| Objective: To evaluate the clinical efficacy and safety of the treatment of adenomyosis caused by qi stagnation and blood stasis combined with wenxia zhuyu tang by clinical observation,and to explore its possible mechanism of action according to the research results,so as to provide a new idea for the clinical treatment of this disease.Methods: All the patients were selected from the outpatient department of gynecology(huayuanshan and phoenix outpatients)of hubei hospital of traditional Chinese medicine from March2018 to September 2019.According to the inclusion criteria,a total of 61 patients were collected clinically,including 31 patients in the acupuncture group and 30 patients in the TCM group.Chinese traditional medicine group shall be under the diaphragm by stasis tonga subtraction oral and needle medicine group on the basis of the added with warm acupuncture treatment,continuous treatment of three menstrual cycles,observing the degree of two groups before and after the treatment of dysmenorrhea,syndromes,local signs,uterine size,the value of serum CA125 and safety index and record adverse reactions during the treatment,using statistical analysis,comprehensive evaluation of curative effect.Results: 1.General data: age,disease course,dysmenorrhea score,TCM syndrome score,main symptoms score,local signs score,uterine volume score,serum CA125 value and other data of patients in the two groups before treatment were compared.There was no significant difference between the two groups(P >,0.05),suggesting comparability.2.Total clinical efficacy: the total effective rate of the acupuncture group was 96.77%,and that of the traditional Chinese medicine group was 90%.The rank-sum test showed that Z=-2.030,P = 0.042,and the difference between the two groups was statistically significant(P<0.05).3.Dysmenorrhea efficacy: compared within the group,after treatment,both groups were lower than before treatment,and the difference was statistically significant(P < 0.05).The effective rate of the acupuncture group was 96.77%,and that of the TCM group was 93.33%.After rank-sum test,Z =-2.277,P=0.023,the acupuncture group was better than the TCM group,and the difference was statistically significant(P < 0.05).4.Efficacy of TCM syndrome: after treatment,both groups were lower than before treatment,and the difference was statistically significant(P < 0.05).The effective rate of the acupuncture group was 90.32%,and that of the TCM group was76.67%.By rank-sum test,Z=-2.19,P=0.029,the acupuncture group was better than the TCM group,and the difference was statistically significant(P < 0.05).5.Main symptoms curative effect: comparing group,needle medicine group was approved by abdominal pain,and the quantity increase,menstrual extension,menstrual color,blood clots,lumbosacral pain,breast pain,breast bilges full,symptoms such as irritability,taken down and more aspects,was improved obviously,the difference was statistically significant(P <0.05),Chinese medicine group was approved by abdominal pain,and the quantity increase,menstrual extension,menstrual symptoms such as color,blood clots,breast bilges full,was improved,the difference was statistically significant(P <0.05),more than a symptom integral comparison,there was no significant statistical difference(P > 0.05);Compared with the traditional Chinese medicine group,the acupuncture and drug group was better than the traditional Chinese medicine group in the treatment of symptoms such as abdominal pain,prolonged menstrual period,lumbosacral pain,breast swelling pain,irritability,leucorrhea,etc.,and the difference was statistically significant(P < 0.05).Comparison of the scores of other symptoms showed no statistically significant difference(P > 0.05).6.Local signs and efficacy: compared within the group,both groups were lower after treatment than before treatment,and the difference was statistically significant(P < 0.05).The comparison between groups showed that the acupuncture group was superior to the traditional Chinese medicine group,and the difference was statistically significant(P < 0.05).7.Efficacy of uterine volume: compared within the group,uterine volume in the acupuncture group was lower than that before treatment,with a statistically significant difference(P < 0.05),while uterine volume in the traditional Chinese medicine group was not significantly changed before and after treatment,with no statistically significant difference(P >0.05).The comparison between groups showed that the acupuncture group was superior to the traditional Chinese medicine group,and the difference was statistically significant(P < 0.05).8.Efficacy of serum CA125: compared with that before treatment,the serum CA125 in the acupuncture group was significantly reduced,with statistically significant difference(P < 0.05),while the serum CA125 in the traditional Chinese medicine group was not significantly changed after treatment,with no statistically significant difference(P >0.05).The comparison between groups showed that the acupuncture group was superior to the traditional Chinese medicine group,and the difference was statistically significant(P < 0.05).9.Safety evaluation: two groups after treatment of the patient’s vital signs,routine blood,liver and kidney function,and there were no obvious abnormal electrocardiogram(ecg),including needle medicine group has three patients take the needle in the process of treatment after a small amount of bleeding,bleeding after dry cotton swabs press disappear,can continue to accept treatment,patients in the treatment of traditional Chinese medicine group does not appear in the process of adverse reactions,after statistics analysis,P =0.125(P > 0.05),two groups of comparisons,there was no significant statistical difference.Conclusion: 1.The warm acupuncture combined under the diaphragm by stasis tonga subtraction treatment of uterine adenomyosis qi stagnancy and blood stasis syndrome curative effect,can control the symptoms and improve the syndromes,especially in improving the abdominal pain,menstrual extension,lumbosacral pain,breast pain,irritability,leucorrhea quantity the symptoms significantly superior to diaphragmatic by stasis soup,and narrow the volume of uterus and alleviate the uterine tenderness,to reduce the serum CA125 has a unique advantage.2.The clinical application of warm acupuncture and moxibustion combined with fenxia zhuyu decoction in the treatment of qi stagnation and blood stasis type adenomyosis is safe and effective.No serious adverse reactions were found in this study,so it is believed that it can be used in clinical application. |
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