蠲痛饮加减方通过抑制子宫内膜抗体对抗子宫内膜异位症痛经的观察

目的：探讨蠲痛饮加减方治疗子宫内膜异位症痛经的临床疗效及部分机制。方法：将本院2011年4月至2013年11月50例子宫内膜异位症痛经纳入研究，根据入院先后顺序分为观察组和对照组，各25例。对照组予口服孕三烯酮，自月经当天起开始服用，口服2次/周，2.5 mg/次，连续服用12周。观察组在对照组治疗方案的基础上再予口服蠲痛饮加减方，自月经结束第2日起开始服用，2次/d，每次100 mL温服，连续服用12周。2组患者治疗期间均无服用其他药物。疗程结束后观察2组患者的肝肾功能、痛经程度积分、子宫内膜中子宫内膜抗体（EmAb)的浓度。结果：1）经过药物干预后痛经积分均有所下降，其中观察组下降的幅度更明显（P<0.05）；2）蛋白印迹法（Western Blotting)、酶联免疫吸附试验（Elisa）检测EmAb水平，发现2组患者子宫内膜的EmAb水平均下降，其中观察组患者血清中EmAb浓度下降趋势较对照组明显（P<0.05）；3）2组均无肝肾功能损害发生。结论：EmAb升高能够诱发子宫内膜异位症痛经，而蠲痛饮加减方能够通过降低EmAb浓度达到治疗子宫内膜异位症痛经的目的。

Observation on Modified Juantong Decoction Against Endometriosis Dysmenorrhea by Inhibiting Emab

To discuss the clinical curative effect and part of its mechanism of modified Juantong decoction for the treatment of endometriosis dysmenorrhea.Methods:Fifty cases of patients with endometriosis dysmenorrhea treated in our hospital during April 2011 to November 2013 were included in the study and divided into observation group and control group according to admission order, with 25 cases in each group. Patients in control group received oral gestrinone from the first day of their menstruation, 2 times per week, 2.5 mg/time, continuously for 12 weeks. The observation group had warm modified Juantong decoction apart from the same treatment as the control group, though from the second day after the menstruation ends, 2 times/day, 100 mL per time, continuously for 12 weeks. No other drugs were applied during treatment in both groups. hepatic and renal function, degree of dysmenorrhea score, endometrial antibody (EmAb) concentration of endometrial of the two groups of the patients after the treatment were observed.Results:1) after the drug intervention, dysmenorrhea score decreased, the decrease of observation group was more obvious (P<0.05); 2) through Western blotting and Elisa detection of EmAb level, it was found that endometrial EmAb level decreased in both of the two groups of patients, the down trend of EmAb serum concentration in the observation group was more significant than the control group (P<0.05); 3) both groups had no hepatic and renal function lesion.Conclusion:The increase of EmAb can induce endometriosis dysmenorrhea, and modified Juantong decoction can reduce EmAb concentration to treat endometriosis dysmenorrhea.