葫芦灸联合改良少腹逐瘀汤在子宫腺肌病中的临床应用

Clinical application of gourd moxibustion combined with modified Shaofu Zhuyu Tang in adenomyosis

目的研究葫芦灸联合改良少腹逐瘀汤治疗子宫腺肌病的临床疗效。方法选取2022年1月至2023年5月于攀枝花市中西医结合医院就诊并确诊为子宫腺肌病的患者80例作为研究对象,随机分为对照组、观察组,两组各40例。对照组口服地诺孕素,观察组采用葫芦灸联合改良少腹逐瘀汤治疗。比较两组治疗前后的子宫体积、中医证候积分、痛经疗效、视觉模拟量表(VAS)评分;以酶联免疫吸附法检测血清中的糖类抗原125(CA125)、D-二聚体水平。结果治疗后,对照组子宫体积无显著变化(P>0.05),观察组子宫体积减小,两组的中医证候积分、VAS评分均下降,且观察组的子宫体积、中医证候积分、VAS评分小于对照组,临床疗效优于对照组(P<0.05)。治疗后,对照组的D-二聚体无变化(P>0.05),观察组的D-二聚体下降,两组患者的CA125下降,且观察组血清中CA125、D-二聚体水平低于对照组(P<0.05)。结论葫芦灸联合改良少腹逐瘀汤治疗寒凝血瘀型子宫腺肌病有较好的临床疗效,可改善患者疼痛、中医证候积分,缩小子宫体积,降低非经期血清CA125、D-二聚体水平。

Objective To study the clinical efficacy of gourd moxibustion combined with modified Shaofu Zhuyu Tang for adenomyosis.Methods From January 2022 to May 2023,80 patients diagnosed with adenomyosis who visited Integrated Traditional Chinese and Western Medicine Hospital were collected as the study subjects.They were randomly grouped into a reference group and an observed group,with 40 patients in each group.The reference group received oral administration of dienogest,while observed group received treatment with gourd moxibustion combined with modified Shaofu Zhuyu Tang.The uterine volume,traditional Chinese medicine(TCM)syndrome scores,dysmenorrhea efficacy,and visual analogue scale(VAS)scores before and after treatment were compared between the two groups;enzyme linked immunosorbent assay(ELISA)was applied to detect the levels of carbohydrate antigen 125(CA125)and D-dimer in serum.Results After treatment,there was no change in the uterine volume of the reference group(P>0.05),and the uterine volume of the observed group decreased,and the TCM syndrome score,and VAS score of both groups decreased,and the uterine volume,TCM syndrome scores,and VAS score of observed group were lower than those of reference group,the clinical efficacy was better than that of reference group(P<0.05).After treatment,there was no change in D-dimer in the reference group(P>0.05),D-dimer decreased in the observed group,CA125 decreased in both groups,and the levels of CA125 and D-dimer in observed group were lower than those in reference group(P<0.05).Conclusion The gourd moxibustion combined with modified Shaofu Zhuyu Tang has good clinical efficacy in treating cold coagulation and blood stasis type adenomyosis,it can improve pain and TCM syndromes,reduce uterine volume,and reduce serum CA125 and D-dimer levels during non menstrual periods.