标题：少腹逐瘀汤配合新生化颗粒在气虚血瘀型子宫腺肌病中的应用

      作者：杨静 1，卢喜洋 2，彭丽 1    1.南阳市第一人民医院产科，河南 南阳 473000；2.河南中医药大学第一附属医院产科，河南 郑州 450000

      卷次： 2023年34卷18期

      【摘要】 目的 研究少腹逐瘀汤配合新生化颗粒对气虚血瘀型子宫腺肌病(AM)患者痛经、月经量多的改善作用。方法 选取2021年 3月至2022年6月南阳市第一人民医院收治的190例气虚血瘀型AM患者为研究对象，采用随机数表法分为对照组和研究组各95例。对照组患者采用新生化颗粒治疗，研究组患者采用少腹逐瘀汤配合新生化颗粒治疗，均治疗3个月经周期。治疗后比较两组患者的临床疗效，以及治疗前和治疗3个月经周期后痛经积分、月经积分及中医证候积分、子宫体积、子宫内膜厚度、子宫血流动力学指标[子宫动脉收缩期峰值流速(Vmax)、舒张末期流速(Vmin)、阻力指数(RI)]、血清细胞因子[白细胞介素-6 (IL-6)、白细胞介素-17 (IL-17)、沉默调节蛋白 6(Sirt6)、磷酸化应激诱导蛋白1 (STIP-1)]水平。结果 研究组患者的临床治疗总有效率为97.89%，明显高于对照组的89.47%，差异有统计学意义(P<0.05)；治疗3个月经周期后，研究组患者的痛经积分、月经积分、中医证候积分分别为(4.93±1.19)分、(1.02±0.31)分、(6.85±1.77)分，明显低于对照组的(6.24±1.28)分、(1.56±0.35)分、(9.43±2.31)分，差异均有统计学意义(P<0.05)；治疗3个月经周期后，研究组患者的子宫体积、子宫内膜厚度分别为(165.37±11.08) cm3、(5.53±1.59) mm，明显低于对照组的(181.46±10.53) cm3、(6.92±1.84) mm，差异均有统计学意义(P<0.05)；治疗3个月经周期后，研究组患者的子宫动脉Vmax、Vmin分别为(15.43±2.81) cm/s、(7.43±1.92) cm/s，明显低于对照组的(19.54±2.69) cm/s、(10.24±2.11) cm/s，RI值为 0.85±0.06，明显高于对照组的 0.74±0.07，差异均有统计学意义(P<0.05)；治疗 3个月经周期后，研究组患者的血清 IL-6、IL-17、STIP-1水平分别为(58.61±7.19) pg/mL、(64.22±5.98) pg/mL、(1.06±0.12) ng/mL，明显低于对照组的(76.32±8.25) pg/mL、(1.78±0.16) pg/mL、(1.78±0.16) ng/mL，Sirt6水平为(6.73±1.62) ng/mL，明显高于对照组的(5.08±1.24) ng/mL，差异均有统计学意义(P<0.05)。结论 少腹逐瘀汤联合新生化颗粒治疗气虚血瘀型AM可有效促进患者子宫体积、子宫内膜厚度、临床症状及子宫动脉血液流变学改善，抑制氧化应激及炎症反应，提高疗效。
      【关键词】 气虚血瘀型；子宫腺肌病；少腹逐瘀汤；新生化颗粒；痛经；疗效
      【中图分类号】 R711.74 【文献标识码】 A 【文章编号】 1003—6350（2023）18—2646—05

Application of Shaofu Zhuyu Tang combined with Xinshenghua Granules in the treatment of Qi deficiency andblood stasis type adenomyosis.
YANG Jing 1, LU Xi-yang 2, PENG Li 1. 1. Department of Obstetrics and Gynecology,Nanyang First People's Hospital, Nanyang 473000, Henan, CHINA; 2. Department of Obstetrics, the First Affiliated Hospitalof Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan, CHINA
【Abstract】 Objective To study the improvement effect of Shaofu Zhuyu Tang combined with XinshenghuaGranules on dysmenorrhea and excessive menstrual flow in patients with Qi deficiency and blood stasis type adenomyo-sis (AM). Methods A total of 190 AM patients with Qi deficiency and blood stasis adenomyosis admitted to NanyangFirst People's Hospital from March 2021 to June 2022 were selected as research objects. They were divided into a con-trol group and a study group by random number table method, with 95 cases in each group. Patients in the control groupwere treated with Xinshenghua Granules, while those in the study group were treated with Shaofu Zhuyu Tang combinedwith Xinshenghua Granules, both for 3 menstrual cycles. The clinical efficacy were compared between the two groups,as well as the dysmenorrhea score, menstrual score, traditional Chinese medicine syndrome score, uterine volume, endo-metrial thickness, uterine hemodynamic indicators [peak systolic flow rate (Vmax), end-diastolic flow rate (Vmin), resis-tance index (RI)], and serum cytokine levels [interleukin-6 (IL-6), interleukin-17 (IL-17), silencing regulatory protein 6(Sirt6), stress-induced-phosphoprotein 1 (STIP-1)] before and after treatment for three menstrual cycles. Results Thetotal clinical effective rate of the study group (97.89%) was significantly higher than that of the control group (89.47%),and the difference was statistically significant (P<0.05). After treatment for three menstrual cycles, the dysmenorrheascore, menstrual score, and traditional Chinese medicine syndrome score of the study group were (4.93±1.19) points,(1.02±0.31) points, and (6.85±1.77) points, respectively, which were significantly lower than (6.24±1.28) points, (1.56±0.35) points, and (9.43±2.31) points in the control group (P<0.05). After treatment, the uterine volume and endometrialthickness of the study group were (165.37±11.08) cm3 and (5.53±1.59) mm, significantly lower than (181.46±10.53) cm3and (6.92±1.84) mm of the control group (P<0.05). After treatment, the Vmax and Vmin of the uterine artery in the studygroup were (15.43±2.81) cm/s, (7.43±1.92) cm/s, significantly lower than (19.54±2.69) cm/s, (10.24±2.11) cm/s in thecontrol group; the RI value was 0.85±0.06, significantly higher than 0.74±0.07 in the control group; the differences werestatistically significant (P<0.05). After treatment, the serum levels of IL-6, IL-17, and STIP-1 in the study group were(58.61±7.19) pg/mL, (64.22±5.98) pg/mL, and (1.06±0.12) ng/mL, respectively, which were significantly lower than(76.32±8.25) pg/mL, (1.78±0.16) pg/mL, and (1.78±0.16) ng/mL in the control group; Sirt6 level was (6.73±1.62) ng/mL,significantly higher than (5.08±1.24) ng/mL in the control group; the differences were statistically significant (P<0.05).Conclusion The combination of Shaofu Zhuyu Tang and Xinshenghua Granules can effectively promote the improve-ment of uterine volume, endometrial thickness, clinical symptoms, and uterine artery hemorheology in patients with Qideficiency and blood stasis type AM, inhibit oxidative stress and inflammatory reactions, and improve the therapeuticeffect.
      【Key words】 Qi deficiency and blood stasis type; Adenomyosis; Shaofu Zhuyu Tang; Xinshenghua Granules;Dysmenorrhea; Curative effect