Zhongguo quanke yixue (Jun 2022)
Clinical Efficacy of Compound Daxueteng Enema plus Dydrogesterone in Post-laparoscopic Adenomyosis Patients with Blood Stasis-heat Syndrome
Abstract
Background Adenomyosis is a difficult-to-treat gynecological disease with unclear pathogenesis, individualized treatment for which is extensively valued, and the integrated traditional Chinese and western medicine treatment has been proven to have unique benefits merits. Objective To examine the clinical efficacy of compound Daxueteng enema plus dydrogesterone for post-laparoscopic adenomyosis patients with blood stasis-heat syndrome. Methods Participants (n=46) were selected from Zhejiang Provincial Hospital of Chinese Medicine during January 2019 to August 2020. All of them received laparoscopic surgery, and were diagnosed with adenomyosis by pathological examination of the surgical specimen, and with blood stasis-heat syndrome by TCM syndrome differentiation. For comparing the effects of two types of postsurgical treatments lasting for three months, they were randomized into a control group (n=22) and a treatment group (n=24) , receiving oral dydrogesterone, and oral dydrogesterone plus compound Daxueteng enema, respectively. TCM syndrome score, pain level (VAS score) , menstrual blood loss (PBAC score) , uterine volume, ovarian function parameters and serum CA125 were measured at baseline and the end of the three-month treatment. The overall efficacies of two groups were assessed at the end of treatment, and one year after the treatment, respectively. Results The treatment group had statistically higher overall three-month efficacy than the control group (u=2.140, P=0.032) . TCM syndrome score of the treatment group were lower than the control group (P<0.05) . After treatment, the VAS score, PBAC score uterine volume, LH, E2 and CA125 showed a statistical decrease in both groups (P<0.05) . And the VAS score, uterine volume, demonstrated decreases, LH and CA125 demonstrated better improvements in the treatment group than the control group (P<0.05) . One-year post-treatment follow-up revealed that treatment group and control group had no statistically significant differences in recurrence rate〔20.8% (5 cases) vs 45.5% (10 cases) 〕 (χ2=3.166, P>0.05) , and pregnancy rate〔8.3% (2 cases) vs 9.1% (2 cases) 〕 (χ2=0.008, P>0.05) . Conclusion Oral dydrogesterone plus compound Daxueteng enema may be superior to oral dydrogesterone alone for post-laparoscopic adenomyosis patients with blood stasis-heat syndrome.
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