温经散寒化瘀方治疗原发性痛经(血瘀证)的临床研究

目的观察温经散寒化瘀方治疗原发性痛经(血瘀证)的临床疗效。方法将105例原发性痛经(血瘀证)患者随机分为观察组53例和对照组52例。观察组采用温经散寒化瘀方治疗,于每次痛经时口服温经散寒化瘀汤剂,每日3次,每次100ml;对照组采用少腹逐瘀颗粒治疗,每次5g,每日3次。两组分别于治疗前、治疗第3个月经周期后采用数字评分法(numerical rating scale,NRS)对患者的疼痛程度、中医症状进行定量评价,并比较两组患者子宫动脉血流峰值比(A/B)、阻力指数(RI)、搏动指数(PI)及经血中前列腺素含量水平。结果①临床疗效比较:观察组临床痊愈25例(47.17%),显效16例(30.19%),有效11例(20.75%),无效1例(1.89%),总有效率为98.11%;对照组临床痊愈16例(30.77%),显效18例(34.62%),有效8例(15.38%),无效10例(19.23%),总有效率为80.77%;两组临床疗效比较差异有统计学意义(P<0.05)。②疼痛及中医症状比较:治疗第3个月经周期后两组腹痛程度(NRS)评分、中医症状总计分及疼痛分值均下降(P<0.01),观察组优于对照组(P<0.01)。③两组患者A/B、RI、PI值比较:治疗第3个月经周期后,两组A/B、RI、PI较治疗前显著下降(P<0.01);观察组A/B、RI、PI值均较对照组下降明显(P<0.05)。④经血中前列腺素含量比较:治疗第3个月经周期后,观察组经血中PGF2α、PGE2含量水平及PGF2α/PGE2比值与对照组比较,均有统计学意义(P<0.01)。结论温经散寒化瘀方能改善盆腔局部血液循环,改善微循环,具有消散瘀血作用。并具有明显的抑制PGF2α活性,调节相关致痛物质趋于正常的生理平衡,达到止痛的作用。

Clinical observation of Wenjing sanhan huayu decoction for treating primary dysmenorrheal(Blood Stasis Syndrome)

Objective To observe the efficacy of Wenjing sanhan huayu decoction for primary dysmenorrheal(Blood Stasis Syndrome).Methods 105 patients with blood stasis syndrome of primary dysmenorrheal were divided into two groups:53 cases for the observation group and 52 cases for the control group.The patients of the observation group were treated by Wenjing sanhan huayu decoction.These patients took 100ml of Wenjing sanhan huayu decoction for every time and for three times a day when they suffered dysmenorrheal.The control group took 5g of Shaofu Zhuyu Granule for one time and for three times a day.The effect in relieving menalgia of both groups was evaluated by numerical rating scale(NRS) before and on the third menstrual cycle after treatment.The degree of pain and the TCM symptoms of both groups were evaluated quantitatively.The ratio at uterus artery blood(A/B),resistance index(RI),pulse Index(PI) and PGE2 content in menstrual fluidof these two groups were tested and compared as well.Results ①After treatment,for the observation group,25 patients(47.17%) were clinically cured,16 were treated markedly effectively(30.19%),11 were treated effectively(20.75%) and 1 ineffective(1.89%).The total effective rate was 98.11%.For the control group these treatment effective rates were 16(30.77%),18(34.62%),8(15.38%),and 10(19.23%) respectively,The total effective rate twas 80.77%.The clinical effect of the observation group was significantly higher than that of the control group(P<0.05).②For the degree of pain and TCM symptoms of the two groups:on the third menstrual cycles,the NRS scores and symptoms of TCM scores in both group decreased in comparison with those before treatment(P<0.01).The decreasing of the observation group was more obvious than that of the control group.③After the treatment of the third menstrual cycles,A/B,RI,PI of both the groups significantly decreased(P<0.01).Those of the observation group decreased more significantly.④On the third menstrual cycles,compared with those of those of the control group,the PGF2α,PGE2 levels of the observation group was significantly lower(P<0.01).Conclusion Wenjing sanhan huayu decoction helps improve blood circulation and microcirculation of the pelvic cavity.It can dissipate blood stasis and curb the activity of PGF2.Wenjing sanhan huayu decoction also helps regulate the algogenic substances to the normal physiologic balance as to relieve the pain.