川夏宁坤汤治疗子宫腺肌病痰湿瘀结证临床研究

目的观察川夏宁坤汤治疗痰湿瘀结证子宫腺肌病(AM)的疗效。方法将60例痰湿瘀结证AM患者随机分为2组,治疗组33例予川夏宁坤汤治疗,对照组27例予散结镇痛胶囊治疗。2组疗程均为3个月。3个月后比较2组治疗前后血清CA125、痛经、月经血量变化情况,其中以中文版COX痛经症状评分量表(CMSS)、数字疼痛强度量表(numerical rating scale,NRS)评价痛经改善情况,采用月经失血图(PBAC)评估月经血量,并统计2组临床综合疗效。结果治疗组总有效率84.84%,对照组62.96%,2组总有效率比较差异有统计学意义(P0.05),治疗组临床疗效优于对照组。2组治疗后血清CA125均较本组治疗前明显降低(P0.05),但2组组间比较差异无统计学意义(P0.05)。2组治疗后NRS评分、PBAC评分及CMSS评分中严重程度和持续时间评分均较本组治疗前下降,且治疗组NRS评分、CMSS评分中严重程度和持续时间评分均低于对照组,比较差异均有统计学意义(P0.05)。2组治疗前后子宫体积均无明显变化(P0.05)。结论川夏宁坤汤对痰湿瘀结证AM有较好的疗效,能有效改善痛经症状,减少月经量,但在降低血清CA125、减小子宫体积方面优势不明显。

Clinical observation of Chuanxia-ningkun decoction on the treatment of adenomyosis with binding of phlegm-damp and static blood type

Objective To observe the clinical effects of Chuanxia-ningkun decoction on the treatment of adenomyosis(AM) with binding of phlegm-damp and static blood type.Methods 60 AM patients with binding of phlegm-damp and static blood type were randomly divided into two groups, the treatment group (n=33) was treated by Chuanxia-ningkun decoction, and the control group (n=27) was treated by Sanjie-zhentong capsules, continuously treatment for 3 months.The serum CA125, the symptom of dysmenorrheal and the menstrual blood loss (MBL) before and after treatment were compared in two groups.The improvement of dysmenorrheal was evaluated by the Cox Menstrual Symptom Scale(CMSS) and Numerical Rating Scale (NRS).The MBL was evaluated by Pictorial Blood Loss Assessment Chart (PBAC).The clinical comprehensive therapeutic effect was evaluated in two groups.Results The total effective rate in treatment and control group was 84.84% and 62.96% respectively, with statistical differences (P<0.05), and the curative effect in treatment group was superior to that in control group.The CA125 after treatment was decreased in two groups (P<0.05), and there was no statistical difference between two groups (P>0.05).The severity score and duration score of NRS, PBAC and CMSS after treatment were decreased in two groups, and the scores of NRS, CMSS were significantly lower than those in control group, with statistical differences (P<0.05).There was no statistical difference on uterine volume between before and after treatment in two groups (P>0.05).Conclusion Chuanxia-ningkun decoction has better therapeutic effects on AM with binding of phlegm-damp and static blood type, can effectively improve the symptom of dysmenorrheal, but with unapparent effects on decreasing CA125 and uterine volume.