摘要
目的 探讨加味四物乌沉汤治疗肝郁血瘀证子宫内膜损伤致月经量少的临床效果及相关机制.方法 选取2020 年1 月—2022 年12 月收治的180 例肝郁血瘀证子宫内膜损伤致月经量少,随机分为对照组、观察组,每组90 例,对照组予以常规西药治疗,观察组在此基础上予以加味四物乌沉汤治疗,连续治疗6 个月经周期.比较2 组临床疗效、中医证候积分、子宫内膜厚度、经血量、行经时间、子宫内膜动脉血流情况[血流搏动指数(PI)、血管阻力指数(RI)、收缩期最高流速(PSV)]、性激素[雌二醇(E2)、黄体生成素(LH)、催乳素(PRL)、卵泡刺激素(FSH)]、血管内皮生长因子(VEGF)/转化生长因子-β1(TGF-β1)信号通路相关因子及不良反应.结果 观察组总有效率 91.11%(82/90)高于对照组76.67%(69/90)(P<0.05).治疗 3、6 个周期,观察组各中医证候积分低于对照组,经血量、子宫内膜厚度高于对照组,行经时间长于对照组(P<0.05);治疗 3、6 个周期,观察组RI、PI、PRL、FSH低于对照组,PSV、E2、LH、VEGF、TGF-β1 高于对照组(P<0.05).2 组不良反应发生率比较无显著差异(P>0.05).结论 加味四物乌沉汤治疗肝郁血瘀证子宫内膜损伤致月经量少具有良好的临床效果,能改善临床症状及子宫内膜血流灌注,其机制可能与改善子宫内膜厚度、调节性激素水平及VEGF/TGF-β1 信号通路有关.
Abstract
Objective To investigate the clinical effect and related mechanism of supplemented Siwu Wuchen decoc-tion in treating low menstrual volume caused by endometrial injury in patients with liver-stagnation and blood-stasis syndrome.Methods A total of 180 patients with endometrial injury caused by liver-stagnation and blood-stasis syndrome treated from January 2020 to December 2022 were randomly divided into control group and observation group,with 90 cases in each group.The control group was treated with conventional Western medicine,and the observation group was treated with supplemented Siwu Wuchen decoction on this basis for 6 consecutive menstrual cycles.The clinical efficacy,TCM syndrome score,endome-trial thickness,blood volume,duration of menstruation,endometrial arterial blood flow[pulsation index(PI),vascular re-sistance index(RI),peak systolic velocity(PSV)],sex hormone[estradiol(E2),luteinizing hormone(LH),prolactin(PRL),follicle stimulating hormone(FSH)],vascular endothelial growth factor(VEGF)/transforming growth factor-β1(TGF-β1)signaling pathway-related factors and adverse reactions were compared between the two groups.Results The total effective rate of observation group was91.11%(82/90),which was higher than that of control group[76.67%(69/90)](P<0.05).After 3 and6 cycles of treatment,the scores of TCM syndromes in the observation group were lower than those in the control group,the blood volume and endometrial thickness in the observation group were higher than those in the control group,and the duration of menstruation was longer than that in the control group(P<0.05).After 3 and 6 cycles of treat-ment,RI,PI,PRL and FSH in observation group were lower than those in control group,while PSV,E2,LH,VEGF and TGF-β1 were higher than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Modified Siwu Wuchen decoction has good clinical effects in treating low menstrual volume caused by endometrial injury in patients with liver-stagnation and blood-stasis syndrome,and can improve clinical symptoms and endometrial blood perfusion,the mechanism of which may be related to improving endome-trial thickness,regulating sex hormone levels and VEGF/TGF-β1 signaling pathway.
基金项目
南通市基础研究和民生科技计划指导性项目(2021)(MSZ21006)
维普
万方数据