1.杭州市中医院妇二科(浙江 杭州 310007)
2.上海中医药大学附属岳阳中西医结合医院妇一科(上海 200437)
汪文迪,女,硕士,住院医师,主要从事中医药治疗妇科生殖内分泌疾病的临床与研究工作
董莉,主任医师,博士研究生导师;E-mail:yydongli@163.com
扫 描 看 全 文
汪文迪,黄宏丽,夏艳秋等.加味没竭片治疗气滞血瘀型原发性痛经的临床研究[J].上海中医药杂志,2022,56(08):63-66.
WANG Wendi,HUANG Hongli,XIA Yanqiu,et al.Clinical research on Jiawei Mojie Tablets in treating primary dysmenorrhea of qi stagnation and blood stasis syndrome[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(08):63-66.
汪文迪,黄宏丽,夏艳秋等.加味没竭片治疗气滞血瘀型原发性痛经的临床研究[J].上海中医药杂志,2022,56(08):63-66. DOI: 10.16305/j.1007-1334.2022.2202052.
WANG Wendi,HUANG Hongli,XIA Yanqiu,et al.Clinical research on Jiawei Mojie Tablets in treating primary dysmenorrhea of qi stagnation and blood stasis syndrome[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(08):63-66. DOI: 10.16305/j.1007-1334.2022.2202052.
目的,2,观察加味没竭片治疗气滞血瘀型原发性痛经的临床疗效。,方法,2,将73例气滞血瘀型原发性痛经患者随机分为治疗组35例、对照组38例。对照组予布洛芬治疗,治疗组予加味没竭片治疗,两组疗程均为3个月经周期。观察临床疗效,比较疼痛视觉模拟评分(VAS)、中医症状积分,血清炎症因子、β-内啡肽水平,以及焦虑自评量表(SAS)、抑郁自评量表(SDS)评分的变化情况。,结果,2,①试验期间治疗组脱落3例、对照组脱落4例,最终完成试验者治疗组32例、对照组34例。②治疗组、对照组总有效率分别为78.12%、 55.88%,治疗组临床疗效优于对照组(,P,<,0.05)。③治疗前后组内比较,两组疼痛VAS评分减少(,P,<,0.05);组间治疗后比较,治疗组疼痛VAS评分少于对照组(,P,<,0.05)。④治疗前后组内比较,治疗组腹痛、经血血块、乳房胀痛、肛门坠胀积分及中医症状总积分减少(,P,<,0.05),对照组腹痛积分及中医症状总积分减少(,P,<,0.05);组间治疗后比较,治疗组腹痛、经血血块、乳房胀痛、肛门坠胀积分及中医症状总积分少于对照组(,P,<,0.05)。⑤治疗前后组内比较,治疗组血清白介素-6水平降低(,P,<,0.05),血清白介素-10、β-内啡肽水平升高(,P,<,0.05);对照组血清β-内啡肽水平升高(,P,<,0.05)。组间治疗后比较,血清白介素-6、白介素-10、β-内啡肽水平差异无统计学意义(,P,>,0.05)。⑥治疗前后组内比较,治疗组SDS评分减少(,P,<,0.05),对照组SAS、SDS评分无明显变化(,P,>,0.05);组间治疗后比较,治疗组SDS评分低于对照组(,P,<,0.05)。,结论,2,加味没竭片可有效缓解气滞血瘀型原发性痛经患者的临床症状,改善抑郁情绪状态;其机制可能与降低血清白介素-6水平、升高血清白介素-10水平,从而改善炎症状态,以及促进内源性阿片类镇痛物质β-内啡肽的分泌,进而降低痛阈有关。
Objective,2,To investigate the clinical effect of Jiawei Mojie Tablets on primary dysmenorrhea of qi stagnation and blood stasis syndrome.,Methods,2,Seventy-three cases of primary dysmenorrhea of qi stagnation and blood stasis syndrome were randomly divided into a treatment group (,n,=35) and a control group (,n,=38). The control group was administered with ibuprofen, while the treatment group was administered with Jiawei Mojie Tablets. The duration of treatment for both groups was 3 menstrual cycles. We observed the clinical efficacy, and compared the changes of pain visual analogue scale (VAS) scores, traditional Chinese medicine (TCM) symptom scores, the serum levels of inflammatory factors and β-endorphin, the Zung Self-Rating Anxiety Scale (SAS) scores and the Zung Self-Rating Depression Scale (SDS) scores before and after intervention.,Results,2,①During the trial, there were 3 drop-out cases in the treatment group and 4 drop-out cases in the control group, and 32 cases in the treatment group and 34 cases in the control group finally completed the trial. ②The total effective rate was 78.12% in the treatment group and 55.88% in the control group. The clinical efficacy of the treatment group was better than that of the control group (,P,<,0.05). ③After treatment, the pain VAS scores decreased in both groups (,P,<,0.05); The pain VAS scores in the treatment group were lower than those in the control group (,P,<,0.05). ④After treatment, the sub-dimension scores of abdominal pain, menstrual blood clots, breast distension and pain, anal pendant expansion and total TCM symptom scores decreased in the treatment group (,P,<,0.05), and the sub-dimension scores of abdominal pain and total TCM symptom scores decreased in the control group (,P,<,0.05); After treatment, the sub-dimension scores of abdominal pain, menstrual blood clots, breast distension and pain, anal pendant expansion and total TCM symptom scores in the treatment group were lower than those in the control group (,P,<,0.05). ⑤After treatment, the serum level of interleukin-6 (IL-6) decreased (,P,<,0.05) and the serum levels of interleukin-10 (IL-10) and β-endorphin increased (,P,<,0.05) in the treatment group,the serum levels of β-endorphin increased (,P,<,0.05) in the control group. After treatment, the differences in serum levels of IL-6, IL-10 and β-endorphin between the two groups were not statistically significant (,P,>,0.05). ⑥After treatment, SDS scores decreased in the treatment group (,P,<,0.05), but SAS and SDS scores did not change significantly in the control group (,P,>,0.05). After treatment, SDS scores in the treatment group were lower than those in the control group (,P,<,0.05).,Conclusions,2,Jiawei Mojie Tablets can effectively alleviate the clinical symptoms and improve the depressed emotional state of patients with primary dysmenorrhea of qi stagnation and blood stasis syndrome. The mechanisms involved may be that Jiawei Mojie Tablets can lower IL-6 level, raise IL-10 level, reduce inflammation, and promote the secretion of endogenous opioid analgesic substance β-endorphin, which in turn lowers pain threshold.
原发性痛经气滞血瘀证国医大师中医药疗法炎症因子临床试验
primary dysmenorrheaqi stagnation and blood stasis syndromeTCM Mastertraditional Chinese medicine therapyinflammatory factorclinical trial
聂文佳,徐帅师,张咏梅. 原发性痛经治疗方法的研究进展[J]. 中国中医基础医学杂志,2021, 27(4): 683-689.
KHO K A, SHIELDS J K. Diagnosis and management of primary dysmenorrhea[J]. JAMA, 2020, 323(3): 268-269.
谢幸,孔北华,段涛. 妇产科学[M]. 北京:人民卫生出版社,2018: 351-352.
马宝璋,杜惠兰. 中医妇科学[M]. 上海:上海科学技术出版社,2017: 93-96.
王征宇,迟玉芬. 焦虑自评量表(SAS)[J]. 上海精神医学,1984, 3(2): 73-74.
王征宇,迟玉芬. 抑郁自评量表(SDS)[J]. 上海精神医学,1984, 3(2): 71-72.
杜美容,刘秀敏,于恬,等. 原发性痛经的研究现状及治疗进展[J]. 中国民间疗法,2020, 28(10): 113-117.
BARCIKOWSKA Z, RAJKOWSKA-LABON E, GRZYBOWSKA M E, et al. Inflammatory markers in dysmenorrhea and therapeutic options[J]. Int J Environ Res Public Health, 2020, 17(4): 1191.
杨雯雯,陈盼碧,金灵敏,等. 近部与远部穴位埋线对原发性痛经大鼠子宫前列腺素、血清IL-2及脾脏NK细胞的影响[J]. 针刺研究,2021, 46(3): 221-225.
蔡亚玮,刘建宏,马宁. 花生四烯酸靶向代谢组学在炎症中的研究现状[J]. 中国临床药理学杂志,2021, 37(19): 2721-2723,2728.
KONECNA L, YAN M S, MILLER L E, et al. Modulation of IL-6 production during the menstrual cycle in vivo and in vitro[J]. Brain Behav Immun, 2000, 14(1): 49-61.
LAMPRIANIDOU E, KORDELLA C, KAZACHENKA A, et al. Modulation of IL-6/STAT3 signaling axis in CD4+FOXP3- T cells represents a potential antitumor mechanism of azacitidine[J]. Blood Adv, 2021, 5(1): 129-142.
宰风雷,邬瑞兰,郑美凤,等. 温针灸对腰椎间盘突出症患者血浆β-内啡肽的影响[J]. 针刺研究,2018, 43(8): 512-515.
赵景州,候园园,李柱. 焦虑症与炎症因子的相关性及中医药干预的研究进展[J]. 中西医结合心脑血管病杂志,2019, 17(14): 2132-2134.
何阳,陈珊珊,苏普玉. 炎症因子与抑郁症的关联及其可能机制[J]. 中华预防医学杂志,2021, 55(4): 539-544.
巩子汉,高静静,佘楷杰,等. 温阳、解郁及温阳解郁方对LPS“二次应激”诱发的抑郁样行为小鼠海马小胶质细胞的影响[J]. 中国实验方剂学杂志,2021, 27(21): 55-62.
张辛宁,王乐琪,李莎莎,等. 丹参从瘀论治抑郁症的潜在靶点及作用机制研究[J]. 中药新药与临床药理,2021, 32(9): 1300-1308.
SZMIDT M K, GRANDA D, SICINSKA E, et al. Primary dysmenorrhea in relation to oxidative stress and antioxidant status: A systematic review of case-control studies[J]. Antioxidants, 2020, 9(10): 994.
王丹丹,王东梅,蔡平平,等. 温经化瘀止痛法治疗原发性痛经的临床疗效及其对T细胞亚群的调控机制[J]. 中国实验方剂学杂志,2020, 26(20): 94-99.
梁潇,段彦苍,宋亚静,等. 基于文献研究与专家共识法的原发性痛经中医证候研究[J]. 中国中医药信息杂志,2020, 27(2): 73-78.
朱南孙. 海派中医朱氏妇科[M]. 上海:上海科学技术出版社,2016: 60-84, 96.
黄宏丽,王怡青,董莉. 海派朱氏妇科治疗妇科痛证经验举隅[J]. 中华中医药杂志,2021, 36(11): 6474-6477.
0
浏览量
281
下载量
0
CSCD
3
CNKI被引量
关联资源
相关文章
相关作者
相关机构