| Objective:To explore the clinical efficacy of Cai's Neiyi Decoction combined with dysmenorrhea relief paste in the treatment of Adenomyosis(AM),and to provide treatment for dysmenorrhea cause by AM.Method:A non-randomized,simultaneous controlled study was conducted to study 64cases of dysmenorrhea with AM that met the inclusion criteria of this study,including33 cases in the Neiyi Decoction group and 31 cases in the Neiyi Decoction combined with Jie Tong paste group(Combined group).Among them,the Neiyi Decoction group took the Neiyi Decoction orally,while the combined group took the Neiyi Decoction orally for the whole menstrual cycle and applied Jie Tong paste on the first and second day of menstruation.Intervention methods of Neiyi Decoction group:took Neiyi?Decoction from the end of menstruation until 3 days before menstruation;took Neiyi I Decoction from 3 days before menstruation until end of menstruation;Patient with menorrhagia took Neiyi?Decoction from 3 days before menstruation until end of menstruation;Patients in the combined group were given orally with the same method as those in the Neiyi Decoction group,and an external application of Jie Tong paste was added on the first and second day of menstruation(specific location:midpoint from umbilicus to the lower abdomen of the pubic symphysis line,and one paste was replaced after 12h).Treatment time are three consecutive menstrual cycles,observing the degree of dysmenorrhea(VAS score),the dysmenorrhea symptom scores of TCM syndrome,premenstrual symptoms integral scale,the size of the uterus,TCM syndrome including cold extremities,lumbar acid,quality of life scale(EHP-5),combinate with serum CA125 and prostacyclin,to comprehensively evaluate the clinical effect of Cai's Neiyi Decoction combined with Jie Tong paste in the treatment of dysmenorrhea cause by AM.Result:1.Clinical efficacy evaluation index(dysmenorrhea symptom score):dysmenorrhea symptom score after three cycles of treatment:the effective rate of the Neiyi Decoction group was 63.6%,the effective rate of the combined group was 90.3%,and the?was26.7%,according to the comparison of dysmenorrhea symptom score and grade data,there were significant differences between the two groups(P<0.05).2.Symptom efficacy scores in three treatment cycles showed statistically significant difference between the two groups(P<0.05).The efficacy comparison between the two groups with severe dysmenorrhea was statistically significant(P<0.05),while the efficacy comparison between the two group with moderate dysmenorrhea was not statistically significant(P>0.05).There was no significant difference between Qi stagnation with blood stasis patient between two groups(P>0.05),and there was a statistical difference between Cold damp stagnation patient between two groups(P<0.05).There was no significant difference between two type of syndrome between the two groups(P>0.05).3.Overall efficacy evaluation of TCM syndrome:after three cycles of treatment,the effective rate in Neiyi Decoction group was 72.7%,the effective rate in the combined group was 90.3%,and?was 17.6%.According to the effective rate of TCM syndrome,there was no significant difference between the two groups(P>0.05).In the first and second treatment cycles,there was no statistical difference in efficacy between the two groups(P>0.05).There were statistically significant differences between the two groups according to the efficacy level(P<0.05).The TCM syndrome score of the two groups decreased with time.Among TCM syndrome score,there is statistically difference of the influence of dysmenorrhea in patient life of two groups(P<0.05),and there was no statistical difference between the two groups in emotional depression,cold limbs,premenstrual breast distension,heavy leucorrhea,back pain,fatigue and diarrhea(P>0.05).4.Dysmenorrhea time:the dysmenorrhea time of patient in the two groups showed a decreasing trend with the extension of time.In the three treatment cycles,the dysmenorrhea time in the two groups was statistically significant(P<0.05),and the dysmenorrhea time in combination group was lower than that the Neiyi Decoction group,indicating that the efficacy of the Neiyi Decoction group combined with Jie Tong paste was better than Neiyi Decoction group.5.VAS score:the VAS score in two groups decreased with time.In the first treatment cycle,there was no statistically significant difference in VAS score between the two groups(P>0.05).In the second and third treatment cycles,the VAS score of the combined group was lower than Neiyi Decoction group(P<0.05),indicating that the efficacy of the combined treatment was better than Neiyi Decoction group.6.For third clauses of ehp-5 scale(emotional instability),there was a statistically significant difference between the two groups after treatment(P<0.05).7.Premenstrual symptom score(COPE score):both groups had therapeutic effects(P<0.05),and the efficacy of the combined group was better than Neiyi Decoction group.8.The mechanism of Cai's Neiyi Decoction combine with Jie Tong paste in the intervention of dysmenorrhea in AM was preliminarily explored.After three cycles of treatment,the uterine volume of two groups was reduced,and the?difference between the combined group and Neiyi Decoction group was 24111.82mm~3,and Neiyi Decoction group is better than combined group.There was no significant difference between TNF difference between the two groups was 3.99pg/ml.Conclusion:The combined group can effectively alleviate dysmenorrhea,reduce dysmenorrhea level,reduce dysmenorrhea time,improve their psychological state,premenstrual symptoms,reduce the size of the uterus,the combined group has a clinical advantage compared with the single use of Cai's Neiyi Decoction group.It indicates that internal and external combined therapy is effective in the treatment of dysmenorrhea of AM,and the combination of Cai's Neiyi Decoction and Jie Tong paste has significant curative effect in the treatment of dysmenorrhea of AM. |
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