益肾活血消癥汤联合药物治疗子宫腺肌病肾虚血瘀证的临床研究

Clinical effect of Yishen Huoxue Xiaozheng Decoction combined with medication in treating uterine adenomyosis with kidney deficiency and blood stasis syndrome

摘要:

目的 探究益肾活血消癥汤联合促性腺激素释放激素激动剂（GnRH-a）、地诺孕素序贯治疗子宫腺肌病肾虚血瘀证的临床效果。方法 前瞻性选取2020年5月—2022年5月河北省沧州中西医结合医院收治的128例子宫腺肌病患者，用随机数字表法分成对照组和观察组，每组64例。对照组予以GnRH-a结合地诺孕素序贯治疗，观察组在对照组基础上增加益肾活血消癥汤治疗。比较两组疗效、子宫及月经恢复情况、雌激素水平、血清指标及不良反应。结果 观察组总有效率高于对照组（P <0.05）。观察组治疗前后中医症状主症、次症评分的差值高于对照组（P <0.05）。观察组治疗前后月经期、月经周期、痛经视觉模拟评分法评分的差值高于对照组（P <0.05）。观察组治疗前后子宫内膜厚度、子宫体积的差值均高于对照组（P <0.05）。观察组治疗前后卵泡刺激素、雌二醇、黄体生成素的差值均高于对照组（P <0.05）。观察组治疗前后血管内皮生长因子、糖类抗原125、白细胞介素-10的差值均高于对照组（P <0.05）。两组总不良反应率比较，差异无统计学意义（P >0.05）。结论 益肾活血消癥汤联合GnRH-a、地诺孕素序贯治疗用于肾虚血瘀证子宫腺肌病可通过改善中医症状、月经及子宫情况，降低雌激素、炎症水平等，提升疗效，且用药安全。

Abstract:

Objective To explore the clinical effect of Yishen Huoxue Xiaozheng Decoction combined with gonadotropin-releasing hormone agonist (GnRH-a) and dienogest in the treatment of uterine adenomyosis with renal deficiency and blood stasis syndrome.Methods A total of 128 patients with uterine adenomyosis admitted to our hospital from May 2020 to May 2022 were prospectively included in the study. They were divided into the control group and the observation group by the random number table method, with 64 cases in each group. The control group was given sequential treatment with GnRH-a combined with dienogest, and the observation group was treated with Yishen Huoxue Xiaozheng Decoction on the basis of the treatment in the control group. The therapeutic effect, uterine and menstrual recovery, estrogen levels, serum indicators and adverse reactions were compared between the two groups.Results The overall effective rate of the observation group was higher than that of the control group (P < 0.05). The differences of the scores of primary and secondary traditional Chinese medicine syndromes before and after treatment in the observation group were greater than those in the control group (P < 0.05). The differences of menstrual periods, menstrual cycles, and Visual Analogue Scale (VAS) scores of dysmenorrhea before and after treatment in the observation group were greater than those in the control group (P < 0.05). The differences of endometrial thickness and uterine volume before and after treatment in the observation group were greater than those in the control group (P < 0.05). The differences of levels of follicle stimulating hormone (FSH), estradiol (E₂), and luteinizing hormone (LH) before and after treatment in the observation group were greater than those in the control group (P < 0.05). The differences of levels of vascular endothelial growth factor (VEGF), carbohydrate antigen 125 (CA-125) and interleukin-10 before and after treatment in the observation group were greater than those in the control group (P < 0.05). There was no significant difference in the overall incidence of adverse reactions between the two groups (P > 0.05).Conclusions Sequential treatment with Yishen Huoxue Xiaozheng Decoction combined with GnRH-a and dienogest for uterine adenomyosis with kidney deficiency and blood stasis can improve traditional Chinese medicine syndromes and menstrual and uterine conditions, reduce the levels of estrogen and inflammation, and promote the efficacy with few drug safety concerns.