)水平均下降(P<0.05),且观察组治疗后CA_(125)低于对照组(P<0.05);两组均未见明显不良反应。结论:暖宫消癥散结汤联合中药灌肠治疗子宫腺肌症能取得更好的临床疗效,改善患者症状,降低血清CA_(125)水平和子宫内膜厚度。

Objective:To explore the clinical efficacy of Nuangong Xiaozheng Sanjie decoction combined with traditional Chinese medicine enema in the treatment of adenomyosis and its effects on dysmenorrhea,endometrial thickness and serum CA_(125)level.Methods:70 patients with adenomyosis were selected with TCM syndrome type of cold coagulation and blood stasis syndrome,and they were divided into observation group(n=35)and control group(n=35)by the random number table method.The patients in the control group were treated with oral Yasmin tablets combined with traditional Chinese medicine enema while the patients in the observation group were additionally given Nuangong Xiaozheng Sanjie decoction on the basis of the control group.Both groups were treated for 21 days.The clinical effective rate,TCM symptoms scores,endometrial thickness,uterine volume,uterine tenderness and serum carbohydrate antigen 125(CA_(125))were compared between the two groups of patients.Adverse reactions during treatment were recorded.Results:After treatment,the clinical effective rate in observation group(88.57%)was higher than that in control group(68.57%,P<0.05).After treatment,the scores of primary and secondary TCM symptoms in the two groups were decreased(P<0.05),and the scores in observation group after treatment were lower than those in control group(P<0.05).The endometrial thickness,uterine volume and uterine tenderness score after treatment were reduced in the two groups(P<0.05),and the above indicators after treatment were lower in observation group compared with those in control group(P<0.05).After treatment,the level of serum CA_(125)in both groups was declined(P<0.05),and the CA_(125)level in observation group after treatment was lower compared with that in control group(P<0.05).There were no obvious adverse reactions in the two groups.Conclusion:Nuangong Xiaozheng Sanjie decoction combined with traditional Chinese medicine enema can achieve good clinical efficacy in the treatment of adenomyosis,improve the symptoms,and reduce the level of serum CA_(125)and endometrial thickness.