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桂枝茯苓丸治疗原发性痛经的随机对照试验。

Effect of Guizhi Fuling Wan in primary dysmenorrhea: A randomized controlled trial.

机构信息

Third-Grade Pharmacological Laboratory on Chinese Medicine Approved By State Administration of Traditional Chinese Medicine, College of Medical and Health Science, China Three Gorges University, Yichang, Hubei, 443302, China.

The Second People's Hospital of Yichang & the Second People's Hospital of China Three Gorges University, Yichang, Hubei, 443302, China.

出版信息

J Ethnopharmacol. 2023 May 10;307:116247. doi: 10.1016/j.jep.2023.116247. Epub 2023 Feb 4.

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE

Guizhi Fuling Wan (GFW) is one of the most widely known traditional Chinese medicine (TCM) formulations that has long been used in China for the treatment of primary dysmenorrhea (PD). However, the quality of evidence is limited and there are few studies on specific TCM syndromes of GFW for PD.

AIM OF THE STUDY

To evaluate the efficacy and safety of GFW on PD patients with the heat-burning blood-stasis syndrome.

MATERIALS AND METHODS

This was a randomized, double-blinded, placebo-controlled trial. Eligible patients were recruited and randomly assigned to one of two groups to receive GFW or the placebo twice daily for three menstrual cycles with a 3-month follow-up. The primary outcome was the baseline-to-month 6 change in pain intensity measured by a Visual Analog Scale (VAS). The secondary outcomes included the changes in the Cox Menstrual Symptom Scale (CMSS), the Self-rating Anxiety Scale (SAS), the Self-rating Depression Scale (SDS), and the TCM syndrome scale from baseline to month 6. Additionally, adverse effect was assessed.

RESULTS

A total of 353 patients were screened for eligibility and 128 were randomly assigned, of whom 121 completed all treatments and follow-ups. In both the full analysis (FAS) and the per-protocol analysis (PPS), the VAS score of pain intensity decreased significantly more in the GFW group than in the placebo group from baseline to month 6 (P < 0.01). Similarly, the decrease in CMSS, SAS and TCM syndrome scores was greater in the GFW group compared with the placebo group (P < 0.01). There were no differences in SDS scores between the two groups (P > 0.05). In addition, no serious adverse events were observed.

CONCLUSION

Our findings revealed that GFW significantly alleviated the severity of menstrual pain in PD patients with the heat-burning blood-stasis syndrome without significant adverse effects.

摘要

民族药理学相关性

桂枝茯苓丸(GFW)是一种广为人知的中药方剂,在中国长期用于治疗原发性痛经(PD)。然而,证据质量有限,且关于 GFW 治疗 PD 的特定中医证候的研究较少。

研究目的

评估 GFW 对伴有热灼血瘀证的 PD 患者的疗效和安全性。

材料和方法

这是一项随机、双盲、安慰剂对照试验。合格的患者被招募并随机分为两组,分别接受 GFW 或安慰剂,每天两次,连续三个月经周期,并进行 3 个月的随访。主要结局是通过视觉模拟量表(VAS)测量的基线至第 6 个月疼痛强度的变化。次要结局包括 Cox 月经症状量表(CMSS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)和中医证候量表从基线到第 6 个月的变化。此外,还评估了不良反应。

结果

共有 353 名患者接受了筛选,其中 128 名符合条件并被随机分配,其中 121 名完成了所有治疗和随访。在全分析集(FAS)和符合方案分析集(PPS)中,从基线到第 6 个月,GFW 组的疼痛强度 VAS 评分显著低于安慰剂组(P<0.01)。同样,GFW 组的 CMSS、SAS 和中医证候评分下降幅度也大于安慰剂组(P<0.01)。两组的 SDS 评分无差异(P>0.05)。此外,未观察到严重不良事件。

结论

我们的研究结果表明,GFW 可显著减轻伴有热灼血瘀证的 PD 患者的月经痛严重程度,且无明显不良反应。

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