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纸质出版日期:2017
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刘洁云, 郭洁, 吴雅俊, 等. 琥珀散加减辨治子宫内膜异位症疼痛(血瘀证)的疗效作用机制[J]. 中国实验方剂学杂志, 2017,23(17):205-210.
LIU Jie-yun, GUO Jie, WU Ya-jun, et al. Effect and Mechanism of Add and Subtract Dialectics of Huposan on Endometriosis with Blood Stasis Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(17): 205-210.
刘洁云, 郭洁, 吴雅俊, 等. 琥珀散加减辨治子宫内膜异位症疼痛(血瘀证)的疗效作用机制[J]. 中国实验方剂学杂志, 2017,23(17):205-210. DOI: 10.13422/j.cnki.syfjx.2017170205.
LIU Jie-yun, GUO Jie, WU Ya-jun, et al. Effect and Mechanism of Add and Subtract Dialectics of Huposan on Endometriosis with Blood Stasis Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(17): 205-210. DOI: 10.13422/j.cnki.syfjx.2017170205.
目的:探讨琥珀散加减辨治子宫内膜异位症(EMs)疼痛(血瘀证)的临床疗效及对致炎细胞因子水平的影响。方法:将138例符合要求的EMs疼痛患者,采用随机区组分化,按数字表法分为对照组和观察组各69例。对照组采用口服米非司酮片治疗,12.5 mg/次,1次/d。观察组采用琥珀散加减辨证治疗,1剂/d。两组疗程均为连续治疗6个月。经期疼痛情况采用视觉模拟评分(VAS)评分,并对非经期的盆腔痛、性交疼痛、盆腔压痛、骶韧带触痛结节和血瘀证进行治疗前后评分;检测治疗前后血清血栓素B2(TXB2),6-酮前列腺素F1α(6-Keto-PGF1α),癌抗原125(CA125),雌激素(E2),肿瘤坏死因子-α(TNF-α),白细胞介素-6(IL-6),白细胞介素-8(IL-8)水平。结果:观察组临床总有效率为95.38%,对照组为81.25%,观察组高于对照组(χ2=6.269,P<0.05);经重复测量的方差分析,两组患者在6个月经周期的治疗过程VAS评分均呈下降趋势(F对照组=6.903
F观察组=7.632,P<0.05),经配对t检验,观察组在第3,4,5,6个月经周期VAS评分均低于对照组(P<0.01);治疗后观察组非经期的盆腔痛、性交疼痛、盆腔压痛、骶韧带触痛结节评分和血瘀证评分均低于对照组(P<0.01);观察组患者血清CA125,E2,TXB2和6-Keto-PGF1α水平均低于对照组(P<0.01);治疗后观察组血清TNF-α,IL-6,IL-8水平均低于对照组(P<0.01)。结论:采用琥珀散加减辨证治疗EMs疼痛(血瘀证)患者,能明显缓解患者的疼痛症状,并能降低雌激素、前列腺素和血清TNF-α,IL-6,IL-8等因子水平,起到改善EMs病情的作用。
Objective: To discuss the clinical efficacy of add and subtract dialectics of Huposan on endometriosis (EMs) with blood stasis syndrome and investigate its effect on inflammation factors. Method: One hundred and thirty-eight patients with EMs were randomly divided into control group 69 cases and observation group 69 cases by random number table. The control group adopted mifepristone
12.5 mg/time
1 time/day. In observation group
the patients received add and subtract dialectics of Huposan
1 dose/day. The treatment course was 6 months in both groups. Score of pain in menstrual period was graded by visual simulation score (VAS)
and scores of pelvic pain
sexual intercourse pain
pelvic tenderness
sacral ligament tenderness nodules and blood stasis syndrome were graded at non-menstrual period both before ans after treatment. In addition
the levels of serum thromboxane-2 (TXB2)
6-Keto prostaglandins F1α (6-Keto-PGF1α)
cancer antigen 125 (CA125)
estrogen (E2)
tumor necrosis factor-α (TNF-α)
interleukin-6 (IL-6)
and interleukin-8 (IL-8) were detected both before and after treatment. Result: The total effective rate was 95.38% in observation group
higher than 81.25% in control group (χ2=6.269
P<0.05). In the variance analysis of repeated measurements
during 6 menstrual cycles
scores of VAS were decreased(Fcontrol=6.903
Fobservation=7.632
P<0.05). In paired t-test
at the 3th
4th
5th and 6th menstrual cycles
scores of VAS in observation group were lower than those in control group (P<0.01). After treatment
scores of pelvic pain
pain in intercourse
pelvic tenderness
tenderness of the sacral ligament
and blood stasis scores
and levels of CA125
E2
TXB2 and 6-Keto-PGF1α
TNF-α
IL-6
and IL-8 in observation group were all lower than those in control group (P<0.01). Conclusion: Add and subtract dialectics of Huposan can ameliorate pain and decrease levels of estrogen
TNF-α
IL-6
and IL-8 to ameliorate conditions in patients with endometriosis pain (blood stasis syndrome).
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