| ObjectiveStubborn chronic pelvic pain caused by endometriosis affects the patien t’s quality of life seriously. There are many modern medical treatments. Ho wever, each treatment has some limitations, such as drug side effects, the possibility of reoperation after surgery, recurrence, etc. The treatment to it is an international problem. My tutor treated it with acupuncture, tradi tional chinese herb, and had achieved good curative effect. It also has goo d therapeutic effect to patients with recurrence that has been treated wi th specific modern medical treatments. The study was aimed to evaluate the effect of acupuncture and traditional Chinese medicine to the intractable chronic pelvic pain caused by endometriosis scientificly and objectively, and provide high level of clinical evidence for the effect of acupuncture and traditional chinese medicine to chronic pelvic pain associated with e ndometriosis and adenomyosis, benefit so many patients. Then, provide more e ffective health measures for endometriosis patients, promote the promotion and application of traditional Chinese medicine and acupuncture, at the s ame time.MethodsThe study took the method of randomized controlled clinical trials.60 cases of the subjects came from the gynecology clinic of department of Guangdong province of TCM hospital. All cases belonged to Kidney deficiency and blood stasis type. They were divided into 2 groups randomly, each group includes 30 cases. Acupuncture and herb was given to group 1 (the needle medicine group), acupuncture was given to group 2 (acupuncture group),4 weeks as a period of treatment, and lasted 2 periods, patients were followed up for 4 weeks. The VAS evaluation was observed and recorded before the treatment, at the end of 4 weeks and 8 weeks of treatment, and 4 week after the treatment, and the quality of life was evaluated by 36-item short-form health survey (SF-36), Endometriosis Health Profile (EHP-5), while TCM syndrome scores were observed to evaluate the treatment effect. The blood, urine routine, liver and kidney function were checked for safety evaluation before and after treatment. SPSS 17.0 was used for establishing database and statistical The mean differences before and after treatment within the group itself were compared with Paired sample t test or matching symbols of rank and inspection analysis. The mean differences between groups were compared with Independent-samples t Test, the Rank Sum Test was adopted while non-normal distribution or heterogeneity of variance. The score of VAS, SF-36, EHP-5 at different observation points were compared using repeated measures analysis of variance. The efficiency.of the two groups were compared by the chi square test (or Fisher)Results(1)The 2 groups had no statistical significance of differences in ages, course of the disease, marriage and sex life, the degree of education, the type of lesion, previous treatment, VAS score, each dimension of SF-36 questionnaires (including Physical Functioning, Role-Physical, General Health, Vitality, Social Functioning, Role-Emotional,Mental Health),11 items of EHP-5, and TCM syndrome scores(P>0.05).(2)The VAS scores decreased after treatment in both group, comparisons w ere statistically significant within group (P<0.05).Acupuncture combined with traditional chinese medicine treatment reduced pain significantly, af ter 8-weeks’treatment, the VAS scores fell 4.32+1.63 points, no case wer ecured,13 cases were markedly improved,13 cases were effective,4 cases were not effective, the total effective rate was 86.67%. Acupuncture could also reduce pain, after 8-weeks’treatment, the VAS scores fell 2.77+1.08 points, no case were cured,0 cases were markedly improved,26 cases were effective,4 cases were not effective, the total effective rate was 86.67%. AS to ease the pain, Acupuncture combined with chinese medicine treatment was superior to simple acupuncture group, with statistical significance(P< 0.05).The total efficiency was equal, but the difference of the effect of grading was statistically significant(P<0.05).(3) As evaluated by SF-36,2 groups both could improve patients’quality of life. After 8-weeks’treatment, PF, RP, BP, GH, VT, SF, RE, and MH were all be improved significantly. The increased value of each dimension of the needle medicine group was PF:21.50±13.71 points, RP:35.83±31.27分 points, RE: 34.44±28.34 points, BP:23.40±28.34 points, MH:35.07±8.32 points, VT: 24.17±10.83 points, SF:41.25±17.10 points, GH:31.00±9.68 points; while it of the acupuncture group was PF:10.50±9.68 points, RP:18.33±24.51 points, RE:14.44±34.67 points, BP:11.40±22.37 points, MH:26.27±7.33 points, VT:14.83±10.21 points, SF:24.17±21.00 points, GH:22.17±9.62 points. The difference was statistically significant within each group themselves (P<0.05).Acupuncture combined chinese medicine treatment was superior to simple acupuncture, with statistical significance (P<0.05)(4)As evaluated by EHP-5,2 groups both could improve patients’quality of life. After 8-weeks’treatment, the 11 items of EHP-5 were reduced. Acupuncture combined with chinese medicine treatment reduced more scores of the item 2, 3,4,5,6,7,8,9,10 (the impact on daily life, mood, individual image, child care, sex, the feeling of reatment effect) than acupuncture group, there was statistics signifieant difference between them(P<0.05), as to item 1,11 (the impact of pain on the body function, worrying about infertility), there was no statistics signifieant difference(P<0.05)-.(5)After 8-weeks’treatment,2 groups both could significantly reduce th e TCM syndrome scores. The decreased value of the needle medicine group wa s 15.07±2.61 points, while it of the acupuncture group was 10.83±3.38 po ints. The difference was statistically significant within each group thems elves (P<0.05).The decreased extent of the needle medicine group was grea ter, better than the acupuncture group, the difference was statistically s ignificant (P<0.05).(5)No obvious abnormal case of two groups was found in all safety index, such as blood, urine routine, liver and kidney function, before and after treatment. Ecchymosis appeared in one case of acupuncture group, patient without discomfort, and it disappear when followed up.Conelusion(1) Acupuncture combined with traditional chinese medicine, and acupuncture itself, could reduce the pelvic pain of endometriosis patients, reduce the TCM syndrome scores, comprehensively improve the quality of life. Acupuncture combined with tradional chinese medicine was more effective,and it was a effective treatment for pelvic pain.(2)2 groups had no adverse reactions. Acupuncture combined with traditional chinese medicine and acupuncture were safe to treat the intractable chronic pelvic pain caused by endometriosis. |
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