李燕

【摘要】 目的：研究自拟温疏化瘀定痛汤联合布洛芬治疗寒凝血瘀型原发性痛经的临床效果。方法：选取2017年5月-2019年10月于笔者所在医院就诊的寒凝血瘀型原发性痛经患者48例，按照随机数字表法分为对照组和研究组，每组24例。对照组予以常规西医治疗，研究组在对照组基础上联合自拟温疏化瘀定痛汤治疗。观察两组临床疗效、中医证候积分、疼痛程度及性激素水平。结果：两组总有效率分别为91.67%、79.17%，差异无统计学意义（P>0.05）。治疗后研究组中医证候（四肢厥冷、冷汗淋漓）积分、VAS评分均显著低于对照组（P<0.05）。治疗后研究组孕激素（P）、前列腺素E2（PGE2）均显著高于对照组，雌激素（E2）显著低于对照组（P<0.05）。结论：采用自拟温疏化瘀定痛汤联合布洛芬治疗寒凝血瘀型原发性痛经能显著缓解症状，纠正性激素紊乱，可于临床中推广。

【关键词】 溫疏化瘀定痛汤 布洛芬 原发性痛经

doi：10.14033/j.cnki.cfmr.2020.19.011 文献标识码 B 文章编号 1674-6805（2020）19-00-03

Clinical Effect of Self-made Wenshuhuayu Dingtong Decoction and Ibuprofen on Primary Dysmenorrheal Caused by Cold Coagulation and Blood Stasis/LI Yan. //Chinese and Foreign Medical Research， 2020， 18（19）： -30

[Abstract] Objective： To study the clinical effect of self-made Wenshuhuayu Dingtong Decoction and Ibuprofen in the treatment of primary dysmenorrhea caused by cold coagulation and blood stasis. Method： From May 2017 to October 2019， 48 patients with primary dysmenorrhea caused by cold coagulation and blood stasis were selected and divided into the control group and the study group according to the random number table， with 24 cases in each group. The control group was treated with conventional western medicine， and the study group was treated with self-made Wenshuhuayu Dingtong Decoction on the basis of the control group. The clinical effect， TCM syndrome scores， pain degree and sex hormone levels of the two groups were observed. Result： The total effective rates of the two groups were 91.67% and 79.17% respectively， and the difference was not statistically significant （P>0.05）. After treatment， the TCM syndrome scores （cold limbs， sweating and dripping） and VAS scores in the study group were significantly lower than those of the control group （P<0.05）. After treatment， progesterone （P） and prostaglandin E2 （PGE2） in the study group were significantly higher than those of the control group， and estrogen （E） was significantly lower than that of the control group （P<0.05）. Conclusion： The self-made Wenshuhuayu Dingtong Decoction and Ibuprofen in the treatment of primary dysmenorrhea caused by cold coagulation and blood stasis can significantly relieve symptoms， correct sexual hormone disorder， and can be promoted in clinical practice.

[Key words] Wenshuhuayu Dingtong Decoction Ibuprofen Primary dysmenorrhea

First-authors address： Wuchuan Peoples Hospital， Wuchuan 524500， China

原发性痛经系内分泌功能失调等因素导致的妇科疾病，好发于年轻女性，临床表现为四肢厥冷、下腹坠痛等症状，可影响患者生活质量。常规西医治疗为镇痛、解热和抗炎，其中布洛芬可通过抑制前列腺素合成以缓解痛经，改善相关症状[1]。但因患者仍存在较为严重的内分泌紊乱问题，因此单用布洛芬的临床疗效欠佳。中医认为，原发性痛经属“痛经”范畴，系寒湿侵体阻脉、气血运行失常所致，治疗要点为温经散寒[2]。本研究选取寒凝血瘀型原发性痛经患者48例，对自拟温疏化瘀定痛汤联合布洛芬治疗的临床效果进行探究，做如下报道。

1 资料与方法

1.1 一般资料

选取2017年5月-2019年10月于笔者所在医院就诊的寒凝血瘀型原发性痛经患者48例。纳入标准：（1）年龄20～35岁;（2）符合2017SOGC临床实践指南中原发性痛经诊断标准[3];（3）疼痛分级为Ⅱ～Ⅳ级;（4）出现腹冷痛、形寒肢冷、月经量少、舌下青紫或瘀斑等寒凝血瘀型的相关临床表现。排除……