Efficacy of Tokishakuyakusan add-on therapy with low-dose oral contraceptive pills on endometriosis patients with dysmenorrhea
Efficacy of Tokishakuyakusan add-on therapy with low-dose oral contraceptive pills on endometriosis patients with dysmenorrhea
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DOI：
10.1111/jog.14424
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发表时间：
2020-08-24
影响因子：
1.6
通讯作者：
Harada, Tasuku
中科院分区：
文献类型：
--
作者：
Taniguchi, Fuminori;Tokita, Yohei;Harada, Tasuku
目的Tokishakuyakusan（TSS）是日本妇女治疗痛经、月经不调和更年期的常用汉方药。然而，目前的激素治疗和低剂量口服避孕药（OC）作为主要症状的首选药物，不良事件的发生率很高，没有提高患者的满意度。我们评估TSS作为附加治疗对服用OC治疗满意度降低的患者生活质量（QOL）的疗效。方法12例子宫内膜异位症患者行OC治疗。TSS（7.5 g/天）与OC联合给药3个月经周期。主要结局是使用子宫内膜异位症健康状况-30（EHP-30）评估的QOL程度。次要结局是月经窘迫问卷（MDQ）、使用Likert量表和寒冷感觉视觉模拟量表（VAS）的患者满意度。结果在EHP-30中，TSS与OC在每个月经周期的变化不明显，但疼痛和情绪幸福感的得分有下降的趋势。在MDQ中，经前期的水潴留得到改善。关于冷感-VAS，治疗前为61.6 mm，终点时降至31.3 mm。TSS治疗后的平均Likert量表值从4.3降至2.6。冷感和患者满意度有所改善。结论TSS添加治疗虽然对生活质量的影响是中等的，但可能改善寒冷感和腹泻相关症状。
Aim Tokishakuyakusan (TSS) is representative of popular Kampo medicines for Japanese women to treat dysmenorrhea, irregular menstruation and menopause. Current hormonal treatments and low-dose oral contraceptives (OCs) used as a first-choice drug for primary symptoms, however, have a high incidence of adverse events without improving patients' satisfaction. We evaluated the efficacy of TSS as additional treatment on the quality of life (QOL) of patients taking OCs with reduced therapeutic satisfaction. Methods Twelve patients treated with OCs for endometriosis were enrolled. TSS (7.5 g/day) in combination with OCs were given for three menstrual cycles. The main outcome was the degree of QOL assessed using the Endometriosis Health Profile-30 (EHP-30). Secondary outcomes were the Menstrual Distress Questionnaire (MDQ), patient's satisfaction using a Likert scale and cold feeling-visual analogue scale (VAS). Results In EHP-30, significant changes by TSS with OCs in each menstrual cycle were not found, although the scores for pain and emotional well-being tended to decrease. In MDQ, water retention in the premenstrual phase was improved. With regard to cold feeling-VAS, 61.6 mm at pretreatment decreased to 31.3 mm at the endpoint. Average Likert scale values after TSS treatment declined from 4.3 to 2.6. Cold feeling and patient's satisfaction have improved. Conclusion Although the influence of TSS add-on therapy on QOL was moderate, possible improvement of cold feeling and menstruation-related symptoms was suggested.