Clinical Observation On Treatment Of Adenomyosis - Related Pain By Modified Wenyang Huoxue Decoction

Objective1 To discuss the characters of syndrome elements of adenomyosis from the survey,to provide the evidences for the clinical treatment.2 Through clinical research, to evaluate the clinical effects and safety of treating the pain of adenomyosis with Wenyanghuoxue decoction, to provide clinical reference for adenomyosis clinical treatment.Methods1 Make a questionnaire composed by the general symptoms, complications, tongue pictures and pulse conditions which is based on systematically review of the literatures and tutor’s many years clinical experience.Under strict quality control,the paitients with pain of the adenomyosis were investigated.Then set up a database and studied the characteristics of TCM Syndrome through k-means cluster analysis.2 The research adopted self-control study method,to evaluate the efficacy after the patients taking Wenyanghuoxue decoction and observe the clinical efficacy in dysmenorrhea,ovulation pain,CPP,TCM syndromes, menstruation, uterine volume,the lesion area and serum level of CA125.ResultsResults 1The patients surveyed were classified into five TCM syndromes through k-means cluster analysis.They were cold coagulation and blood stasis syndrome,qi-stagnancy and blood stasis,syndrome of qi-deficiency and blood stasis, kidney deficie-ncy and blood stasis syndrome,phlegm and blood stasis syndrome.Cold coagulation-and blood stasis accounted for 44.0% which was the most,thereinto,44 people’s main suit was pain.Results 21) Pain:①Dysmenorrhea:The group which don’t take the painkillers, the longer time for treatment,the lighter degree of VAS dysmenorrhea,COX dysmenorrhea,and the shorter dysmenorrhea duration. The VAS scores reduced and the dysmenorrhea duration shortened very significantly after treatment for 3 cycles and 6 cycles(P<0.01),and the dysmenorrhea accompanying symptoms were improved significantly (P<0.01 or P< 0.05).The heavier degree of dysmenorrhea, the more obvious of treatment effect.The group which take the painkillers,with the extension of treatment cycle, dysmenorrhea and its accompanying symptom scores decreased,and the number of taking painkillers was decreasing.②Oviposit period pain and chronic pelvic pain:With the extension of treatment cycle, Oviposit period pain scores, duration and chronic pelvic pain scores both decreased. Compared with prior treatment,oviposit period pain scores had a extremely significant difference after treatment for 3 cycles and 6 cycles(P<0.01),duration and chronic pelvic pain scores both shortened or decreased significantly(P<0.05).2) General symptoms and menstruation:The longer time for treatment,the lighter degree of TCM syndromes scores and menstruation scores,and the menorrhagia was dropping to normal.Compared with prior treatment,TCM syndromes scores, menstrual color and texture scores both have a extremely significant difference after treatment for 3 cycles and 6 cycles(P<0.01),the PBAC scores of menorrhagia decreased significantly(P<0.05).3) Ultrasound index:With the extension of treatment cycle, the uterine volum and the pathological area were both shrinking. After treatment for 3 cycles and 6 cycles, respectively compared with prior treatment,no significant change was found after treatment in uterine volume(P>0.05),but the pathological area shrinked significantly(P<0.05).4) Serum level of CA125:After treatment for 3 cycles and 6 cycles in serum level of CA125, compared with prior treatment,no significant change was found (P>0.05).ConclusionThe main syndrome type of the patients with pain related to adenomyosis is cold blood coagulation and blood stasis syndrome,and the degree of pain was positively correlated with the cold coagulation. The treatment of Wenyanghuoxue decoction can significantly release the pain of adenomyosis and reduce the symptoms and signs.