温经疏肝化瘀通络法治疗原发性痛经的疗效及机制研究
|
摘要
目的:观察温经疏肝化瘀通络法治疗原发性痛经的效果和可能的机制。方法:回顾性选取2015年1月至2017年10月我院收治的原发性痛经患者200例,根据治疗方法不同分为对照组和观察组。对照组患者采用口服布洛芬缓释胶囊治疗,观察组患者采用温经疏肝化瘀通络法治疗,分析两组患者治疗效果。结果:观察组患者治疗后总有效率为95.00%,对照组为75.00%,观察组患者总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者痛经症状总发作时间及平均严重程度比较无统计学差异(P>0.05)。治疗1、2、3个月经周期后,观察组患者痛经症状总发作时间及平均严重程度均优于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者谷胱甘肽过氧化物酶(GSH-PX)、总抗氧化能力(T-AOC)、血清β-内啡肽(β-EP)、6-酮前列腺素F1α(6-keto-PGF1α)含量比较无统计学差异(P>0.05)。治疗后,观察组患者GSH-PX、T-AOC、β-EP、6-keto-PGF1α含量高于对照组,差异有统计学意义(P<0.05)。结论:温经疏肝化瘀通络法治疗原发性痛经疗效显著,其作用机制可能与激活机体抗氧化能力减少机体氧化损伤,同时调节6-keto-PGF1α水平减轻患者子宫痉挛性收缩有关。
Objective:To investigate the interventional mechanism and therapeutic effect of applying warming meridian to soothe liver and removing blood stasis and dredging collaterals method in the treatment of primary dysmenorrhea.Methods:From January 2015 to October 2017,200 patients with primary dysmenorrhea were selected and divided into controlled group and observation group according to different treatment methods. The patients in the controlled group were treated with Ibuprofen Sustained Release Capsule and the patients in the observation group were treated with the method of soothing the liver and removing the blood stasis and dredging the collaterals. The therapeutic effects of the two groups were analyzed. Results:The total effective rate was 95.00% in the observation group and 75.00% in the controlled group. The total effective rate in the observation group was higher than that in the controlled group(P<0.05). Before treatment,there was no significant difference in total onset time and mean severity of dysmenorrhea between the two groups(P>0.05). After 1 and 3 menstrual cycles,the total onset time and average severity of dysmenorrhea in the observation group were better than those in the controlled group(P<0.05). Before treatment,glutathione peroxidase(GSH-PX) and total antioxidant capacity(T-AO) were observed in both groups. There was no significant difference in the content of serumβ-endorphin(β-EP) 6-keto-PGF1α(P>0.05). After treatment,the levels of GSH-PXX T-AOC,β-EPX 6-keto-PGF1αin the observation group were higher than those in the controlled group(P<0.05). Conclusion:The treatment of primary dysmenorrhea by warming meridian and soothing liver and removing blood stasis and dredging collaterals method may be related to the reduction of oxidative damage by activating the antioxidant capacity of the body,and the regulation of the level of 6-keto-PGF1αto alleviate the uterine spasmodic contraction in the patients.
Objective:To investigate the interventional mechanism and therapeutic effect of applying warming meridian to soothe liver and removing blood stasis and dredging collaterals method in the treatment of primary dysmenorrhea.Methods:From January 2015 to October 2017,200 patients with primary dysmenorrhea were selected and divided into controlled group and observation group according to different treatment methods. The patients in the controlled group were treated with Ibuprofen Sustained Release Capsule and the patients in the observation group were treated with the method of soothing the liver and removing the blood stasis and dredging the collaterals. The therapeutic effects of the two groups were analyzed. Results:The total effective rate was 95.00% in the observation group and 75.00% in the controlled group. The total effective rate in the observation group was higher than that in the controlled group(P<0.05). Before treatment,there was no significant difference in total onset time and mean severity of dysmenorrhea between the two groups(P>0.05). After 1 and 3 menstrual cycles,the total onset time and average severity of dysmenorrhea in the observation group were better than those in the controlled group(P<0.05). Before treatment,glutathione peroxidase(GSH-PX) and total antioxidant capacity(T-AO) were observed in both groups. There was no significant difference in the content of serumβ-endorphin(β-EP) 6-keto-PGF1α(P>0.05). After treatment,the levels of GSH-PXX T-AOC,β-EPX 6-keto-PGF1αin the observation group were higher than those in the controlled group(P<0.05). Conclusion:The treatment of primary dysmenorrhea by warming meridian and soothing liver and removing blood stasis and dredging collaterals method may be related to the reduction of oxidative damage by activating the antioxidant capacity of the body,and the regulation of the level of 6-keto-PGF1αto alleviate the uterine spasmodic contraction in the patients.
引文
[1] 张玉珍.中医妇科学[M].7 版.北京:中国中医药出版社,2002:124
[2] 韩蓁,张明慧.原发性痛经病因研究进展 [J].国外医学妇幼保健分册,1997,8(1):1～2
[3] 谷蓓蓓.中西医结合治疗原发性痛经 51 例[J].河南中医,2013,33(12):2164～2165
[4] 鲁佳,顾一煌.近 10 年原发性痛经针灸治疗研究进展[J].中医药信息,2014,31(3):165
[5] LIU M J,WANG K.Treatment of primary dysmenorrhea with herb-partitioned moxibustion plus ultra-short wave[J].J AcupunctTuina Sci,2014,12(2):109～113
[6] 赵耀东,韩豆瑛,郭霞.温通针法治疗地震后抑郁症:随机对照研究[J].中国针灸,2014,34(8):755～758
[7] 杨文,蔡勤华,胡萍,等.胡氏温经化瘀法治疗寒凝血瘀型原发性痛经临床研究[J].中医药临床杂志,2017,29(11):1878～1880
[8] 王诗琦,王祖龙,刘亚美,等.潮舒煎联合五子衍宗丸治疗大学在校女生原发性痛经 30 例[J].河南中医,2013,33(12):2160～2161
[9] 杜亚娟,朱颖.温经汤加味配合穴位贴敷治疗痛经 40 例[J].河南中医,2014,34(4):724
[10] 何秀莲,何德华.疏肝温经汤联合针灸治疗原发性痛经临床研究[J].河南中医,2016,36(2):278～280
[11] 欧阳白莎,张倩,郝青,等.温经汤联合穴位埋线治疗原发性痛经的疗效观察[J].湖北中医药大学学报,2014,16(5):99-100.。
[12] 徐丁洁,杜惠兰,成秀梅,等.加减温经汤对寒凝血瘀模型大鼠卵巢氧化损伤的影响 [J].中国中西医结合杂志,2012,32(1):58～60
[13] Agarwal A,Aponte-Mellado A,Premkumar BJ,et al.The effects of oxidative stress on female reproduction:a review[J].Reprod Biol Endocrinol,2012,10:49
[14] 国家中医药管理局《中华本草》编委会·中华本草·8[M].上海科学技术出版社,1999:617～622
[15] 高学敏.中药学[M].中国中医药出版社,2012.
[16] 迟晓丽,刘国云,周文霞,等.刘超.原发性痛经的治疗药物和治疗靶点研究进展 [J].军事医学科学院院刊,2007,31(5):470
[2] 韩蓁,张明慧.原发性痛经病因研究进展 [J].国外医学妇幼保健分册,1997,8(1):1～2
[3] 谷蓓蓓.中西医结合治疗原发性痛经 51 例[J].河南中医,2013,33(12):2164～2165
[4] 鲁佳,顾一煌.近 10 年原发性痛经针灸治疗研究进展[J].中医药信息,2014,31(3):165
[5] LIU M J,WANG K.Treatment of primary dysmenorrhea with herb-partitioned moxibustion plus ultra-short wave[J].J AcupunctTuina Sci,2014,12(2):109～113
[6] 赵耀东,韩豆瑛,郭霞.温通针法治疗地震后抑郁症:随机对照研究[J].中国针灸,2014,34(8):755～758
[7] 杨文,蔡勤华,胡萍,等.胡氏温经化瘀法治疗寒凝血瘀型原发性痛经临床研究[J].中医药临床杂志,2017,29(11):1878～1880
[8] 王诗琦,王祖龙,刘亚美,等.潮舒煎联合五子衍宗丸治疗大学在校女生原发性痛经 30 例[J].河南中医,2013,33(12):2160～2161
[9] 杜亚娟,朱颖.温经汤加味配合穴位贴敷治疗痛经 40 例[J].河南中医,2014,34(4):724
[10] 何秀莲,何德华.疏肝温经汤联合针灸治疗原发性痛经临床研究[J].河南中医,2016,36(2):278～280
[11] 欧阳白莎,张倩,郝青,等.温经汤联合穴位埋线治疗原发性痛经的疗效观察[J].湖北中医药大学学报,2014,16(5):99-100.。
[12] 徐丁洁,杜惠兰,成秀梅,等.加减温经汤对寒凝血瘀模型大鼠卵巢氧化损伤的影响 [J].中国中西医结合杂志,2012,32(1):58～60
[13] Agarwal A,Aponte-Mellado A,Premkumar BJ,et al.The effects of oxidative stress on female reproduction:a review[J].Reprod Biol Endocrinol,2012,10:49
[14] 国家中医药管理局《中华本草》编委会·中华本草·8[M].上海科学技术出版社,1999:617～622
[15] 高学敏.中药学[M].中国中医药出版社,2012.
[16] 迟晓丽,刘国云,周文霞,等.刘超.原发性痛经的治疗药物和治疗靶点研究进展 [J].军事医学科学院院刊,2007,31(5):470