Clinical And Experimental Study On Treatment Of Primary Dysmenorrhea Of Qi Stagnation And Blood Stasis Type With Zhi Tong Tiao Jing Recipe

Objective: Primary dysmenorrhea is a common disease in gynecology.Recurrent attacks of the disease greatly affect the daily life of women.This paper is to study the clinical observation and animal experiment of "Zhitong Tiaojing recipe" for treating primary dysmenorrhea of qi stagnation and blood stasis type,observing the specific curative effect of Zhitong Tiao Jing recipe,and preliminarily exploring the mechanism of its effect.To provide some theoretical basis and data support for clinical popularization and application.Methods:(1)Clinical observation:Forty patients with primary dysmenorrhea of Qi stagnation and Blood stasis type were treated with Zhitong Tiaojing recipe orally and treated for 3 menstrual cycles.The scores of dysmenorrhea symptoms and TCM symptom scores were observed before and after the treatment.Evaluating the total curative effect of Zhitong Tiaojing recipe and analyzing the influence of abdominal pain degree and course of disease on the total clinical curative effect.(2)Animal experiment: sixty female non-pregnant SD rats were divided into 6 groups(normal group,model group,medium dose group,low dose group and ibuprofen group).The primary dysmenorrhea model of Qi stagnation and blood stasis in rats was established by continuous subcutaneous inject-ion of estr-adiol benzoate,epinephrine and intraperitoneal injection of oxytocin,combined with comprehensive stimulation(light,sound,binding,clip tail).Obs-erving the writhing behavior of dysmenorrhea model rats.The whole blood viscosity,plasma viscosity,hematocrit of the rats were measured by whole blood viscosity analyzer.The changes of PGF2?,PGE2,PGF2?/PGE2 and OT levels i-n rat uterus were detected by ELISA method.Results:(1)Clinical observation:(1)clinical efficacy: 5 cases were cured,13 cases were markedly effective,19 cases were effective and 3 cases were ineffective.The total effective rate was 92.5%.(2)Abdominal pain degree: the score of abdominal pain was significantly decreased,the difference was statistically significant(P<0.01).(3)The TCM symptom score: the scores of TCM symptoms are decreased significantly after treatment,Especially in the area of abdominal pain,duration,premenstrual distension,chest tightness,obstruction of menstruation,etc.(P<0.01).(4)General condition and follow-up period: there was no discomfort during treatment.After 3 cycles of treatment,the duration of disease was cured,and the duration of disease was significantly relieved.(2)Animal experiment:(1)Compared with normal group,model group rats writhing times increased,in 30 minutes,the The level of PGF2? and OT were significantly increased,The level of PGE2 has decreased.The ratio of PGF2?/PGE2 is increased.The whole blood viscosity,plasma viscosity and hematocrit were higher at different shear rates,and the difference was statistically significant(P < 0.05).(2)Compared with the model group,the Ibuprofen group could effectively inhibit the writhing times of rats within 30 minutes(P < 0.05),decrease the levels of PGF2? and PGF2?/PGE2,increased the levels of PGE2,and the difference was statistically significant(P < 0.05).The levels of PGF2? and OT in the high dose group were significantly lower than that of the control group(P < 0.05).(3)Compared with ibuprofen group,the whole blood viscosity,plasma viscosity and hematocrit were significantly decreased in each dose group of Zhitong Tiaojing recipe,and there was significant difference in high dose group(P < 0.01).Conclusion:(1)The zhitong tiaojing recipe is effective in treating primary dysmenorrhea of qi stagnation and blood stasis type,especially in the improvement of abdominal pain,premenstrual bulge,discomfort of chest tightness and poor menstrual flow.The shorter the course of the disease,the better the curative effect.(2)Behavioral manifestations and hemorheological changes confirmed that the rat model of Qi stagnation and blood stasis and dysmenorrhea was successfully established.The mechanism of Zhi Tong Tiaojing recipe is it can regulate the levels of PGF2?,PGE2 and OT,It's also can improve the disturbance of local blood circulation,thus reducing the dysmenorrhea caused by the ischemic anoxia of the uterus.