当归芍药散加味内服结合四黄散外敷治疗妇科慢性盆腔痛疗效观察

陈小姗　周凤洁　曾研章

[摘要] 目的 观察当归芍药散加味内服结合四黄散外敷治疗妇科慢性盆腔痛的疗效。 方法 选取我院2014年1～12月门诊治疗的慢性盆腔痛患者66例，随机分为观察组和对照组，观察组采用当归芍药散加味内服配合四黄散外敷结合特定电磁波照射治疗，对照组采用盐酸克林霉素棕榈酸酯分散片加妇炎康软胶囊口服治疗，观察两组患者治疗前、治疗结束时及停药3个月疼痛指数及生活质量改善情况和临床疗效。 结果 疼痛程度NRS评分：疗程结束时两组患者评分明显降低，且观察组低于对照组，差异有统计学意义（P<0.05）；两组疗程结束后3个月比较，差异有统计学意义（P<0.05）。SF-36量表各维度综合评分：疗程结束时两组明显升高，且观察组高于对照组，差异有统计学意义（P<0.05）；疗程结束3个月两组比较，差异有统计学意义（P<0.05）。临床总有效率：观察组优于对照组，差异有统计学意义（P<0.05）。 结论 当归芍药散加味内服结合四黄散外敷治疗妇科慢性盆腔痛，改善患者疼痛程度，提高生活质量，临床疗效较好，值得推广。

[关键词] 当归芍药散；四黄散；慢性盆腔痛；临床研究

[中图分类号] R271.9 [文献标识码] B [文章编号] 2095-0616（2015）11-13-04

[Abstract] Objective To evaluate the treatment of Danggui Shaoyao powder supplements combined with external use of Sihuang powder in treating chronic pelvic pain. Methods 66 clinic patients with chronic pelvic pain from Jan to Dec 2014 were randomly divided into observation group and control group. The observation group received the Danggui Shaoyao powder supplements combined with external use of Sihuang powder and raying of special electromagnetic wave. The control group received the Clindamycin Palmitate Hydrochloride Dispersible Tablets and Fuyankang soft capsule. The pain index， the improvement of life quality and clinical efficacy between the two groups were observed in the period of before treatment， after treatment and 3 months after drug withdrawal. Results The NRS score of pain degree in the two groups after treatment both significantly lowered， and the score in the observation group was lower than that in the control group（P<0.05）. The differences of NRS score of pain degree were statistically significant； the NRS score of pain degree between the two groups after 3 months drug withdrawal indicated that the difference were also statistically significant （P<0.05）. The comprehensive score of each evaluation in SF-36 dimension in the two groups after treatment both significantly higher， and the score in the observation group was higher than that in the control group （P<0.05）.The differences were statistically significant； the comparison between the two groups after 3 months drug withdrawal indicated that the differences were also statistically significant （P<0.05）. The total clinical effective rate in the observation group was higher than that in the control group （P<0.05）， and the differences were statistically significant. Conclusion The treatment of chronic pelvic pain by Danggui Shaoyao powder supplements combined with external use of Sihuang powder， which helps relieve patients pain degree and improve the life quality， has better clinical effects and worth popularization.

[Key words] Danggui Shaoyao powder； Sihuang powder； Chronic pelvic pain； Clinical research

慢性盆腔痛（chronic pelvic pain，CPP）是指盆腔区、前腹壁、后背和（或）臀部至少持续6个月的非周期性疼痛。其为育龄妇女的常见病，在18～50岁的妇女中，其发病率为3.8%，在不孕患者中可高达40%[1-2]。Mara等[3]研究发现妇科慢性盆腔痛的患者中盆腔粘连者占22.3%，子宫内膜异位症者占22.4%，慢性盆腔炎性疾病者占17.7%，无明显病理改变者占17.0%。患者多有腰部和下腹部胀痛，经期或劳动后加重。可伴有性交痛，易反复发作，严重者导致不孕，因本病缠绵难愈，使患者长期承受着经济、身体和精神上的折磨，严重者伴发抑郁症和焦虑症，使患者生活质量明显下降[4]。本研究从中医药角度研究当归芍药散加味内服结合四黄散外敷治疗妇科慢性盆腔痛的疗效，临床疗效较好，现报道如下。

1 资料与方法