| Objective:The purpose of this study was to analyze the effectiveness and safety of TCM comprehensive treatment for adenomyosis.Based on this,long-term follow-up was conducted to screen out patients with recurrent adenomyosis symptoms during the follow-up period,and to analyze and summarize the risk factors of recurrent adenomyosis symptoms in patients with adenomyosis by questionnaire.Methods: 1.Part 1:Use prospective cohort study design,a total of 139 patients with adenomyosis were included and observed.According to the different exposure factors,they were divided into the TCM comprehensive treatment cohort and the Western medicine conventional treatment cohort.A total of 69 patients were included in the TCM cohort and 70 patients in the Western medicine cohort.Patients in the TCM cohort received the treatment of "Tongmaihua syndrome decoction,Sanjie tablet oral + Kang Fu anti-inflammatory supp rectal administration + Artemsia mugwort foot bath",patients in the Western medicine cohort received conventional western medicine treatment,and the two groups were continuously treated for 3 months.The changes of TCM symptom score,menstrual volume score,dysmenorrhea degree score and serum tumor marker carbohydrate antigen(CA)125 index were observed before and after treatment.2.Part 2:In the first part of the TCM cohort as the baseline cohort,patients with recurrent symptoms of adenomyosis during the follow-up period were selected as the case group,using the method of propensity scoring,matching the control group in terms of height and weight in a 1:1 ratio,and collecting the relevant data of the two groups by questionnaire.According to the characteristics of the variables,non-parametric test or Chi-square test was conducted,and the values were described by frequency and percentage.Multivariate binary logistic regression analysis was used to analyze the variables with statistical differences,and the risk factors for recurrence of symptoms in patients with adenomyosis were obtained.Results:1.Part 1:(1)Before treatment,there was no statistical difference in TCM syndrome scores between the two groups(P>0.05),indicating comparability.After treatment,the comparison between the two groups showed that the two groups had P<0.05 in abdominal pain,tingling refusal,dark menstrual blood color,blood clots,purple tongue with petechiae and petechiae,astringent and delayed pulse,mania and amnesia,and the total score.After treatment,there was no statistical difference among the groups in terms of astringency and delay of pulse,skin malocclusion,limb numbness,manic,amnesia and surgical history(P>0.05),abdominal pain and stinging refusal during menstrual period,dark blood color with blood clots,purple tongue with petechiae and ecchymosis(P<0.05),and the total score of the Chinese medicine cohort was better than the Western medicine cohort.After 3 months of treatment,the TCM syndrome scores of the two groups were compared,the total effective rate of the TCM cohort was 98.55%,and the total effective rate of the Western medicine cohort was 80%,P=0.001<0.01,there was a significant statistical difference,the efficacy of the TCM cohort was better than the Western medicine cohort.(2)Before treatment,there were no significant differences in the degree of dysmenorrhea,menstrual volume and CA125 between the two groups(P>0.05),indicating comparability.After treatment,the efficacy index data of the two groups were lower than before,and the difference was statistically significant(P<0.01).For comparison between groups,CA125 P>0.05 was not statistically significant between the TRADITIONAL Chinese medicine cohort and the Western medicine cohort,while all other P<0.05 was statistically significant,indicating that both methods had therapeutic effects and the traditional Chinese medicine cohort was superior to the Western medicine cohort in terms of efficacy.After 3 months of treatment,the total effective rate of the TCM cohort was 95.65%,and that of the Western medicine cohort was 92.86%,with no statistical difference(P=0.731>0.05).The total effective rate of the Chinese medicine cohort was 89.86%,and that of the Western medicine cohort was 87.14%,P=0.616>0.05,showing no statistical difference.(3)During the treatment,1 patient in the TCM cohort developed slight diarrhea and 1patient developed a small skin rash on the leg;One patient in the Western medicine cohort developed mild nausea,which was relieved by themselves after drug withdrawal,and the safety was certain.2.Part2:History of induced abortion(OR=14.597,95%CI 1.613-132.083),history of cesarean section(OR=8.747,95%CI 1.012-75.584)and endometrial lesions(OR=9.711,95%CI 1.137-82.917)were high-risk factors for adenomyosis.Conclusions:The effectiveness and safety of TCM comprehensive treatment for adenomyosis are worthy of confirmation.History of induced abortion,cesarean section and endometrial lesions are high risk factors for the recurrence of symptoms in patients with adenomyosis,but this conclusion still needs to be confirmed by clinical studies with a larger sample size. |
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