| Backgrounds:Endometriosis (or EMS) Refers to the endometrial tissue (including glands and stroma)appear outside the uterine cavity, it have the ability to infiltrate and growth, can form nodule and mass at the attachment site.It is one of the gynecological disease prombl-ems.Endometriosis has the property of being aggressive and extensively planted,often cause dysmenorrheal,irregular menstruation, infertility and so on, which has seriously affected the physical and mental health of reproductive women. In recent years, the incidence rate of EMs is on an obvious increase. At the same time, EMs is hard to cure and easy to recur. Therefore, the study on the pathogenesis and treatment of EMs has a great significance.After long-term clinical observation, Professor Lin, gynecologic experts at Dongfang hospital, think most of endometriosis are Inner-Heat type. Review the literature in recent ten years, dysmenorrhea caused by endometriosis usually diagnosed as Cold syndrome or blood stasis syndrome, and the treatment of TCM is warming channel and activating blood circulation However, this treatment for endometriosis whose chief complaint is dysmenorrheal will aggravate their symptoms. In addiction,the liver is the key viscus in the physiology,so the treatment of Gynecological diseases lies in regulating the liver. Liver belongs to Yin in physique and Yang in function, maladjustment of workand rest,Qi depressio n,m-enstruation, vaginal discharge, pregnancy, childbirth, or breastfeeding can all lead to Yin-deficiency Syndrome. Liver-blood deficienc can lead to Qi depression,and after accumulate a long time can aid inner heat pathogen.Therefore, Professor Lin have an idea to use the Chinese traditional medicine which can nourish blood and smooth the liver、discharge liver and clear heat、disperse blood stasis and dredge collateral to treat dysmenorrheal caused by endometriosis.The Chinese tradition medicine prescription choose Xuanyu Tongjing Dec-oction of Fu Qingzhu. Through his clinical observations, Professor Lin verify this therapy can significantly ease the symptoms of dysmenorrhea and other related symptoms. By the way,even heat syndrome is not obvious,use the Chinese traditional medicine which can nourish blood and smooth the liver、discharge liver and clear heat can also have good curative effect.The treatments in TCM of this type of endometriosis is dispersing Qi, dredging collaterals and relieve pain,Purpose:To objectively evaluate the clinical efficacy and safety of Xuanyu Tongjing D-ecoction in the treatment of endometriosis patients whose chief complaint is dysmenorrheal stick to evidence-based principles. This experiment is intended to provide a sound scientific ev-idence for further research and dissemination of the dialectical typing and therapy. And it also provides some ideas and guidance for the study of the etiology and pathogenesis of endometriosis and the treatment of TCM.Methods:70 cases choose from Beijing Chinese medicine science and Technology Development Fund Project 《Study on the clinical efficacy of Xuan Yu Tong Luo Tang in treatment of dysmenorrhea caused by endometriosis》, groups were divided by randomfigure table, 35 cases in the treatment group and 35 cases in the control group. The treatment group was given Xuanyu Tongjing decoction, the control group took a placebo. Two groups of patients were continuous treated of three menstrual cycles, take medicine 7-10 days per cycle.Treatment was started 10 days before menstruation, one dose for 1 day,each decoction was decocted two times, menstruation stop takin. Before and after the treatment,respectively recorded the dysmenrrhea symptom score, the dysmenorrhea VAS score and the TCM syndrome score of patients, and check the CA-125 level, gynecological B ultrasound and related safety indicators. After collecting the required data, using SPSS 17 statistical package to analyze and process the collected data.Results:There were 9 patients who met the criteria for shedding and removing, and finally a total of 61 people 61 patients completed this research, of which 31 cases of the treatment group,30 cases of the control group.Before the treatment, there were no statistical difference betweet two groups as regards the age, duration, dysmenorrhea degree score, dysmenorrhea VAS score, TCM syndrome score, level of CA-125 and maximum diameter of endometriosis cyst (P>0.05), which were comparable.After 3 months of therapy——In the treatment group,7 cases were cured,3 cases were markedly effective,13 cases were effective,8 cases ineffective, the total effective rate was 74.19%, the clinical cure rate 22.58%, markedly effective 9.68%;In the contronl group, there were no clinical cure and markedly effective cases,1 cases were effective, the total effective rate was 3.33%.Dysmenorrhea VAS score:In the treatment group,9 cases were cured,4 cases were markedly effective,12 cases were effective,6 cases were ineffective, the total effective rate was80.65%, the cure rate was 29.03%, the markedly effective rate was 12.90%; In the control group, there was no cured and markedly effective case, lease was effective,29 cases were ineffective, the total efficiency rate was 3.33%.TCM syndrome score:In the treatment group,1 cases were cured,8 cases were markedly effective,13 cases were effective,9 cases were ineffective, the total effective rate was 70.97%, the cure rate was 3.23%, the markedly effective rate was 25.81%; In the control group, there was no cured and markedly effective case, lease was effective,29 cases were ineffective, the total efficiency rate was 3.33%.After treatment, the level of CA-125 in treatment group was significantly lower than before treatment(P<0.01). There was no significant difference in the level of CA-125 in control group before and after treatment(P>0.05).In the treatment group, there were 22 patients has ovarian endometriosis cyst,and there was no significant difference in the maximum diameter of the ovarian endometriosis cyst before and after treatment(P> 0.05). In the control group, there were 21 patients has ovarian endometriosis cyst,and the maximal diameter of the ovarian endometriosis cyst after treatment was longer than that before treatment(P< 0.01).During and after treatment, the treatment group and the control group did not appear adverse reactions.Conclusion:Xuanyu Tongjing decoction has obvious effect on relieving dysmenorrhea in endometriosis patients. And this treatment can also improve the TCM syndrome,and can reduce endometriosis patients’CA-125 levels,and can control the growth rate of ovarian endometriosis cyst. This method is safe, have no obvious side effects and curative effect is steady. Therefore, this dialectical typing and method deserves further research. |
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