Treatment Of Cold Clotting And Blood Stasis Type By Combining Shao Abdominal Expelling Stasis Tang With Leuprolide Acetate Clinical Efficacy Of Adenomyosis Of The Uterus

Objective: This clinical study used the combination of Shao Abdominal Expelling Stasis Tang and leuprolide acetonate in the study of cold-coagulation and stasis of blood type adenomyosis.By using comparative observational and mathematical analysis of the changes of efficacy index before and after treatment,such as Chinese medicine signs and symptoms score,serum CA125 level,uterine volume(unit: cm3)and dysmenorrhea degree score,the clinical efficacy and safety of this treatment were evaluated to provide a new way of thinking for the combination of Chinese medicine with western medicine in adenomyosis.The treatment of adenomyosis with western medicine combined with traditional Chinese Medicine provides new thinking.Methods: Sixty-six Patients who were eligible for the type of uterine glandular myopathy with cold stagnation and blood stasis and who were consulted at the gynecology and obestructive departments of Gansu Provincial Hospital of traditional Chinese medicines and the hospital of the Hospital of Gansu University of Traditional Chinese Medicine from between December 2021 and December 2022 were selected and divided into observation and control groups according to the random control principle,with 33 each group.In the group of observation,oral dosage of Shao Guo Hua Yi Yu Tang(granules)was given from day 15 of the Menstrual cycle until day 2 of the next cycle.Then on the 3rd day of period cycle,1injection of leuprolide acetate(same as the control group)was given in subcutaneous form,1shot/course of drug treatment,for a total of 3 menstrual cycles.(If the menopause occurred after the use of the Leuprolide acetate in both groups,the medication was administered according to the cycle of the original male period.)The relevant efficacy indexes were observed and recorded before and after the treatment in both groups: Chinese medicine symptoms score,dysmenorrhea degree score,uterus volume(cm3),serum CA125 concentration,and safety observation.The clinically collected data were statistically examined by each test using the use of statistical software SPSS22.0 and Graph Pad Prism 8.Results:1.The group comparison between the two groups of pre-treatment patients in terms of TCM evidence integral,dysmenorrhea degree integral,uterine volume(cm3),and serum CA125 level were all p > 0.05,indicating that the observation and control groups were comparable before treatment.2.After three therapies,the in-group compared of the TCM syndrome score,the dysmenorrhea degree score,Uterus(cm3)volume and serum CA125 level in both groups were all P < 0.05,which was found to be statistical significant,which indicated that the clinical symptoms related to cold-clotting and blood-stasis adenomyosis could be improved by the treatment methods in both the Observer and Control groups.3.After three sessions of treatments in both groups,the intra-group differences in the TCM evidence score and the dysmenorrhea degree score were statistical and significant at P < 0.05,suggesting that the observation group was better than the control group in improving cold fear,cold extremities,purple and dark tongue,lower abdominal pain,and relieving the dysmenorrhea degree.4.After three courses of therapy,the total effective rate of the two groups was 86.6% in the TCM symptom efficacy observation group and 56.6% In the control group,P < 0.05;the dysmenorrhea degree efficacy was 90.00% in the observational group and 56.67% in the control group,P < 0.05;the comparison was statistically important,and the efficacy of the observation group was significantly better than that of that of the control group.The efficacy of the observation group was significantly better than that of the control group.5.During the treatment period,the total number of patients with adverse reactions such as hot flushes and night sweating,abscess of vulva,vaginal dryness,loss of sleep,unstable mood,glaucoma,muscular pain and nausea in the observation group was less than the total number of patients with negative effects in the control group,with good safety.Conclusion: The therapy of adenomyosis with cold and blood clots and blood stasis combined with leuprolide acetate was significantly better than leuprolide acetate only in improving TCM syndrome and easing the dysmenorrhea degree;it was comparable to the application of the acid leuprolide hydrochloride microspheres alone in reducing the uterine volume and improving the serum CA125 level;it was less effective in the occurrence of adverse reactions than the total number of patients who experienced adverse reactions with leuprolide acetate alone.The effectiveness and safety of this therapy are remarkable and worth promoting.