摘要
目的观察腹腔镜下骶骨神经切断术联合中药水蛭内金汤治疗子宫内膜异位症性盆腔痛疗效,探讨其在临床中的具体作用。方法随机选取2015年1月—2017年12月就诊西医诊断为慢性盆腔疼痛、中医辨证属于血瘀证的病例作为研究对象,将其分为腹腔镜联合中药水蛭内金汤研究组与手术治疗对照组,每组患者各50例。研究组:月经干净3～7天行腹腔镜切断子宫骶骨神经,术后7天开始口服水蛭内金汤,连续口服3个月。对照组:月经干净3～7天行腹腔镜切断子宫骶骨神经。结果两组患者的手术时间、术中出血量比较,差异均无统计学意义(P> 0.05)。治疗后,两组患者疼痛强度、影响活动程度、疼痛分级比较,差异均具有统计学意义(P <0.05),且研究组优于对照组,差异均具有统计学意义(P <0.05)。术后临床疗效评估,研究组优于对照组,差异具有统计学意义(P <0.05)。结论采用腹腔镜切断子宫骶骨神经,术后联合口服水蛭内金汤治疗子宫内膜异位症引起的慢性盆腔疼痛,可有效缓解疼痛,改善活动程度,有较好的临床疗效。
Objective To observe the curative effect of laparoscopic sacral neurotomy combined with shuizhi neijin decoction in the treatment of endometriosis pelvic pain and explore its specific role in clinical practice.Methods From January 2015 to December 2017,patients with chronic pelvic pain diagnosed by western medicine and TCM syndrome differentiation of blood stasis syndrome were randomly selected as the subjects of study.They were divided into laparoscopic combined with traditional Chinese medicine shuizhi neijin decoction research group and surgical treatment control group,50 cases in each group.Study group: Laparoscopic uterosacral nerve transection was performed in 3 to 7 days after menstruation,and oral administration of shuizhi neijin decoction was started 7 days after operation for 3 consecutive months.Control group: Laparoscopic hysterosacral nerve transection was performed for 3 to 7 days after menstruation.Results There was no significant difference in operation time and bleeding volume between the two groups (P>0.05).After treatment,there were significant differences in pain intensity,activity and pain classification between the two groups (P<0.05).The clinical efficacy of the study group was better than that of the control group (P<0.05). Conclusion Laparoscopic transection of uterosacral nerve combined with oral hirudo neijin decoction can effectively relieve the pain and improve the activity of pelvic pain caused by endometriosis.
作者
许红英
甘晓琴
XU Hongying;GAN Xiaoqin(Department of Gynaecology,Jingzhou Traditional Chinese Medicine Hospital,Jingzhou Hubei 434000,China)
出处
《中国继续医学教育》
2019年第12期158-160,共3页
China Continuing Medical Education
基金
国家中药管理局"2011年刘云鹏名老中医传承工作室建设项目"
关键词
腹腔镜
子宫骶骨韧带
水蛭内金汤
血瘀证
慢性盆腔疼痛
疗效
laparoscopy
uterosacrobone ligament
shuizhi neijin decoction
blood stasis syndrome
chronic pelvic pain
curative effect
