葫芦巴丸加减治疗子宫内膜异位症腺肌病痛经及盆腔痛临床研究

【作者】 史梅莹；

【导师】 刘雁峰；

【作者基本信息】 北京中医药大学 ， 中医妇科学， 2010， 硕士

【摘要】 目前,子宫内膜异位症及子宫腺肌病发病率逐年升高,已成为困扰临床医师和患者的常见病、多发病、疑难病。痛经及盆腔痛是内异症及腺肌病临床最常见,也是患者最痛苦的症状之一。它不仅造成患者躯体上的不适与痛苦,也给患者带来巨大的精神压力,严重影响患者的生存质量。西医手术后和停药后复发率均较高,且药物治疗副作用较大。中医药在治疗子宫内膜异位症、腺肌病痛经及盆腔痛方面有一定的优势,肖承惊教授治疗本病独具特色,以阳气不足,寒凝血瘀立论,采用《局方》葫芦巴丸加减治疗,取得了很好的临床疗效。目的通过临床研究,对葫芦巴丸加减治疗子宫内膜异位症、腺肌病痛经及盆腔痛的临床疗效做出评价；同时对患者的精神状况及生存质量进行问卷调查,以了解疼痛对患者的影响及中药治疗后的变化情况,以便对葫芦巴丸加减治疗本病做出综合评价；并对肖承惊教授的学术思想、用药特点进行总结。方法将符合诊断标准的40例病例,以葫芦巴丸加减治疗,共治疗3个月。治疗期间观察患者的疼痛状况和全身症状、疼痛对患者精神状况、生存质量的影响。全部资料以sAs8.2统计软件建立数据库,分析统计学意义。结果本组患者治愈率为37%(15/40),显效率为33%(13/4),有效率为25%(10/40),无效率为5%(2/40),总有效率为95%。治疗后患者痛经积分、疼痛总积分以及症状总积分均有明显下降；疼痛症状的自评方面,经中药治疗后也有明显下降。可见经葫芦巴丸加减治疗后患者的全身症状及疼痛症状均有明显好转。另外,治疗后CA125值较治疗前明显下降,但其均值仍高于正常值。结论葫芦巴丸加减治疗子宫内膜异位症、腺肌病痛经及盆腔痛,是著名中医妇科专家肖承惊教授的宝贵经验,具有良好的临床疗效,且安全无副作用。运用中药治疗可明显减轻患者的疼痛、缓解其临床症状,还可调节患者的心理状态,提高其生存质量,综合疗效好,体现了中医药治疗的特点和优势。更多还原

【Abstract】 At present, the incidence of endometriosis and adenomyosis increases year by year, It has become one of clinical common,complicated and frequently-occurring diseases which plagued clinicians and patients.Dysmenorrhea is not only the most common clinical symptom of endometriosis and adenomyosis,but also is the most painful.It cause discomfort and pain both in physics but also in the spirit.It seriously affects patient’s life quality. Recurrence is high after surgery or after western medicine treatment, and drug treatment has side effects. Traditional Chinese medicine (TCM)in treatment of the disease has certain advantages, Professor Xiao Chengzong believes that the pathogenesis of endometriosis and adenomyosis is deficiency in yang, cold accumulation and blood stasis. She treats this disease with the Fenugreek Pill,this therapy has showed marked clinical effects.ObjectiveThrough clinical research, assessed the clinical efficacy of fenugreek Pill to treat Endometriosis and Adenomyosi pain. The same time,survey the mental status and life quality of patients by questionnaire to gauge the impact of pain on patients, as well as changes after traditional Chinese medicine treatment,then make a comprehensive evaluation of treatment of the disease. Summary the academic thinking and medication characteristics of Professor Xiao Chengzong.Method40 cases who met the diagnostic criteria were treated for 3 months with fenugreek Pill.Observed pain and systemic symptoms,life quality of patients during the treatment.Survey the mental state of patients by a questionnaire. All information were establish a database with SAS8.2 statistical software to analyze statistical significance.ResultsThe cure rate in patients is 37%(15/40), markedly effective rate 33%(13/40), efficiency 25%(10/40), the inefficiency 5%(2/40),and the total efficiency is 95%.After treatment, total scores of pain, dysmenorrhea points and total scores of symptoms all reduced ignificantly; the self-assessment aspects of pain has significantly decreased after traditional Chinese medicine treatment. In addition, CA125 values significantly decreased than before, but the average was still higher than normal.ConclusionTreatment of endometriosis and adenomyosis with Fenugreek Pill has good clinical efficacy, It is very safe;It’s the valuable experience of famous Chinese gynecologist Professor Xiao Chengzong. TCM alleviate patients’pain and clinical symptoms, at the same time, regulate the psychological state of patients, improve patient quality of life. Its good integrated effect reflected the characteristics and advantages of TCM.更多还原