摘要
目的研究少腹逐瘀汤配合新生化颗粒对气虚血瘀型子宫腺肌病(AM)患者痛经、月经量多的改善作用。方法选取2021年3月至2022年6月南阳市第一人民医院收治的190例气虚血瘀型AM患者为研究对象,采用随机数表法分为对照组和研究组各95例。对照组患者采用新生化颗粒治疗,研究组患者采用少腹逐瘀汤配合新生化颗粒治疗,均治疗3个月经周期。治疗后比较两组患者的临床疗效,以及治疗前和治疗3个月经周期后痛经积分、月经积分及中医证候积分、子宫体积、子宫内膜厚度、子宫血流动力学指标[子宫动脉收缩期峰值流速(Vmax)、舒张末期流速(Vmin)、阻力指数(RI)]、血清细胞因子[白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、沉默调节蛋白6(Sirt6)、磷酸化应激诱导蛋白1(STIP-1)]水平。结果研究组患者的临床治疗总有效率为97.89%,明显高于对照组的89.47%,差异有统计学意义(P<0.05);治疗3个月经周期后,研究组患者的痛经积分、月经积分、中医证候积分分别为(4.93±1.19)分、(1.02±0.31)分、(6.85±1.77)分,明显低于对照组的(6.24±1.28)分、(1.56±0.35)分、(9.43±2.31)分,差异均有统计学意义(P<0.05);治疗3个月经周期后,研究组患者的子宫体积、子宫内膜厚度分别为(165.37±11.08)cm3、(5.53±1.59)mm,明显低于对照组的(181.46±10.53)cm3、(6.92±1.84)mm,差异均有统计学意义(P<0.05);治疗3个月经周期后,研究组患者的子宫动脉Vmax、Vmin分别为(15.43±2.81)cm/s、(7.43±1.92)cm/s,明显低于对照组的(19.54±2.69)cm/s、(10.24±2.11)cm/s,RI值为0.85±0.06,明显高于对照组的0.74±0.07,差异均有统计学意义(P<0.05);治疗3个月经周期后,研究组患者的血清IL-6、IL-17、STIP-1水平分别为(58.61±7.19)pg/mL、(64.22±5.98)pg/mL、(1.06±0.12)ng/mL,明显低于对照组的(76.32±8.25)pg/mL、(1.78±0.16)pg/mL、(1.78±0.16)ng/mL,Sirt6水平为(6.73±1.62)ng/mL,明显高于对照组的(5.08±1.24)ng/mL,差异均有统计学意义(P<0.05)。结论少腹逐瘀汤联合新生化颗粒治疗气虚血瘀型AM可有效促进患者子宫体积、子宫内膜厚度、临床症状及子宫动脉血液流变学改善,抑制氧化应激及炎症反应,提高疗效。
Objective To study the improvement effect of Shaofu Zhuyu Tang combined with Xinshenghua Granules on dysmenorrhea and excessive menstrual flow in patients with Qi deficiency and blood stasis type adenomyosis(AM).Methods A total of 190 AM patients with Qi deficiency and blood stasis adenomyosis admitted to Nanyang First People's Hospital from March 2021 to June 2022 were selected as research objects.They were divided into a control group and a study group by random number table method,with 95 cases in each group.Patients in the control group were treated with Xinshenghua Granules,while those in the study group were treated with Shaofu Zhuyu Tang combined with Xinshenghua Granules,both for 3 menstrual cycles.The clinical efficacy were compared between the two groups,as well as the dysmenorrhea score,menstrual score,traditional Chinese medicine syndrome score,uterine volume,endometrial thickness,uterine hemodynamic indicators[peak systolic flow rate(Vmax),end-diastolic flow rate(Vmin),resistance index(RI)],and serum cytokine levels[interleukin-6(IL-6),interleukin-17(IL-17),silencing regulatory protein 6(Sirt6),stress-induced-phosphoprotein 1(STIP-1)]before and after treatment for three menstrual cycles.Results The total clinical effective rate of the study group(97.89%)was significantly higher than that of the control group(89.47%),and the difference was statistically significant(P<0.05).After treatment for three menstrual cycles,the dysmenorrhea score,menstrual score,and traditional Chinese medicine syndrome score of the study group were(4.93±1.19)points,(1.02±0.31)points,and(6.85±1.77)points,respectively,which were significantly lower than(6.24±1.28)points,(1.56±0.35)points,and(9.43±2.31)points in the control group(P<0.05).After treatment,the uterine volume and endometrial thickness of the study group were(165.37±11.08)cm3 and(5.53±1.59)mm,significantly lower than(181.46±10.53)cm3 and(6.92±1.84)mm of the control group(P<0.05).After treatment,the Vmax and Vmin of the uterine artery in the study group were(15.43±2.81)cm/s,(7.43±1.92)cm/s,significantly lower than(19.54±2.69)cm/s,(10.24±2.11)cm/s in the control group;the RI value was 0.85±0.06,significantly higher than 0.74±0.07 in the control group;the differences were statistically significant(P<0.05).After treatment,the serum levels of IL-6,IL-17,and STIP-1 in the study group were(58.61±7.19)pg/mL,(64.22±5.98)pg/mL,and(1.06±0.12)ng/mL,respectively,which were significantly lower than(76.32±8.25)pg/mL,(1.78±0.16)pg/mL,and(1.78±0.16)ng/mL in the control group;Sirt6 level was(6.73±1.62)ng/mL,significantly higher than(5.08±1.24)ng/mL in the control group;the differences were statistically significant(P<0.05).Conclusion The combination of Shaofu Zhuyu Tang and Xinshenghua Granules can effectively promote the improvement of uterine volume,endometrial thickness,clinical symptoms,and uterine artery hemorheology in patients with Qi deficiency and blood stasis type AM,inhibit oxidative stress and inflammatory reactions,and improve the therapeutic effect.
作者
杨静
卢喜洋
彭丽
YANG Jing;LU Xi-yang;PENG Li(Department of Obstetrics and Gynecology,Nanyang First People's Hospital,Nanyang 473000,Henan,CHINA;Department of Obstetrics,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,Henan,CHINA)
出处
《海南医学》
CAS
2023年第18期2646-2650,共5页
Hainan Medical Journal
基金
河南省中医药科学研究专项课题(编号:20-21ZY2032)。
关键词
气虚血瘀型
子宫腺肌病
少腹逐瘀汤
新生化颗粒
痛经
疗效
Qi deficiency and blood stasis type
Adenomyosis
Shaofu Zhuyu Tang
Xinshenghua Granules
Dysmenorrhea
Curative effect
