| Objective:Observing the pain symptoms,the improvement of TCM symptoms and changes of uterine volume of deficiency-cold type dysmenorrhea of adenomyosis with modified wenchong decoction,and to explore the clinical efficacy of modified wenchong decoction in treating deficiency-cold type dysmenorrhea of adenomyosis,and to observe the changes of serun CA125,IL-6,IL-8 and IGF-1 levels before and after treatment to unde rstand their correlation with adenomyosis and pain degree.Methods:60 patients diagnosed as deficiency-cold type dysmenorrhea of adenomyosi s who met the inclusion criteria and were not included in the exclusion criteria from March 2019 to January 2020 were randomly divided into the treatment group and the contr ol group in the gynecology clinic of Jiangsu province hospital of TCM,each with 30 cases.The treatment group took modified wenchong decoction orally in the morning and evening of non-menstrual period.The control group took sanjiezhentong capsules orally in the morning and evening during non-menstrual period,3 times a day,4 capsules each time.Both groups took 3 menstrual cycles in succession.The levels of serum CA125,IL-6,IL-8,IGF-I,VAS score,dysmenorrhea symptoms,TCM symptom score,uterine volume and safety index were observed before and after 3 menstrual cycles.Results:(1)Through intra-group comparison,the dysmenorrhea score,VAS score and TCM symptom score of the two groups after treatment were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).Through the comparis on between the two groups,the dysmenorrhea score,VAS score and TCM symptom score of the two groups after treatment were obtained with statistical significance(P<0.05).(2)In terms of the efficacy of dysmenorrhea,the total effective rate of the modified wenchong decoction group after treatment was 88.89%,and the total effective rate of the sanjiezhentong capsule group after treatment was 69.23%.Through inter-group comparison,the difference was statistically significant(P<0.05).In terms of comprehensive efficacy of TCM symptoms,the total effective rate of the modified wenchong decoction group after treatment was 88.89%,and the total effective rate of the sanjiezhentong capsule group after treatment was 69.23%.Through inter-group comparison,the difference was statistic ally significant(P<0.05).(3)Through intra-group comparison,the uterus volume in the modified wenchong decoction group after treatment was significantly lower than that before treatment,with statis tical significance(P<0.05)and the uterus volume in the sanjiezhentong capsule group after treatment was not significantly lower than that before treatment,with no statistical significance(p>0.05).After treatment,the comparison between the two groups showed that there was no significant difference in uterine volume between the two groups(P>0.05).(4)Through intra-group comparison,the levels of serum CA125 and IL-8 in the modified wenchong decoction group after treatment were significantly lower than those before treatment,with statistical significance(P<0.05).Through intra-group comparison,the levels of serum IL-6 and IGF-I in the modified wenchong decoction group after treatment were not significantly lower than those before treatment,with no statistical significance(P>0.05).Through intra-group comparison,the levels of serum CA125 and IGF-I in the sanjiezhentong capsule group after treatment were significantly lower than those before treat ment,with statistical significance(P<0.05).Through intra-group comparison,the levels of IL-6 and IL-8 in serum of sanjiezhentong capsule group were not significantly lower than before treatment,with no statistical significance(p>0.05).Through inter-group comparison,the difference between the two groups in serum CA125 and IL-8 levels after treatm ent was statistically significant(P<0.05).Through inter-group comparison,the difference between the two groups in serum IL-6 and IGF-I levels after treatment was not statisticall y significant(P>0.05).Conclusion:Modified wenchong decoction can significantly improve the pain symptoms,TCM symptoms and uterine volume of deficiency-cold type dysmenorrhea of adenomyosis,and reduce the levels of serum IL-8 and CA125.In the study,it was found that the increase of serum IL-6 in patients with adenomyosis dysmenorrhea was not obvious before treatment,and the decrease of serum IL-6 was not obvious after treatment,which s uggested that serum IL-6 had limited effect on diagnosis and treatment of adenomyosis.The serum IGF-I level was higher before treatment,suggesting that it had certain correlat ion with adenomyosis,but the effect of modified wenchong decoction in reducing serum IGF-I level was limited.Through Spearman rank correlation analysis,it can be concluded that the levels of serum IL-6,IL-8,IGF-I and CA125 have no correlation with the degree of pain.In 3 months of treatment,the patients had no obvious adverse reactions.The ancient prescription can provide new ideas for the treatment of deficiency-cold type dy smenorrhea of adenomyosis with traditional Chinese medicine,which is worthy of clinical application. |
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