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Article(id=1322923880846860779, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.06.018, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339231931, onlineDateStr=2026-10-30, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339231931, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339231931, creator=13701087609, updateTime=1793339231931, updator=13701087609, issue=Issue{id=1322923782029062261, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='6', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1749484800000', pubDateStr='2025-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339208371, creator='13701087609', updateTime=1793340556755, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929437859258468, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929437859258469, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=100, endPage=103, ext={EN=ArticleExt(id=1322923881031410156, articleId=1322923880846860779, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Clinical Analysis of Danggui Shaoyao Powder（当归芍药散）Assisted by Massage along Meridian on Patients with Chronic Pelvic Pain and Pelvic Floor Rehabilitation of Qi Deficiency and Blood Stasis Type, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the clinical effect of Danggui Shaoyao Powder（当归芍药散）assisted by massage along meridian on pelvic floor rehabilitation of chronic pelvic pain with Qi deficiency and blood stasis.

Methods

One hundred and twelve patients with chronic pelvic pain of Qi deficiency and blood stasis were enrolled in the hospital from January 2021 to June 2022.They were randomly divided into the study group（56 cases）and the control group（56 cases）.Both groups received pelvic floor rehabilitation intervention and massage along the meridian，and the study group was given Danggui Shaoyao Powder orally.The treatment of both groups lasted for 12 weeks.The clinical symptom score，pain visual analogue scale（VAS），pelvic floor resting potential and quality of life of the two groups were compared before and after treatment，and the clinical efficacy of the two groups was evaluated.

Results

After 12 weeks of treatment，the symptom scores of lower abdominal pain，lumbosacral pain，abnormal leukorrhagia，aggravation after fatigue and mental fatigue in the two groups decreased，and the rest potential of pelvic floor decreased before and after treatment，and the scores of various dimensions of quality of life increased.After 12 weeks'treatment，the scores of clinical symptoms and resting potential before and after pelvic floor in the study group were lower than those in the control group，and the scores of quality of life in all dimensions were higher than those in the control group，with statistical significance（P<0.05）.After 1，4，8 and 12 weeks of treatment，the VASscores of the two groups decreased compared with those before treatment，and the VASscores of the study group were lower than those of the control group at all time points after treatment with statistical significance（P<0.05）.After 12 weeks of treatment，the total clinical effective rate in the study group was 92.86%，which was higher than that in the control group（76.79%），and the difference was statistically significant（P<0.05）.

Conclusion

On the basis of pelvic floor rehabilitation and massage along meridians，Danggui Shaoyao Powder can further improve patients'clinical symptoms，relieve pain and regulate pelvic floor resting potential，which is of positive significance for improving patients'quality of life and clinical efficacy.

, authors=Yan CHEN, Liqun YE, Chen YANG, Chunhua WANG, Hongbo FENG, Shuzhen ZHENG, authorsList=Yan CHEN, Liqun YE, Chen YANG, Chunhua WANG, Hongbo FENG, Shuzhen ZHENG, authorCompany=null, correspAuthors=Liqun YE, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923884684648959, articleId=1322923880846860779, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=当归芍药散辅以循经按摩对气虚血瘀型慢性盆腔痛盆底康复患者疗效分析, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

分析当归芍药散辅助循经按摩对气虚血瘀型慢性盆腔痛盆底康复患者临床疗效。

方法

纳入医院2021年1月—2022年6月收治的112例气虚血瘀型慢性盆腔痛患者，使用简单随机法分别纳入研究组（56例）、对照组（56例），两组均接受盆底康复干预及循经按摩，研究组加用当归芍药散口服；两组治疗均持续12周。对比两组治疗前后临床症状积分、疼痛视觉模拟评分（visual analogue scale，VAS）、盆底静息电位、生活质量变化，并评估两组临床疗效。

结果

两组治疗12周后下腹疼痛、腰骶疼痛、带下异常、劳累后加重、神疲乏力症状积分，盆底前后静息电位均较治疗前下降，生活质量各维度评分均较治疗前升高；研究组治疗12周后各项临床症状积分、盆底前后静息电位均低于对照组，其生活质量各维度评分均高于对照组，差异有统计学意义（P<0.05）。两组治疗1周、4周、8周、12周后VAS评分均较治疗前下降，研究组治疗后各时点VAS评分均低于对照组，差异有统计学意义（P<0.05）。研究组治疗12周后临床总有效率为92.86%，高于对照组的76.79%，差异有统计学意义（P<0.05）。

结论

在盆底康复及循经按摩的基础上，应用当归芍药散能够进一步改善患者临床症状、减轻疼痛、调节盆底静息电位，对于提高患者生活质量及临床疗效有积极意义。

, authors=陈嫣, 叶利群, 杨晨, 王春华, 冯洪波, 郑书真, authorsList=陈嫣, 叶利群, 杨晨, 王春华, 冯洪波, 郑书真, authorCompany=null, correspAuthors=叶利群, authorNote=

陈嫣（1983-），女，浙江宁波人，副主任中医师，硕士，研究方向：盆底功能障碍性疾病。

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叶利群（1973-），女，浙江宁波人，主任中医师，硕士研究生导师，硕士，研究方向：中医妇科。E-mail：。
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陈嫣（1983-），女，浙江宁波人，副主任中医师，硕士，研究方向：盆底功能障碍性疾病。

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陈嫣（1983-），女，浙江宁波人，副主任中医师，硕士，研究方向：盆底功能障碍性疾病。

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Neurourology and Urodynamics，2021，40（6）：1609-1615., articleTitle=Pain and functionality improved when underlying neuromuscular dysfunction addressed in chronic pelvic pain patients, refAbstract=null), Reference(id=1322923893387829836, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, doi=null, pmid=null, pmcid=null, year=2022, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［18］, rfOrder=17, authorNames=王坤宁, journalName=null, refType=null, unstructuredReference=王坤宁. 大柴胡汤合当归芍药散加味治疗急性胰腺炎作用机制研究［D］. 天津：天津中医药大学，2022., articleTitle=大柴胡汤合当归芍药散加味治疗急性胰腺炎作用机制研究, refAbstract=null), Reference(id=1322923893845008973, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, doi=null, pmid=null, pmcid=null, year=2023, volume=20, issue=26, pageStart=148, pageEnd=151, url=null, language=null, rfNumber=［19］, rfOrder=18, authorNames=李泽惠, 杨洋, 刘南阳, journalName=中国医药导报, refType=null, unstructuredReference=李泽惠，杨洋，刘南阳，等. 李浩教授运用当归芍药散从“血虚水盛”论治脱发的经验［J］. 中国医药导报，2023，20（26）：148-151., articleTitle=李浩教授运用当归芍药散从“血虚水盛”论治脱发的经验, refAbstract=null), Reference(id=1322923894293799502, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, doi=null, pmid=null, pmcid=null, year=2022, volume=41, issue=6, pageStart=648, pageEnd=650, url=null, language=null, rfNumber=［20］, rfOrder=19, authorNames=闵潇, journalName=北京中医药, refType=null, unstructuredReference=闵潇. 当归芍药散治疗慢性前列腺炎的探讨与发微［J］. 北京中医药，2022，41（6）：648-650., articleTitle=当归芍药散治疗慢性前列腺炎的探讨与发微, refAbstract=null), Reference(id=1322923894767755855, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, doi=null, pmid=null, pmcid=null, year=2020, volume=41, issue=2, pageStart=215, pageEnd=217, url=null, language=null, rfNumber=［21］, rfOrder=20, authorNames=李丽, 黄帅, 陆立, journalName=广东医学, refType=null, unstructuredReference=李丽，黄帅，陆立，等. 当归芍药散联合生物反馈治疗功能性肛门直肠痛的疗效［J］. 广东医学，2020，41（2）：215-217., articleTitle=当归芍药散联合生物反馈治疗功能性肛门直肠痛的疗效, refAbstract=null), Reference(id=1322923895061357136, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, doi=null, pmid=null, pmcid=null, year=2023, volume=45, issue=9, pageStart=3155, pageEnd=3158, url=null, language=null, rfNumber=［22］, rfOrder=21, authorNames=宋春荣, 席奇, 刘永刚, journalName=中成药, refType=null, unstructuredReference=宋春荣，席奇，刘永刚，等. 当归芍药散加味联合甘遂臌胀贴对血瘀水停证乙肝肝硬化腹水患者的临床疗效［J］. 中成药，2023，45（9）：3155-3158., articleTitle=当归芍药散加味联合甘遂臌胀贴对血瘀水停证乙肝肝硬化腹水患者的临床疗效, refAbstract=null), Reference(id=1322923895233323601, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, doi=null, pmid=null, pmcid=null, year=2022, volume=38, issue=12, pageStart=2243, pageEnd=2246, url=null, language=null, rfNumber=［23］, rfOrder=22, authorNames=张明月, 李丽琦, journalName=实用中医药杂志, refType=null, unstructuredReference=张明月，李丽琦. 当归芍药散临床应用研究进展［J］. 实用中医药杂志，2022，38（12）：2243-2246., articleTitle=当归芍药散临床应用研究进展, refAbstract=null), Reference(id=1322923895480787538, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, doi=null, pmid=null, pmcid=null, year=2022, volume=40, issue=12, pageStart=130, pageEnd=133, url=null, language=null, rfNumber=［24］, rfOrder=23, authorNames=尤雪莲, 梁晨, 李杨, journalName=四川中医, refType=null, unstructuredReference=尤雪莲，梁晨，李杨. 补阳还五汤联合芍药甘草汤加减治疗脑梗死后遗症对患者肢体运动功能恢复及生活质量的影响［J］. 四川中医，2022，40（12）：130-133., articleTitle=补阳还五汤联合芍药甘草汤加减治疗脑梗死后遗症对患者肢体运动功能恢复及生活质量的影响, refAbstract=null), Reference(id=1322923897192063571, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, doi=null, pmid=null, pmcid=null, year=2020, volume=35, issue=23, pageStart=3796, pageEnd=3798, url=null, language=null, rfNumber=［25］, rfOrder=24, authorNames=唐春梅, 唐文富, journalName=光明中医, refType=null, unstructuredReference=唐春梅，唐文富. 当归芍药散方论及其在急性胰腺炎中的临床运用［J］. 光明中医，2020，35（23）：3796-3798., articleTitle=当归芍药散方论及其在急性胰腺炎中的临床运用, refAbstract=null), Reference(id=1322923897338864212, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, doi=null, pmid=null, pmcid=null, year=2021, volume=30, issue=9, pageStart=1344, pageEnd=1351, url=null, language=null, rfNumber=［26］, rfOrder=25, authorNames=CARRUBBA A R, EBBERT J O, SPAULDING A C, journalName=Journal of Women's Health, refType=null, unstructuredReference=CARRUBBA A R，EBBERT J O，SPAULDING A C，et al. Use of cannabis for self-management of chronic pelvic pain［J］. Journal of Women's Health，2021，30（9）：1344-1351., articleTitle=Use of cannabis for self-management of chronic pelvic pain, refAbstract=null)], funds=[Fund(id=1322923889973666360, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, awardId=GZY-ZJ-KJ-Z3090, language=CN, fundingSource=国家中医药管理局科技司-浙江省中医药管理局共建科技计划项目(GZY-ZJ-KJ-Z3090), fundOrder=null, country=null), Fund(id=1322923890061746745, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, awardId=2021S159, language=CN, fundingSource=宁波市公益类科技计划项目(2021S159), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322923884927918592, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, xref=null, ext=[AuthorCompanyExt(id=1322923884936307201, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, companyId=1322923884927918592, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Ningbo Municipal Hospital of Traditional Chinese Medicine，Affiliated Hospital of Zhejiang Chinese Medical University，Ningbo 315000，Zhejiang，China), AuthorCompanyExt(id=1322923884948890114, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, companyId=1322923884927918592, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=浙江中医药大学附属宁波市中医院，浙江 宁波 315000)])], figs=[ArticleFig(id=1322923889017365036, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数年龄/（岁±s）病程/（年±s）月经周期/（d±s）婚姻状态/［例（%）］
已婚其他
研究组5634.85±5.322.81±0.5329.59±2.6338（67.86）18（32.14）
对照组5635.17±5.162.69±0.4929.71±2.4540（71.43）16（28.57）
t/χ2值-0.3231.2440.2500.169
P值-0.7470.2160.8030.681
), ArticleFig(id=1322923889092862509, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, language=CN, label=表1, caption=

两组慢性盆腔痛患者基线临床资料比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数年龄/（岁±s）病程/（年±s）月经周期/（d±s）婚姻状态/［例（%）］
已婚其他
研究组5634.85±5.322.81±0.5329.59±2.6338（67.86）18（32.14）
对照组5635.17±5.162.69±0.4929.71±2.4540（71.43）16（28.57）
t/χ2值-0.3231.2440.2500.169
P值-0.7470.2160.8030.681
), ArticleFig(id=1322923889168359982, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时期下腹疼痛腰骶疼痛带下异常劳累后加重神疲乏力
研究组56治疗前4.76±0.324.13±0.682.83±0.332.85±0.293.14±0.35
治疗12周后2.08±0.25*1.66±0.17*1.13±0.22*1.26±0.21*1.34±0.19*
对照组56治疗前4.68±0.404.09±0.552.89±0.342.87±0.313.22±0.39
治疗12周后2.57±0.33*#2.19±0.22*#1.95±0.17*#1.77±0.26*#2.03±0.25*#
), ArticleFig(id=1322923889239663151, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, language=CN, label=表2, caption=

两组慢性盆腔痛患者临床症状积分变化比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时期下腹疼痛腰骶疼痛带下异常劳累后加重神疲乏力
研究组56治疗前4.76±0.324.13±0.682.83±0.332.85±0.293.14±0.35
治疗12周后2.08±0.25*1.66±0.17*1.13±0.22*1.26±0.21*1.34±0.19*
对照组56治疗前4.68±0.404.09±0.552.89±0.342.87±0.313.22±0.39
治疗12周后2.57±0.33*#2.19±0.22*#1.95±0.17*#1.77±0.26*#2.03±0.25*#
), ArticleFig(id=1322923889315160624, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗1周后治疗4周后治疗8周后治疗12周后
研究组565.62±0.813.11±0.36*2.34±0.23*1.68±0.19*1.23±0.22*
对照组565.74±0.694.07±0.48*3.25±0.46*2.47±0.25*1.78±0.31*
t值-0.84411.97313.24118.82710.827
P值-0.401<0.001<0.001<0.001<0.001
), ArticleFig(id=1322923889373880881, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, language=CN, label=表3, caption=

两组慢性盆腔痛患者VAS评分变化比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗1周后治疗4周后治疗8周后治疗12周后
研究组565.62±0.813.11±0.36*2.34±0.23*1.68±0.19*1.23±0.22*
对照组565.74±0.694.07±0.48*3.25±0.46*2.47±0.25*1.78±0.31*
t值-0.84411.97313.24118.82710.827
P值-0.401<0.001<0.001<0.001<0.001
), ArticleFig(id=1322923889457766962, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时期盆底前静息电位盆底后静息电位
研究组56治疗前9.19±0.7610.17±1.25
治疗12周后4.62±0.58*4.88±0.73*
对照组56治疗前9.27±0.8110.09±1.34
治疗12周后5.47±0.62*#5.90±0.83*#
), ArticleFig(id=1322923889537458739, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, language=CN, label=表4, caption=

两组慢性盆腔痛患者盆底静息电位变化比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时期盆底前静息电位盆底后静息电位
研究组56治疗前9.19±0.7610.17±1.25
治疗12周后4.62±0.58*4.88±0.73*
对照组56治疗前9.27±0.8110.09±1.34
治疗12周后5.47±0.62*#5.90±0.83*#
), ArticleFig(id=1322923889608761908, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时期生理健康心理健康社会关系躯体功能
研究组56治疗前6.47±0.447.61±0.588.24±0.477.39±0.40
治疗12周后13.76±1.25*14.48±2.36*15.29±2.63*14.91±2.19*
对照组56治疗前6.55±0.397.62±0.578.29±0.387.41±0.52
治疗12周后10.25±1.13*#12.06±2.25*#13.87±2.41*#12.36±1.77*#
), ArticleFig(id=1322923889671676469, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, language=CN, label=表5, caption=

两组慢性盆腔痛患者生活质量评分变化比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时期生理健康心理健康社会关系躯体功能
研究组56治疗前6.47±0.447.61±0.588.24±0.477.39±0.40
治疗12周后13.76±1.25*14.48±2.36*15.29±2.63*14.91±2.19*
对照组56治疗前6.55±0.397.62±0.578.29±0.387.41±0.52
治疗12周后10.25±1.13*#12.06±2.25*#13.87±2.41*#12.36±1.77*#
), ArticleFig(id=1322923889780728374, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治愈显效有效无效总有效
研究组5619（33.93）22（39.29）11（19.64）4（7.14）52（92.86）
对照组5612（21.43）15（26.79）16（28.57）13（23.21）43（76.79）
χ2值-----5.617
P值-----0.018
), ArticleFig(id=1322923889873003063, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923880846860779, language=CN, label=表6, caption=

两组慢性盆腔痛患者治疗12周后临床疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治愈显效有效无效总有效
研究组5619（33.93）22（39.29）11（19.64）4（7.14）52（92.86）
对照组5612（21.43）15（26.79）16（28.57）13（23.21）43（76.79）
χ2值-----5.617
P值-----0.018
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当归芍药散辅以循经按摩对气虚血瘀型慢性盆腔痛盆底康复患者疗效分析
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陈嫣 , 叶利群 , 杨晨 , 王春华 , 冯洪波 , 郑书真
中华中医药学刊 | 国家项目点击 2025,43(6): 100-103
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中华中医药学刊 |国家项目点击 2025 , 43 (6) : 100 -103
当归芍药散辅以循经按摩对气虚血瘀型慢性盆腔痛盆底康复患者疗效分析
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陈嫣, 叶利群 , 杨晨, 王春华, 冯洪波, 郑书真
作者信息
  • 浙江中医药大学附属宁波市中医院，浙江 宁波 315000
通讯作者:
叶利群（1973-），女，浙江宁波人，主任中医师，硕士研究生导师，硕士，研究方向：中医妇科。E-mail：。
作者简介:

陈嫣（1983-），女，浙江宁波人，副主任中医师，硕士，研究方向：盆底功能障碍性疾病。

Clinical Analysis of Danggui Shaoyao Powder（当归芍药散）Assisted by Massage along Meridian on Patients with Chronic Pelvic Pain and Pelvic Floor Rehabilitation of Qi Deficiency and Blood Stasis Type
Yan CHEN, Liqun YE , Chen YANG, Chunhua WANG, Hongbo FENG, Shuzhen ZHENG
Affiliations
  • Ningbo Municipal Hospital of Traditional Chinese Medicine，Affiliated Hospital of Zhejiang Chinese Medical University，Ningbo 315000，Zhejiang，China
出版时间: 2025-06-10 doi: 10.13193/j.issn.1673-7717.2025.06.018
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摘要
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目的

分析当归芍药散辅助循经按摩对气虚血瘀型慢性盆腔痛盆底康复患者临床疗效。

方法

纳入医院2021年1月—2022年6月收治的112例气虚血瘀型慢性盆腔痛患者，使用简单随机法分别纳入研究组（56例）、对照组（56例），两组均接受盆底康复干预及循经按摩，研究组加用当归芍药散口服；两组治疗均持续12周。对比两组治疗前后临床症状积分、疼痛视觉模拟评分（visual analogue scale，VAS）、盆底静息电位、生活质量变化，并评估两组临床疗效。

结果

两组治疗12周后下腹疼痛、腰骶疼痛、带下异常、劳累后加重、神疲乏力症状积分，盆底前后静息电位均较治疗前下降，生活质量各维度评分均较治疗前升高；研究组治疗12周后各项临床症状积分、盆底前后静息电位均低于对照组，其生活质量各维度评分均高于对照组，差异有统计学意义（P<0.05）。两组治疗1周、4周、8周、12周后VAS评分均较治疗前下降，研究组治疗后各时点VAS评分均低于对照组，差异有统计学意义（P<0.05）。研究组治疗12周后临床总有效率为92.86%，高于对照组的76.79%，差异有统计学意义（P<0.05）。

结论

在盆底康复及循经按摩的基础上，应用当归芍药散能够进一步改善患者临床症状、减轻疼痛、调节盆底静息电位，对于提高患者生活质量及临床疗效有积极意义。

当归芍药散  /  循经按摩  /  气虚血瘀  /  慢性盆腔痛  /  盆底康复
Objective

To analyze the clinical effect of Danggui Shaoyao Powder（当归芍药散）assisted by massage along meridian on pelvic floor rehabilitation of chronic pelvic pain with Qi deficiency and blood stasis.

Methods

One hundred and twelve patients with chronic pelvic pain of Qi deficiency and blood stasis were enrolled in the hospital from January 2021 to June 2022.They were randomly divided into the study group（56 cases）and the control group（56 cases）.Both groups received pelvic floor rehabilitation intervention and massage along the meridian，and the study group was given Danggui Shaoyao Powder orally.The treatment of both groups lasted for 12 weeks.The clinical symptom score，pain visual analogue scale（VAS），pelvic floor resting potential and quality of life of the two groups were compared before and after treatment，and the clinical efficacy of the two groups was evaluated.

Results

After 12 weeks of treatment，the symptom scores of lower abdominal pain，lumbosacral pain，abnormal leukorrhagia，aggravation after fatigue and mental fatigue in the two groups decreased，and the rest potential of pelvic floor decreased before and after treatment，and the scores of various dimensions of quality of life increased.After 12 weeks'treatment，the scores of clinical symptoms and resting potential before and after pelvic floor in the study group were lower than those in the control group，and the scores of quality of life in all dimensions were higher than those in the control group，with statistical significance（P<0.05）.After 1，4，8 and 12 weeks of treatment，the VASscores of the two groups decreased compared with those before treatment，and the VASscores of the study group were lower than those of the control group at all time points after treatment with statistical significance（P<0.05）.After 12 weeks of treatment，the total clinical effective rate in the study group was 92.86%，which was higher than that in the control group（76.79%），and the difference was statistically significant（P<0.05）.

Conclusion

On the basis of pelvic floor rehabilitation and massage along meridians，Danggui Shaoyao Powder can further improve patients'clinical symptoms，relieve pain and regulate pelvic floor resting potential，which is of positive significance for improving patients'quality of life and clinical efficacy.

Danggui Shaoyao Powder  /  massage along the meridian  /  Qi deficiency and blood stasis  /  chronic pelvic pain  /  pelvic floor rehabilitation
陈嫣, 叶利群, 杨晨, 王春华, 冯洪波, 郑书真. 当归芍药散辅以循经按摩对气虚血瘀型慢性盆腔痛盆底康复患者疗效分析. 中华中医药学刊, 2025 , 43 (6) : 100 -103 . DOI: 10.13193/j.issn.1673-7717.2025.06.018
Yan CHEN, Liqun YE, Chen YANG, Chunhua WANG, Hongbo FENG, Shuzhen ZHENG. Clinical Analysis of Danggui Shaoyao Powder（当归芍药散）Assisted by Massage along Meridian on Patients with Chronic Pelvic Pain and Pelvic Floor Rehabilitation of Qi Deficiency and Blood Stasis Type[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (6) : 100 -103 . DOI: 10.13193/j.issn.1673-7717.2025.06.018
正文
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慢性盆腔痛是指由多种因素引发的持续6个月及以上的非周期性、非阿片类药物治疗无效的盆腔疼痛，与泌尿系统、生殖系统、消化系统、骨骼肌肉系统等多系统病变有关[1]。男性群体的慢性盆腔痛多由细菌性前列腺炎引发，炎症缓解后疼痛症状一般可明显好转，但女性群体慢性盆腔痛与子宫内膜异位症、盆底松弛、子宫脱垂等多种妇产科病变相关，治疗方法有限且治愈率低[2]。中医认为，女性慢性盆腔痛属“癥瘕”“痛经”等范畴，多属虚实夹杂，以气虚血瘀证常见，即湿热之邪蕴结于盆腔，热邪除去后湿邪重浊黏腻难除，气机阻滞瘀血内生，即引发气血两虚、胞脉失于濡养[3]。因此，气虚血瘀型慢性盆腔痛的治疗当以通补兼施之法。既往报道显示，循经按摩是缓解慢性疼痛的有效手段，而当归芍药散属妇科益气化瘀名方，《金匮要略》记载，该方对腹痛等多种疾病均有显著效果[4]。基于此，本研究尝试将当归芍药散辅助循经按摩应用于气虚血瘀证慢性盆腔痛患者的盆底康复干预，并就其干预效果予以总结报道。
1　资料与方法
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1.1　一般资料
纳入我院2021年1月—2022年6月收治的112例气虚血瘀型慢性盆腔痛患者，纳入标准：（1）符合慢性盆腔痛临床诊断标准[5]：盆腔、前腹壁、腰骶部或臀部存在非周期性疼痛，持续≥6个月，体格检查未见阳性体征；（2）符合《中医妇科学》关于气虚血瘀症的判断[6]：主症：下腹部坠痛或隐痛，痛可引及腰骶，病程绵延，劳累后症状加剧，带下量明显增多，颜色白、质地清；次症：月经不调、经期延长、经血黯淡或可见血块，精神萎靡、乏力倦怠、纳呆食少，便溏；（3）女性患者，年龄20～50岁；（4）既往月经规律；（5）拟接受盆底康复治疗。排除标准：（1）拟行手术治疗，或治疗后慢性盆腔痛复发；（2）慢性盆腔痛由已知器质性病变引发；（3）合并严重内外科疾病；（4）合并认知、精神异常；（5）既往有盆腔手术史。使用简单随机法将患者分别纳入研究组（56例）、对照组（56例），两组年龄、病程、月经周期等基线资料比较，差异未见统计学意义（P>0.05），本临床研究具有可比性。本研究经本院医学伦理委员会审核通过。两组基线资料详见表1。
1.2　治疗方案
两组均接受盆底康复干预及循经按摩，持续12周：（1）局部电刺激。使用MLDB4S生物刺激反馈仪（南京麦澜德医疗科技股份有限公司），嘱患者排空膀胱、取仰卧位，将电极片贴于患者下腹部，常规局部消毒后涂抹导电膏，将探头插入阴道内约5 cm，连接探头、电极片及治疗仪，开启仿生电刺激。电刺激频率80～120 Hz，脉宽80～120μs，强度以患者感受刺麻但无疼痛感为宜。每次局部电刺激于月经干净后3～5 d开始，每周2次，每次20 min。（2）盆底肌肉锻炼。嘱患者取侧卧位，屈曲双下肢，食指涂抹液状石蜡后伸入阴道约2 cm，嘱患者行阴道收缩、放松动作，确保每次收缩≥3 s。阴道舒缩训练每日2～3次，每次15～20 min。嘱患者根据训练情况逐渐增加训练频次、延长训练时长并提高阴道收缩持续时间。（3）循经按摩：腹部操作：患者仰卧于治疗床上，治疗者坐在患者的右侧，将双手擦热后采用摩法按照顺时针的方向在患者脐下小腹部操作，约6 min，直至感觉到患者小腹部温热。然后循小腹部任脉施以中等力度推，最后用一指禅推法或按揉法在气海、关元、中极、子宫穴处操作，每个穴位按摩2 min。腰背部操作：患者俯卧于治疗床上，治疗者站在患者右侧，在腰背部脊柱两侧的膀胱经第一侧线上以及骶部施以手法，时间约4 min。然后用指按法按压肾俞、八髎穴，以患者感觉到酸胀为度。再横擦八髎穴，以热度经过患者体表渗透到身体内为度。然后拿揉血海、三阴交，穴位处的操作均以酸胀为标准。每次治疗时间20 min。循经按摩每周2次。
在盆底康复干预及循经按摩的基础上，观察组加用当归芍药散内服。组方：当归10 g，芍药10 g，茯苓15 g，白术10 g，泽泻15 g，川芎10 g，桂枝3 g。水煎服，每剂200 mL，每日1剂，持续12周。
1.3　观察指标
对比两组治疗前后临床症状积分、疼痛视觉模拟评分（visual analogue scale，VAS）、盆底静息电位、生活质量变化，并评估两组临床疗效。（1）临床症状积分：包括下腹疼痛、腰骶疼痛、带下异常、劳累后加重、神疲乏力共5项主要症状，0分为无症状，评分越高则症状越严重，2分、4分、6分分别为轻度、中度、重度症状[7]。（2）VAS评分：总分0～10分，0分为完全无痛，评分越高则疼痛越明显，10分为难以忍受的强烈疼痛[8]；VAS评分评估时间点包括治疗前、治疗1周后、治疗4周后、治疗8周后、治疗12周后。（3）盆底静息电位：使用盆底Glazer肌电进行评估，分别记录盆底前、盆底后静息电位。（4）生活质量：使用生存质量测量量表简表（THE WORLD HEALTH ORGANIZATION QUALITY OF LIFE，WHOQOLBREF）进行评估，量表涵盖生理功能、心理健康、社会关系、躯体功能共4个维度，评分越高则生活质量越佳[9]。（5）临床疗效：参照文献标准进行疗效评价[10]，疼痛完全消失，症状积分降低≥95%判定为治愈；疼痛显著好转，症状积分降低70% ～<95%判定为显效；疼痛减轻，症状积分降低30% ～<69%判定为有效；疼痛未明显减轻或加重，症状积分降低<30%或上升判定为无效。总有效率＝（治愈+显效+有效）/总例数×100%。
1.4　统计学分析
使用SPSS 22.0统计学软件分析本研究相关数据，计数资料以（例数/百分比）表示，并采用卡方检验（χ2检验），计量资料均符合正态分布，以（平均数±标准差）即（）表示，采用双侧t检验，当P<0.05时，认为差异存在统计学意义。
2　结果
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2.1　临床症状积分
两组患者治疗12周后下腹疼痛、腰骶疼痛、带下异常、劳累后加重、神疲乏力症状积分均较治疗前下降，研究组治疗12周后各项临床症状积分均低于对照组，差异有统计学意义（P<0.05）。见表2。
2.2　疼痛评分
两组患者治疗1周、4周、8周、12周后VAS评分均较治疗前下降，研究组治疗后各时点VAS评分均低于对照组，差异有统计学意义（P<0.05）。见表3。
2.3　盆底静息电位
两组患者治疗12周后盆底前后静息电位均较治疗前下降，研究组治疗12周后盆底前后静息电位均低于对照组，差异有统计学意义（P<0.05）。见表4。
2.4　生活质量
两组患者治疗12周后生活质量各维度评分均较治疗前升高，研究组治疗12周后生活质量各维度评分均高于对照组，差异有统计学意义（P<0.05）。见表5。
2.5　临床疗效
研究组治疗12周后临床总有效率为92.86%，高于对照组的76.79%，差异有统计学意义（P<0.05）。见表6。
3　讨论
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慢性盆腔痛是育龄期女性常见病、高发病，具有病因复杂、疼痛明显、病程迁延等特征，且往往伴有排便、排尿疼痛以及性交痛等症状，严重影响患者生活质量。有研究认为，盆腔炎是引发女性慢性盆腔痛的主要原因，但仍有大量患者盆腔炎症改善后疼痛未获有效缓解，且盆腔炎病因多样、影响因素众多，故单纯药物治疗往往难以取得满意的疗效[11]。
鉴于药物治疗慢性盆腔痛的效果有限，盆底康复在慢性盆腔痛的治疗中占据着重要地位，其目的在于通过缓解妇产科子宫内膜异位症、盆底松弛等基础疾病，改善疼痛症状、预防疼痛复发。局部电刺激疗法是慢性盆腔痛盆底康复治疗的重要组成部分，该疗法主要借助电刺激实现局部肌肉收缩、促进神经传导，从而改善血液循环、减轻盆腔瘀血，并被证实能够抑制子宫内膜异常增生、出血，一方面能够缓解疼痛，另一方面也有助于提高患者疼痛阈值，从而减轻疼痛感受[12]。其次，积极开展盆底肌肉锻炼不仅能够改善盆腔充血、促进局部粘连松解，也能够提高盆底肌肉张力，从而促进局部新陈代谢、加快炎症及积液吸收，进而实现疼痛的有效缓解[13]。在此基础上，本研究将循经按摩应用于两组患者的盆底康复，其目的在于借助循经按摩扩张局部血管、提高局部血流流速，能够有效加快淋巴回流，从而促进炎性渗出的吸收，对于减轻水肿有积极意义，而水肿的减轻意味着神经受压减少，因神经受压所致疼痛感即可明显减轻[14]。同时，已有大量研究证实了循经按摩在缓解原发性、继发性痛经方面的积极作用[15-16]。
为进一步提高慢性盆腔痛治疗效果，此次研究尝试联合使用当归芍药散方案。中医认为，气虚血瘀型慢性盆腔痛的病机为湿邪阻滞气机致瘀血内生，进一步阻滞胞脉胞络，最终引发疼痛。同时，绵延病程也导致正气耗损，与劳累后症状加重相关[17]。因此，治疗应以通补兼施为纲。当归芍药散方中当归为君，有补脾益肺、活血行血、散瘀止痛之功，“肺气充足则宗气足，脾气充足则气血生化有源”[18-19]；芍药为臣，可达养血补肝、柔肝止痛之功[20-21]；茯苓、白术、川芎、泽泻为使，茯苓、白术联用可有效利脾化湿，加之川芎祛风通络、泽泻利水渗湿，可增强全方补益疏泻之效[22-24]；桂枝为使，可温经通脉、行气活血。数药共奏温补中阳、缓急止痛之功[25-26]。得益于当归芍药散的应用，研究组治疗12周后各项临床症状积分、VAS评分均更低，生活质量各维度评分均更高，而更低的盆底前后静息电位一方面意味着盆腔对疼痛刺激的阈值提高，另一方面也表明引发患者盆腔疼痛的病因得到有效控制。随着临床症状的好转，研究总有效率达到92.86%，较对照组的76.79%更高，进一步印证了当归芍药散在气虚血瘀型慢性盆腔痛治疗中的重要意义和价值。此次研究的局限性在于缺乏长期随访，未能明确两组患者远期盆腔痛复发情况，将在日后的观察中予以补充。
综上所述，在盆底康复及循经按摩的基础上，应用当归芍药散能够进一步改善患者临床症状、减轻疼痛、调节盆底静息电位，对于提高患者生活质量及临床疗效有积极意义，值得推广应用。
基金
收起
  • 国家中医药管理局科技司-浙江省中医药管理局共建科技计划项目(GZY-ZJ-KJ-Z3090)
  • 宁波市公益类科技计划项目(2021S159)
文献
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参考文献 引证文献
排序方式：
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2025年第43卷第6期
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文章信息
doi: 10.13193/j.issn.1673-7717.2025.06.018
  • 首发时间：2026-10-30
  • 出版时间：2025-06-10
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基金
国家中医药管理局科技司-浙江省中医药管理局共建科技计划项目(GZY-ZJ-KJ-Z3090)
宁波市公益类科技计划项目(2021S159)
作者信息
    浙江中医药大学附属宁波市中医院，浙江 宁波 315000

通讯作者:

叶利群（1973-），女，浙江宁波人，主任中医师，硕士研究生导师，硕士，研究方向：中医妇科。E-mail：。
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https://castjournals.cast.org.cn/joweb/zhzyyxk/CN/10.13193/j.issn.1673-7717.2025.06.018
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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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