少腹逐瘀汤加减治疗原发性痛经寒凝血瘀型疗效探讨

Exploration of the Efficacy of Shaofuzhuyu Decoction with Addition and Reduction in the Treatment of Primary Dysmenorrhea with Cold Clotting and Blood Stasis

目的探讨对中医辨证寒凝血瘀型原发性痛经者予少腹逐瘀汤治疗的效果。方法选择泰兴市中医院2021年2月—2022年4月收治的85例原发性痛经患者为研究对象,随机分为布洛芬缓释胶囊治疗的对照组(n=42)与联合少腹逐瘀汤治疗的观察组(n=43),比较两组临床疗效,评估治疗前后中医证候积分及疼痛视觉模拟法(VAS)评分,并检测血流流变学指标评估两组血瘀改善情况。结果观察组在少腹逐瘀汤治疗后总有效率较对照组高(95.35%vs 73.81%),差异有统计学意义(χ^(2)=7.609,P<0.05)。治疗后观察组中医证候积分(4.28±1.17)分、VAS评分(1.32±0.54)分,均低于对照组,差异有统计学意义(t=8.280、7.715,P<0.05)。治疗后观察组红细胞压积(37.62±4.91)mPa·s、血小板粘附率(28.11±4.05)mPa·s、血浆黏度(1.41±0.11)%、全血黏度(7.68±1.12)%,均低于对照组,差异有统计学意义(t=12.483、20.488、15.710、15.996,P<0.05)。结论对中医辨证为寒凝血瘀型的原发性痛经患者予少腹逐瘀汤治疗疗效确切,能改善患者症状及疼痛,且可改善血液流变学指标。

Objective To investigate the efficacy of treating primary dysmenorrhea in the type of cold clotting and blood stasis identified by traditional Chinese medicine by giving Shaofuzhuyu decoction.Methods Eighty-five patients with primary dysmenorrhea admitted to Taixing Hospital of Traditional Chinese Medicine from February 2021 to April 2022 were selected as study subjects.The patients were randomly divided into the control group treated with ibuprofen sustained release capsule(n=42)and the observation group treated with combined Shaofuzhuyu decoction(n=43).The clinical efficacy of the two groups was compared,and the Chinese medicine evidence score and Visual Analogue of Scale(VAS)score were evaluated before and after treatment,and blood flow rheology indexes were detected to assess the improvement of blood stasis in the two groups.Results The total effective rate of the observation group was higher than that of the control group(95.35%vs 73.81%),and the difference was statistically significant(χ^(2)=7.609,P<0.05).After treatment,the TCM syndrome score(4.28±1.17)points and VAS score(1.32±0.54)points in the observation group were lower than those in the control group,and the differences were statistically significant(t=8.280,7.715,P<0.05).After treatment,the hematocrit(37.62±4.91)mPa·s,platelet adhesion rate(28.11±4.05)mPa·s,plasma viscosity(1.41±0.11)%and whole blood viscosity(7.68±1.12)%in the observation group were lower than those in the control group,and the differences were statistically significant(t=12.483,20.488,15.710,15.996,P<0.05).Conclusion The treatment of primary dysmenorrhea in patients with cold clotting and blood stasis identified by traditional Chinese medicine as Shaofuzhuyu decoction was effective,improving patients'symptoms and pain,and improving blood rheological indexes.