腹腔镜联合水蛭内金汤对慢性盆腔痛疗效观察
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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.
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.
引文
[1]马丽珍.分析中医治疗妇科慢性盆腔疼痛的临床效果[J].世界最新医学信息文摘(连续型电子期刊),2018,18(58):177.
[2]廖飞燕.子宫内膜异位症保守性手术后应用曼月乐、GnRH-a治疗的临床观察[J].现代诊断与治疗,2015,35(10):905-908.
[3]Ohlsson B.Gonadotropin-releasing hormone and its physiological and pathophysiological roles in relation to the structure and function of the gastrointestinal trac[J].Eur Surg Res,2016,57(1-2);22-33.
[4]阳华.米非司酮联合桂枝茯苓胶囊治疗子宫内膜异位症的临床疗效观察[J].中国处方药,2018,16(9):85-86.
[5]杜鑫.内异方联合GnRh-a对气滞血瘀型卵巢子宫内膜异位囊肿术后患者疗效的临床观察[D].济南:山东中医药大学,2015:1-30.
[6]郭立丽,刘正清,朱燕.腹腔镜子宫骶神经切断术治疗子宫内膜异位症疼痛的安全性和有效性观察[J].中国性科学,2015,24(9):22-24.
[7]陈春林.子宫腺肌病保守治疗痛经缓解后再发的处理[J].中国实用妇科与产科杂志,2016,32(11):1045-1048.
[8]高振宁.探讨运用中医疗法治疗妇科慢性盆腔疼痛症的临床疗效[J].中外女性健康研究,2018(8):111-112.
[9]王红,李玉丽,孙小玉,等.膈下逐瘀汤治疗气滞血瘀型子宫内膜异位症[J].中医学报,2018,33(10):2007-2011.
[10]郑秋萍.中医治疗妇科慢性盆腔疼痛的疗效观察[J].中国社区医师,2018,34(3):91,93.
[11]邓莉芸,赵岩,楼江燕.腹腔镜骶前神经联合宫骶韧带切断术对深部浸润型子宫内膜异位症患者疼痛及性生活质量的影响[J].中国妇幼保健,2018,33(6):1230-1233.
[12]丁婷.大黄蛰虫胶囊联合曲普瑞林治疗子宫内膜异位症的临床研究[J].现代药物与临床,2018,33(9):2339-2343.
[13]梁红艳,许红英.中药水蛭内金汤治疗血瘀型慢性盆腔疼痛疗效观察[J].河北医学,2014,20(5):838-839.
[2]廖飞燕.子宫内膜异位症保守性手术后应用曼月乐、GnRH-a治疗的临床观察[J].现代诊断与治疗,2015,35(10):905-908.
[3]Ohlsson B.Gonadotropin-releasing hormone and its physiological and pathophysiological roles in relation to the structure and function of the gastrointestinal trac[J].Eur Surg Res,2016,57(1-2);22-33.
[4]阳华.米非司酮联合桂枝茯苓胶囊治疗子宫内膜异位症的临床疗效观察[J].中国处方药,2018,16(9):85-86.
[5]杜鑫.内异方联合GnRh-a对气滞血瘀型卵巢子宫内膜异位囊肿术后患者疗效的临床观察[D].济南:山东中医药大学,2015:1-30.
[6]郭立丽,刘正清,朱燕.腹腔镜子宫骶神经切断术治疗子宫内膜异位症疼痛的安全性和有效性观察[J].中国性科学,2015,24(9):22-24.
[7]陈春林.子宫腺肌病保守治疗痛经缓解后再发的处理[J].中国实用妇科与产科杂志,2016,32(11):1045-1048.
[8]高振宁.探讨运用中医疗法治疗妇科慢性盆腔疼痛症的临床疗效[J].中外女性健康研究,2018(8):111-112.
[9]王红,李玉丽,孙小玉,等.膈下逐瘀汤治疗气滞血瘀型子宫内膜异位症[J].中医学报,2018,33(10):2007-2011.
[10]郑秋萍.中医治疗妇科慢性盆腔疼痛的疗效观察[J].中国社区医师,2018,34(3):91,93.
[11]邓莉芸,赵岩,楼江燕.腹腔镜骶前神经联合宫骶韧带切断术对深部浸润型子宫内膜异位症患者疼痛及性生活质量的影响[J].中国妇幼保健,2018,33(6):1230-1233.
[12]丁婷.大黄蛰虫胶囊联合曲普瑞林治疗子宫内膜异位症的临床研究[J].现代药物与临床,2018,33(9):2339-2343.
[13]梁红艳,许红英.中药水蛭内金汤治疗血瘀型慢性盆腔疼痛疗效观察[J].河北医学,2014,20(5):838-839.