消癥止痛汤联合孕三烯酮胶囊治疗子宫内膜异位症盆腔疼痛临床研究

目的:观察消癥止痛汤联合孕三烯酮胶囊治疗子宫内膜异位症盆腔疼痛的临床效果。方法:将80例气滞血瘀证患者随机分为对照组和观察组各40例。2组均服用孕三烯酮胶囊治疗,对照组加服血府逐瘀胶囊,观察组加服消癥止痛汤,2组均连续观察3个月经周期。痛经情况采用疼痛视觉模拟评分法(VAS)于治疗前和治疗后第1、2、3个月经周期进行评价,并应用COX痛经症状评分量表(CMSS)对痛经症状进行评价。治疗前后评定盆腔疼痛症状、体征评分和气滞血瘀证评分、子宫内膜异位症专用生存质量评价量表(EHP-5)评分。结果:治疗后,观察组改善疼痛方面的疗效优于对照组(P<0.05)。2组VAS评分均较治疗前逐渐下降(P<0.01),观察组治疗后第1~3个月经周期的VAS评分均低于同期对照组(P<0.01)。2组CMSS痛经持续时间评分和严重程度评分均较治疗前下降(P<0.01),观察组2项评分均低于对照组(P<0.01)。2组疼痛相关症状、体征评分,气滞血瘀证评分和EHP-5评分均较治疗前下降(P<0.01),观察组3项评分均低于对照组(P<0.01)。结论:在孕三烯酮胶囊治疗的基础上加予消癥止痛汤治疗子宫内膜异位症盆腔疼痛气滞血瘀证患者,可有效减轻痛经及盆腔疼痛症状、体征,提高患者的生活质量。

Clinical Study on Xiaozheng Zhitong Tang Combined with Gestrinone Capsules for Pelvic Pain Caused by Endometriosis

Objective: To observe the clinical effect of Xiaozheng Zhitong tang combined with gestrinone capsules for pelvic pain caused by endometriosis. Methods:A total of 80 cases of patients with qi stagnation and blood stasis syndrome were randomly divided into the control group and the observation group,40 cases in each group. Both groups were treated with gestrinone capsules. The control group was additionally treated with Xuefu Zhuyu capsules,and the observation group was additionally treated with Xiaozheng Zhitong tang. Both groups were continuously observed for three menstrual cycles.Before treatment and in the first,second and third menstrual cycle after treatment,dysmenorrhea was evaluated by Visual Analogue Scale(VAS), and the symptoms of dysmenorrhea by COX Menstrual Symptom Scale(CMSS). Before and after treatment,the scores of symptoms of pelvic pain,signs,qi stagnation and blood stasis syndrome and Endometriosis Health Profile(EHP-5) for quality of life were evaluated. Results: After treatment, the curative effect of relieving pain in the observation group was superior to that in the control group(P<0.05). The scores of VAS in the two groups were gradually decreased when compared with those before treatment(P<0.05);during the first three menstrual cycles after treatment,the scores of VAS in the observation group were lower than those in the control group in the same period respectively(P<0.01). The scores of duration and severity of dysmenorrhea in CMSS in the two groups were decreased when compared with those before treatment(P<0.01), and the above two scores in the observation group were both lower than those in the control group(P<0.01). The scores of pain-related symptoms,signs,qi stagnation and blood stasis syndrome and EHP-5 in the two groups were decreased when compared with those before treatment(P<0.01),and the above three scores in the observation group were all lower than those in the control group(P<0.01). Conclusion:Based on gestrinone capsules,the additional treatment of Xiaozheng Zhitong tang in treating pelvic pain caused by endometriosis with qi stagnation and blood stasis syndrome can effectively relieve the symptoms of dysmenorrhea and pelvic pain and signs,and improve the quality of life.