蓉归化瘀汤联合地诺孕素治疗肾虚血瘀型子宫腺肌症随机对照研究OA

Objective To study the clinical efficacy of Ronggui Huayu Decoction(RHD)with dienogest(DNG)in treatment of adenomyosis(AM)patients with Shen deficiency blood stasis syndrome(SDBSS).Methods The 140 patients with SDBSS type AM,all treated at the Gynecology Department of Jiangsu Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January to June 2024,met the inclusion criteria.Totally 134 cases were randomly assigned to either the control group or the experimental group using a random number table method,67 patients in each group.Patients in the control group took DNG 2 mg per day,while those in the test group additionally took RHD,400 mL per day.The therapeutic course for all was 3 months.The primary efficacy indicators included dysmenorrhoea score,menstrual volume score,Chinese medicine(CM)syndrome score,and uterine volume.The secondary efficacy indicators included intimal thickness,arterial blood flow parameters and the contents of serum carbohydrate antigen 125(CA125),serum creatine kinase-MM(CK-MM),and soluble human leukocyte antigen-G(sHLA-G).Adverse reactions in each group were observed.Results Compared with before treatment in the same group,the dysmenorrhoea scores,menstrual volume scores,CM syndrome scores,uterine volume,intimal thickness,arterial flow parameters,and serological indicators decreased in the two groups after treatment(P＜0.01).Compared with the control group after treatment,the dysmenorrhoea score,menstrual volume score,CM syndrome score,uterine volume,intimal thickness,arterial blood flow parameters,and serum levels of CA125,CK-MM,sHLA-G in the test group were all lower than those in the control group(P＜0.01).The incidence of adverse reactions in the test group was lower than those of the control group(P＜0.01).Conclusion Treatment of AM patients with SDBSS by DNG+RHD improved clinical symptoms such as dysmenorrhea and excessive menstrual flow,decreased CM syndrome score,uterine volume,the thickness of the endometrium,arterial blood flow parameters,and the expression of serum markers,and also reduced adverse reactions such as irregular vaginal bleeding and hectic fever caused by dienogest.