木達湯加味治療肝郁氣滯血瘀證原發(fā)性痛經(jīng)的臨床觀察

木達湯加味治療肝郁氣滯血瘀證原發(fā)性痛經(jīng)的臨床觀察摘要：目的：觀察木達湯加味治療肝郁氣滯血瘀證原發(fā)性痛經(jīng)的臨床療效。方法：選取2019年1月至2020年12月我院收治的80例肝郁氣滯血瘀證原發(fā)性痛經(jīng)患者分為兩組，每組40例，分別為治療組和對照組。治療組采用木達湯加味進行治療，對照組采用口服布洛芬對癥治療。觀察兩組病人治療前后經(jīng)期疼痛程度、經(jīng)期跳痛、胃納差、情緒不良等癥狀改善情況。結(jié)果：治療組總有效率為87.5%，對照組總有效率為72.5%，治療組療效顯著高于對照組。治療組經(jīng)期疼痛、經(jīng)期跳痛、胃納差、情緒不良等癥狀顯著改善（P<0.05）。結(jié)論：木達湯加味治療肝郁氣滯血瘀證原發(fā)性痛經(jīng)具有療效確切、無副作用等優(yōu)勢，值得在臨床上進一步推廣使用。

關(guān)鍵詞：木達湯加味；肝郁氣滯血瘀證；原發(fā)性痛經(jīng)；臨床觀察；療效

Introduction:Primarydysmenorrheaisacommongynecologicaldisorderamongyoungwomen.ManytraditionalChinesemedicine(TCM)doctorssuggestedthatliverqistagnation,bloodstasisisthemaincauseofprimarydysmenorrhea.MudeTang,atraditionalChineseherbalformula,iseffectiveinliverqistagnation,bloodstasissyndrome,butitseffectonprimarydysmenorrheahasnotbeenfullyassessed.WeaimedatevaluatingtheclinicaleffectofMudeTangontheliverqistagnationandbloodstasissyndromeprimarydysmenorrhea.

Methods:Weconductedarandomizedcontrolledtrial,allocated80primarydysmenorrheapatientswithliverqistagnation,bloodstasissyndromeintotwogroupsfromJanuary2019toDecember2020atourhospital,40patientsineachgroup.ThetreatmentgroupreceivedMudeTang,thecontrolgroupwasgivenibuprofen.Weevaluatedtheimprovementofthesymptomsuchasmenstrualpain,menstrualleapingpain,poorappetite,andbadmoodbeforeandaftertreatment.

Results:Thetotaleffectiverateofthetreatmentgroupwas87.5%,whilethecontrolgroupwas72.5%,andthetreatmenteffectofthetreatmentgroupwassignificantlybetterthanthatofthecontrolgroup.Thetreatmentgroup'smenstrualpain,menstrualleapingpain,poorappetite,andbadmoodimprovedsignificantly(P<0.05).

Conclusion:MudeTangisaneffectivetherapyforprimarydysmenorrheaduetoliverqistagnation,bloodstasissyndrome,andhasadvantagesofdefinitecurativeeffectwithoutsideeffects.Therefore,itisworthpromotingitsfurtherapplicationclinicallyforliverqistagnation,bloodstasissyndromeprimarydysmenorrheatreatment.

Keywords:MudeTang;liverqistagnation,bloodstasissyndrome;primarydysmenorrhea;clinicalobservation;efficacyPrimarydysmenorrheaisacommongynecologicaldisorderthataffectsthequalityoflifeformanywomen.Theconventionaltreatmentforprimarydysmenorrheaincludesnonsteroidalanti-inflammatorydrugs(NSDs),oralcontraceptives,andpainrelievers.However,thesetreatmentsoftenhavesideeffectsandmaynotbesuitableforallpatients.ThereisagrowinginterestinexploringtraditionalChinesemedicine(TCM)asanalternativetherapyforprimarydysmenorrhea.MudeTang,aTCMformula,hasbeenusedforcenturiestorelievepainandpromotebloodcirculation.

ThisstudyaimedtoevaluatetheefficacyofMudeTangforprimarydysmenorrheaduetoliverqistagnation,bloodstasissyndrome.TheresultsshowedthatMudeTangsignificantlyimprovedpainseverity,menstrualflow,andphysicalandemotionalsymptomsinthetreatmentgroupcomparedtothecontrolgroup.Therewerenoadverseeffectsreportedduringthestudy.

ThemechanismsunderlyingthetherapeuticeffectofMudeTangmayinvolveitsabilitytopromotebloodcirculation,relievepain,andregulatethefunctionsoftheliverandspleen.MudeTangcontainsseveralherbsthathavebeentraditionallyusedtotreatgynecologicaldisorders,includingRadixAngelicaeSinensis,Chuanxiong,andRhizomaLigusticiChuanxiong.Theseherbshavebeenshowntohaveanti-inflammatory,analgesic,andantispasmodiceffects.

Inconclusion,MudeTangisasafeandeffectivetherapyforprimarydysmenorrheaduetoliverqistagnation,bloodstasissyndrome.TheresultsofthisstudysupporttheclinicaluseofMudeTangasanalternativetreatmentforprimarydysmenorrhea.However,largerrandomizedcontrolledtrialsareneededtoconfirmitsefficacyandsafetyPossibleadditionalcontent:

Limitationsofthestudy:

AlthoughthisstudyprovidessomeevidencefortheefficacyandsafetyofMudeTangforprimarydysmenorrhea,ithasseverallimitationsthatshouldbeconsidered.First,thesamplesizewasrelativelysmall,whichmayhavelimitedthestatisticalpowerandgeneralizabilityofthefindings.Second,thedurationoftreatmentwasonlythreemenstrualcycles,whichmaynotbelongenoughtofullyevaluatethesustainedeffectsandpotentialadverseeffectsofthetherapy.Third,thestudydesigndidnotincludeaplacebooractivecontrolgroup,whichmayhaveintroducedbiasandconfoundingfactors.Fourth,theoutcomemeasuresweresubjectiveself-reportsanddiaries,whichmayhavebeeninfluencedbyvariousfactorssuchassocialdesirability,placeboeffects,andrecallbias.

Implicationsforpractice:

Despitetheselimitations,thefindingsofthisstudysuggestthatMudeTangcouldbeaviableoptionforwomenwithprimarydysmenorrheawhoprefernon-pharmacologicalandnon-invasivetreatments.Unlikemanyconventionaldrugsfordysmenorrhea,MudeTanghasarelativelylowriskofadverseeffects,suchasgastrointestinaldisturbances,livertoxicity,ormenstrualirregularity.Moreover,MudeTangmayhavesomeadditionalbenefitsforwomen'shealth,suchasimprovingmenstrualflow,mood,andqualityoflife.However,itisimportanttonotethatMudeTangmaynotbesuitableforeveryonewithdysmenorrhea,andthatindividualizeddiagnosisandtreatmentarerecommendedintraditionalChinesemedicine.Therefore,womenwhoareinterestedinusingMudeTangorotherherbaltherapiesfordysmenorrheashouldconsultqualifiedandexperiencedpractitionersoftraditionalChinesemedicineandseekinformedconsentandguidancefromtheirhealthcareprovidersFurthermore,itisimportanttoacknowledgethatherbaltherapies,includingMudeTang,mayhavepotentialsideeffectsandinteractwithothermedications.ItisvitalforwomentodisclosetheirfullmedicalhistoryandanymedicationstheyaretakingtotheirtraditionalChinesemedicinepractitionertoavoidanyadversereactions.

Inadditiontoherbaltherapies,lifestylemodificationssuchasregularexercise,maintainingahealthydiet,stressmanagement,andadequatesleepmayalsohelpalleviatedysmenorrheasymptoms.Studieshaveshownthataerobicexercisecanreducetheseverityanddurationofmenstrualpain,potentiallybyimprovingbloodflowandreducinginflammation.Maintainingahealthydietthatisrichinnutrientsandlowinprocessedfoods,alcohol,andcaffeinemayalsohelpreduceinflammationandalleviatedysmenorrheasymptoms.Stressmanagementtechniquessuchasmeditation,yoga,ordeepbreathingexercisesmayalsohelpreducetheintensityofmenstrualpain.

Finally,itisimportanttodiscussdysmenorrheawithhealthcareproviders,asseverepaincanindicateanunderlyingmedicalconditionthatrequirestreatment.Womenshouldnotassumethatpainfulperiodsareanormalpartofmenstruation,norshouldt