Real-world Study Of Traditional Chinese Medicine And Observation On The Therapeutic Effect Of A Combination Of Chinese Patent Medicines For Adenomyosis

Objective:Through the datamini ng analysis of the clini cal diagnosis and treatment information of adenomyosis(AM)outpatients and inpatients,to discuss the incidence and Chinese medication rules of adenomyosis in the real world preliminarily,and adenomyosis patients were treated with guizhi fuling capsule,sanjie analgesic capsule and gongxuening capsule,then the main clinical symptoms of the patients were observed to evaluate the efficacy of the combination of Chinese patent medicines in the treatment of adenomyosis.Methods:Extracted gynecological color ul trasound informations,basic informations,medical informations and so on from gynecological adenomyosis outpatients and inpatients of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from 2012 to 2017,and using EXCEL,SPSS,Oracle and other software for data analysis and mining,obtained the patients’ incidence trend,the ages of onset,and the rules of traditional Chinese medicines,etc.;thirty patients with adenomyosis were selected and treated with the combination of Chinese patent medicines(guizhi fuling capsule,sanjie analgesic capsule and gongxuening capsule)for 3 months,then the improvement of clinical main symptoms such as dysmenorrhea VAS score,menstrual blood loss map and TCM syndrome were observed.Results:1.Real-world study:(1)in terms of the incidence trend,the number of patients in 2012 was 1607,and the number of patients in 2017 was 2239,showing an overall increasing trend,and the number of patients in each age group also showed an increasing trend;(2)in terms of age of onset,40-49 years old group had the most visits,accounting for 45%of the total number of patients,followed by 30-39 years old group,accounting for 41%of the total,the 20-29 years old group,50-59 years old group accounted for 9%,5%of the total;(3)in terms of traditional Chinese medicine,the total number of prescriptions was 8986,and the number of information on traditional Chinese medicines was 201242,using 392 flavors of traditional Chinese medicines;the core prescription of the medicine is:vinegar fragrant,angelica,ligusticum wallichii,vinegar corydalis tuber,pollen typhae,radix paeoniae alba,codonopsis pilosula,honey-fried licorice root;there are 8 common compatibilities of medicines;among the top 20 traditional Chinese medicines in the medication frequency of AM patients aged 40-49 years old,from high to low,according to the proportion of drug efficacy,they are respectively nourishing yin and blood tonifying drugs,invigorating spleen and qi tonifying drugs,qi-regulating and pain-relieving drugs,blood-activating and pain-relieving drugs,removing blood stasis and stopping bleeding drugs,activating blood circulation and regulating menstruation drugs,eliminating mass and removing stasis drugs,warming meridians and toning the arteries and veins drugs,water-disinhibiting and dampness-excreting drugs,and heat-clearing and blood-cooling drugs;2.Observation on the therapeutic effect:(1)after the treatment,the VAS score of dysmenorrhea decreased from 5.433±1.5013 to 3.700±1.5790,and the difference was statistically significant(P<0.001);the dysmenorrhea time was shortened from 16.90±7.743 hours to 12.53±8.178 hours,and the difference was statistically significant(P<0.001);the total effective rate of dysmenorrhea relief was 70%;(2)after the treatment,the menstrual blood loss map score decreased from 179.97±49.453 to 134.00±49.438,and the difference was statistically significant(P<0.05);the total effective rate of menstrual volume treatment was 60%;(3)after the treatment,the TCM syndrome score decreased from 13.63±4.327 to 10.33±4.302,the difference was statistically significant(P<0.001);the total effective rate of TCM syndrome improvement was 60%.Conclusion:The characteristics of the incidence of adenomyosis in the real world as well as the characteristics of tranditional Chinese medicines’use in overall and in different age groups were preliminarily obtained.From 2012 to 2017,the incidence of adenomyosis was generally on the rise,and the age of onset was mainly around 40-49 years old,which was basically consistent with the epidemiological knowledge of adenomyosi s reported in the literature.Traditional Chinese medicine treatment took resolving blood stasis as the core,combining the methods of tonifying kidney and spleen,invigorating qi and breaking blood,eliminating mass and removing stasis,tonifying qi and nourishing blood,warming meridians and dispersing cold,clearing heat and cooling blood,resolving phlegm and removing dampness,etc.It reflected that the core pathogenesis of adenomyosis was blood stasis which impeded chong ren and the womb,and the common etiology and pathogenesis included kidney deficiency and blood stasis,qi stagnation and blood stasis,qi deficiency and blood stasis,cold coagulation and blood stasis,hot burning and blood stasis,etc.At the same time,according to the characteristics of physiological changes in different ages,treatment was conducted.It was basically consistent with the traditional and modern doctors’understanding of the etiology and pathogenesis of adenomyosis and the use of drugs based on syndrome differentiation.It can provide certain reference for further study of the etiology and pathogenesis of adenomyosis and discussion of the law of drug use at different ages.What’s more,the excavation of core prescriptions and multi-layer sub-network compatibilities can provide some ideas for the exploration of new treatment options and new drug developments for Chinese medicine treatment of adenomyosis.The observation on the therapeutic effect showed that the treatment of adenomyosis with the combination of Chinese patent medicines had a significant effect,significantly reducing the degree of abdominal pain,shortening the pain time,reducing the amount of menstruation,and improving the TCM syndromes of patients,which is worthy of further clinical promotion and verification.