琥珀散治療原發性痛經之研究

Study of Primary Dysmenorrhea Treatment by Hu-Po-San

本文為琥珀散治療原發性痛經的中醫辨證研究，研究對象為中國醫藥學院中醫婦科門診痛經病人計 19 位，其中 13 位完成治療，對照組為正常無痛經的婦人 6 位。中醫臨床辨證分五種類型，痛經評分依據 1982 年 Andersch和 Milson 所訂定的痛經評分表(Verbal multidimensional scoringsystem，VMDSS)以評估琥珀散治療前後經血和血清中前列腺素PGF2α、PGE2。結果顯示，19名痛經患者 VMDSS 評分屬第一、二級痛經有十位，其中氣滯血瘀佔70%，寒濕凝滯佔 10%，濕熱瘀阻佔 10%，肝腎虧損佔 10%；屬第三級痛經有九位，其中氯滯血瘀55.6%，寒濕凝滯佔 22.2%，氣血虛弱佔22.2%。治療組未服藥與服藥後琥珀散組和安慰劑組 VMDSS 評分，經檢定顯示未服藥與琥珀散組比較有統計學意義(p<0.05)，未服築與安慰劑組比較無顯著差異，表示沒有安慰劑作用。比較治療組的各項指標變化，經血中的PGF2α在琥珀散與安慰劑療程有顯著差異，而經血中的PGF2和血漿中PGF2α在兩次潦程無顯著差異。以VMDSS評分將治療組分為輕申度痛經組和重度痛經組，結果顯示，輕中度痛經患者，使用唬珀散與安慰劑兩種治療，週期經血中PGF2α和PGF2濃度皆無顯著差異；重度痛經患者琥珀散治療週期經血中PGF2α濃度降低(p<0.05)，而PGF2濃度變化沒有影響。

The purpose of the present was to investigate the therapeutic effect of Hu-Po-San(Amber Power) on treating primary dysmenorrhea. The subjects were 19 dysmenorrhea patients from the department of Chinese gynecological medicine in China medical college hospital. Among of them thirteen is finished the therapy for dysmenorrhea. All the patients were divided into five Chinese medical disease patterns. The dysmenorrhea scoring system is according to the Verbal multidimensional scoring system (VMDSS) by Andersch and Milson in 1982. The PGF ?砠\ and PGE ?? levels change in menstrual blood and plasma were evaluated after and before treatment. The results demonstrated thatamong often dysmenorrhea patients belonging to first and second de- gree in the VMDSS, the percentage of qistagnation(qi zhi) and blood stasis(xue yu) type.is 70%, con- cealing cold-damp type is 1O%, damp-heat stasis(shire yu zu) and obstruction type is 10%1, and liver and kidney yin vacuity(gan shen yin xu) is 10%. 55.6% of Nine dysmenorrhea patients belonging to third degree in the VMDSS was the qi stagnation and blood stasis type, 22.2% was the concealing cold- damp type and 22.2% was the vacuity of qi and blood type. Comparison before and after treatUnent showed that Hu-Po-San group was significantly different than before treatment, but placebo group was not sig- nificant The PGF ?砠\ levels change of menstrual blood, the Hu-Po-San group was significantly different than the placebo group. The change of PGE ?? levels in the menstrual blood and PGF ?砠levels in the plasma, the Hu-Po-San group was not significantly different than the placebo group. The PGE ?? and PGF ?砠\ levels change in the menstrual blood, whose belonging to the first and second degree group in the VMDSS, the Hu-Po-San group was not significantly different than the placebo group. The PGF ?砠levels change in the menstrual blood, whose belonging to the third degree group in the VMDSS, the Hu- Po-San group was significantly different from the placebo group, and the PGE ?? levels in the menstrual blood /was on change.