当归四逆汤加减治疗痛经的调查研究

当归四逆汤加减治疗痛经的调查研究

目的调查研究当归四逆汤加减对痛经的治疗作用，为临床提供科学依据。方法选取在2015年2月—2016年2月期间该院收治的166例痛经患者作为研究对象，随机分成试验组和对照组，每组83例。采用调查问卷的方法对患者进行调查，内容包括患者一般资料、痛经类型、病因及治疗效果等等。结果调查中的两组患者经不同用药方案治疗后，试验组患者治愈46例，治愈率为55.42%，痛经情况有所改善患者33例，起效率为39.76%，总有效率为95.18%;对照组患者治愈21例，治愈率为25.31%，痛经情况有所改善的患者37例，起效率为44.58%，总有效率为69.88%。经统计学分析，试验组总有效率明显高于对照组，差异有统计学意义（P<0.05）;试验组患者中轻度痛经38例，中度痛经40例，严重痛经5例;对照组中患者轻度痛经36例，中度痛经41例，严重痛经6例。结论通过对痛经患者进行调查可知，根据患者痛经症状采取不同中药治疗，有助于改善患者痛经情况，使患者免除痛经的折磨，临床疗效明显，值得临床推广。

标签：当归四逆汤;加减;痛经;疗效

Investigation of Modification of Danggui Sini Decoction in Treatment of Dysmenorrhea

LI Chang-hui1，CUI Guang-hao2，WANG Yan-ping1

1.Department of Gynaecology，Affiliated Hospital of Changchun University of Traditional Chinese Medicine，Changchun，Jilin Province，130021 China;

2.Department of Orthopedics and Traumatology，First Clinical Hospital of Jilin Provincial Academy of Traditional Chinese Medicine，Changchun，Jilin Province，130021 China

[Abstract] Objective To investigate the effect of modification of danggui sini decoction in treatment of dysmenorrhea and provide scientific basis for the clinic. Methods 186 cases of patients with dysmenorrhea admitted and treated in our hospital from February 2015 to February 2016 were selected as the research objects and randomly divided into two groups with 83 cases in each，the patients were surveyed by the questionnaires，and the contents included the general data，dysmenorrhea type，cause and treatment effect and so on. Results After treatment，in the test group，46 cases were cured，and the cure rate was 55.42%，the dysmenorrhea condition of 33 cases was improved，and the efficacy was 39.76%，and the total effective rate was 95.18%; in the control group，21 cases were cured，and the cure rate was 25.31%，the dysmenorrhea condition of 37 cases was improved，and the efficacy was 44.58%，and the total effective rate was 69.88%，and the statistical analysis showed that the total effective rate in the test group was obviously higher than that in the control group，and the difference was obvious with statistical significance（P<0.05），in the test group，mild-middle dysmenorrhea occurred to

38 cases，middle dysmenorrhea occurred to 40 cases，and severe dysmenorrhea occurred to 5 cases; in the control group，mild-middle dysmenorrhea occurred to 36 cases，middle dysmenorrhea occurred to 41 cases，and severe dysmenorrhea occurred to 6 cases. Conclusion The investigation shows that adopting different traditional Chinese medicine treatment according to the dysmenorrhea symptoms contributes to improving the dysmenorrhea condition，and reliving the pains of patients，and the clinical curative effect is obvious，which is worth clinical promotion.[Key words] Danggui sini decoction; Modification; Dysmenorrhea; The curative effect

痛经，又称经痛，为女性的常见妇科病之一，多发于12～45岁，病因复杂，反复性大，治疗较慢，患者出现下腹部胀痛、刺痛、坠痛、绞痛、痉挛痛等等，严重影响了生活质量，甚至导致不孕不育。中医认为：“男人以肾为主，女人以血为主。”女性如果气血调和，则内分泌正常，月经期间就不会发生痛经[1]。当归四逆汤由当归、桂枝、芍药、细辛、通草、甘草组成，主治手足厥寒、腰腿疼痛等血虚寒厥证。该院采用当归四逆汤治疗女性痛经取得了较好的效果，因此笔者对2015年2月—2016年2月在该院治疗的166例痛经患者进行回顾性分析，现报道如下。

1 调查对象与方法

1.1 调查对象

选取2015年2月—2016年2月该院收治的痛经患者166例作为研究对象，随机分成试验组和对照组，每组83例。试验组患者年龄14～45岁，平均年龄为29.5岁;病程为2个月～6年。对照组患者年龄15～42岁，平均年龄为28.5岁;病程为2个月～7年。两组患者在年龄、病情、病程等方面比较差异无统计学意义（P>0.05），故具有可比性。

1.2 调查中医师采用的治疗方法

1.2.1 分型大多数中医研究者认为，痛经的病因以气血亏虚为主，按照痛经辩证可分为五种类型：气滞血瘀型、寒湿凝滞型、湿热瘀阻型、气血虚弱型和肝肾亏损型[2]。

①气滞血瘀型。经前由于情志不畅，引起肝气郁结，气机下沉，造成血瘀、疼痛。经前或经期出现下腹部胀痛，坐立不宁，经期经量少，或者经行不畅，经月颜色黯淡发紫，有瘀块;舌头紫黯，有时舌边有瘀斑，或出现弦涩或脉弦。

②寒湿凝滞型。由于经前或经期受寒或冒雨，或吃寒凉的食物，导致寒湿藏于胞中，血液凝滞，气失温化，血行不畅导致痛经。临床症状：下腹部坠痛，得热则减，经血颜色黯淡，有血块，患者面白，四肢发冷，肢体无力，舌头黯淡，舌苔发白，脉沉。