温经疏肝化瘀通络法对原发性痛经患者疼痛、生存质量及相关炎性指标的影响
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摘要
目的观察中医温经疏肝化瘀通络法治疗原发性痛经患者的疗效以及对疼痛、生存质量与炎性因子的影响。方法将130例原发性痛经患者随机分为2组,对照组65例给予益母草冲剂治疗(月经来潮前3 d开始口服,每次15 g,每天3次,连服7 d),治疗组65例给予温经疏肝化瘀中药治疗(月经来潮前3 d开始口服,每天1剂,每次服150 m L,早晚各1次,连服7 d),2组均以连续治疗3个月经周期为1个评估疗程。统计2组临床疗效,观察治疗前后痛经程度及疼痛评分、生存质量WHOQOL-BREF量表评分和血清高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平变化情况。结果治疗组的临床总有效率明显高于对照组(P <0. 05); 2组治疗后的痛经程度评分、VAS评分及血清hs-CRP、IL-6、TNF-α水平均明显低于治疗前(P均<0. 05),且治疗组明显低于对照组(P均<0. 05)。治疗后治疗组患者生存质量、健康主观感觉评分均明显高于对照组与治疗前(P均<0. 05);心理与社会关系评分明显高于治疗前(P均<0.05),但与对照组比较差异无统计学意义(P均>0. 05)。结论中医温经疏肝化瘀通络法能够有效提高原发性痛经的临床治疗有效性,缓解痛经疼痛并提高患者的生存质量,对微炎症状态也有良好的改善作用。
Objective It is to observe the curative effect of Wenjing Shugan Huayu Tongluo therapy on primary dysmenorrhea( PD) and its effects on pain,quality of life and inflammatory factors. Methods 130 patients with PD were randomly divided into two groups. The control group( n = 65) was treated with Yimucao granules( orally starting 3 days before menstruation,15 g each time,3 times a day,continuly for 7 days),the treatment group( n = 65) was treated with Chinese drugs for Wenjing Shugan Huayu( orally starting 3 days before menstruation,1 dose per day,continuly for 7 days),both groups were treated for 3 months for 1 assessment session. The clinical efficacy was analyzed,the changes of degree of dysmenorrhea and pain score,the quality of life WHOQOL-BREF scale and the levels of serum inflammatory factors hs-CRP,IL-6 and TNF-α were observed before and after treatment in both groups. Results The total clinical effective rate of the treatment group was significantly higher than that of the control group( P < 0. 05). The dysmenorrhea degree scores,VAS scores and levels of serum hs-CRP,IL-6 and TNF-α in the two groups were significantly lower after treatment than those before treatment( P < 0. 05),the decrease was more significant in the treatment group( P < 0. 05). After treatment,the quality of life and subjective sensory scores of the treatment group were significantly higher than those of the control group and before treatment( P < 0. 05); the psychological and social relationship scores were significantly higher than those before treatment( P < 0. 05),but there was no significant difference compared with the control group. Conclusion Wenjing Shugan Huayu Tongluo method can effectively improve the clinical effect on PD,relieve dysmenorrhea pain and improve the quality of life,and also improve the microinflammation state.
Objective It is to observe the curative effect of Wenjing Shugan Huayu Tongluo therapy on primary dysmenorrhea( PD) and its effects on pain,quality of life and inflammatory factors. Methods 130 patients with PD were randomly divided into two groups. The control group( n = 65) was treated with Yimucao granules( orally starting 3 days before menstruation,15 g each time,3 times a day,continuly for 7 days),the treatment group( n = 65) was treated with Chinese drugs for Wenjing Shugan Huayu( orally starting 3 days before menstruation,1 dose per day,continuly for 7 days),both groups were treated for 3 months for 1 assessment session. The clinical efficacy was analyzed,the changes of degree of dysmenorrhea and pain score,the quality of life WHOQOL-BREF scale and the levels of serum inflammatory factors hs-CRP,IL-6 and TNF-α were observed before and after treatment in both groups. Results The total clinical effective rate of the treatment group was significantly higher than that of the control group( P < 0. 05). The dysmenorrhea degree scores,VAS scores and levels of serum hs-CRP,IL-6 and TNF-α in the two groups were significantly lower after treatment than those before treatment( P < 0. 05),the decrease was more significant in the treatment group( P < 0. 05). After treatment,the quality of life and subjective sensory scores of the treatment group were significantly higher than those of the control group and before treatment( P < 0. 05); the psychological and social relationship scores were significantly higher than those before treatment( P < 0. 05),but there was no significant difference compared with the control group. Conclusion Wenjing Shugan Huayu Tongluo method can effectively improve the clinical effect on PD,relieve dysmenorrhea pain and improve the quality of life,and also improve the microinflammation state.
引文
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[13]金媛媛.加减温经汤治疗寒凝血瘀证原发性痛经的临床观察[D].武汉:湖北中医药大学,2011
[14]陈长勋,曾南,沈映君.中药药理学[M]. 2版.上海:上海科学技术出版社,2015:124-158
[15]刘芳,巨瑛,杨红睚,等.桂枝茯苓丸联合西药治疗子宫腺肌病继发性痛经患者的临床疗效及对血清IL-6、PGE2及ET的影响[J].陕西中医,2016,37(10):1279-1280
[16]郑仁省,刘金里.芍药甘草汤对痛经患者血清IL-1β、TNF-α及疼痛的影响[J].长春中医药大学学报,2017,33(4):614-616
[2]孙晓理,杜彩素.原发性痛经的影响因素及干预研究进展[J].中国社会医学杂志,2017,34(3):262-264
[3]王北婴.中药治疗痛经的临床研究指导原则[J].中华中医药杂志,1989,4(2):70-72
[4]丰有吉,沈铿,马丁,等.妇产科学[M].北京:人民卫生出版社,2010:318-326
[5]国家中医药管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:146-148
[6]严广斌.视觉模拟评分法[J/CD].中华关节外科杂志:电子版,2014,8(2):34
[7]刘弘,经燕,辛茜庭.中医治疗痛经指南指标德尔菲法调查分析[J].中国中医基础医学杂志,2008,14(3):238-240
[8]张书堂.米非司酮对子宫内膜异位症痛经患者hs-CRP及痛经积分的影响[J].河北医药,2013,35(13):1985-1986
[9]徐丁洁,张碧溦,杜晨光,等.金匮温经汤对虚寒证原发性痛经患者微炎症状态的影响[J].云南中医学院学报,2016,39(3):64-67
[10]谢丹,居明乔,曹鹏,等.炎症因子和原发性痛经相关性的研究进展[J].中国临床药理学与治疗学,2014,19(3):346-350
[11]姜云国,方玲,贾强华.原发性痛经的病因病机研究进展[J].长春中医药大学学报,2011,27(4):683-684
[12]程芳,程红,曹俊红,等.原发性痛经中医证候分布特点探讨[J].中医学报,2013,28(8):1194-1196
[13]金媛媛.加减温经汤治疗寒凝血瘀证原发性痛经的临床观察[D].武汉:湖北中医药大学,2011
[14]陈长勋,曾南,沈映君.中药药理学[M]. 2版.上海:上海科学技术出版社,2015:124-158
[15]刘芳,巨瑛,杨红睚,等.桂枝茯苓丸联合西药治疗子宫腺肌病继发性痛经患者的临床疗效及对血清IL-6、PGE2及ET的影响[J].陕西中医,2016,37(10):1279-1280
[16]郑仁省,刘金里.芍药甘草汤对痛经患者血清IL-1β、TNF-α及疼痛的影响[J].长春中医药大学学报,2017,33(4):614-616