[Thunder-fire moxibustion combined with mifepristone for ovarian chocolate cyst dysmenorrhea with kidney deficiency and blood stasis: a randomized controlled trial].

To observe the clinical efficacy of thunder-fire moxibustion combined with mifepristone for ovarian chocolate cyst dysmenorrhea with kidney deficiency and blood stasis.Seventy patients were randomly divided into an observation group and a control group, 35 cases in each group. The patients in the the control group were treated with oral administration of mifepristone, 10 mg each time, once a day; based on the treatment of the control group, the patients in the observation group were treated with thunder-fire moxibustion at Guanyuan (CV 4), Zigong (EX-CA 1), Xuehai (SP 10), once every other day. Both the groups were treated for 3 months. The Cox menstrual symptom scale (CMSS) score, the maximum cross-sectional area of ectopic cyst, and the serum levels of transforming growth factor-β1 (TGF-β1) and interleukin-17 (IL-17) were observed before and after treatment in the two groups. The clinical efficacy was evaluated.Compared before treatment, the severity scores and duration scores of CMSS as well as the serum levels of TGF-β1 were reduced after treatment in the two groups (P<0.05), and the serum level of IL-17 in the observation group was reduced (P<0.05); the reducing of the severity score and duration score of CMSS as well as the serum levels of TGF-β1 and IL-17 in the observation group were more significant than those in the control group (P<0.05). After treatment, the maximum cross-sectional area of ectopic cyst in the two groups was decreased (P<0.05), and the reducing in the observation group was more significant than that in the control group (P<0.05). The total effective rate was 94.3% (33/35) in the observation group, which was higher than 71.4% (25/35) in the control group (P<0.05).Thunder-fire moxibustion combined with mifepristone could significantly improve dysmenorrhea symptoms, shorten dysmenorrhea time and promote atrophy of ovarian heterotopic cyst in patients with ovarian chocolate cyst dysmenorrhea of kidney deficiency and blood stasis, and the mechanism may be related to the reduction of serum levels of TGF-β1 and IL-17.目的：观察雷火灸联合米非司酮治疗肾虚血瘀型卵巢巧克力囊肿痛经的临床疗效。方法：将70例患者随机分为观察组和对照组，各35例。对照组予口服米非司酮治疗，每次10 mg，每日1次；观察组在对照组基础上予雷火灸治疗，穴取关元、子宫、血海，隔日1次，两组均治疗3个月。观察两组患者治疗前后COX痛经症状量表（CMSS）评分、异位囊肿最大截面积、血清转化生长因子-β1（TGF-β1）及白介素-17（IL-17）水平，并评定临床疗效。结果：治疗后，两组患者CMSS严重程度、发作时间评分及血清TGF-β1水平均较治疗前降低（P<0.05），观察组血清IL-17水平降低（P<0.05）；观察组CMSS痛经症状严重程度、发作时间评分及血清TGF-β1、IL-17水平降低程度均大于对照组（P<0.05）。治疗后，两组患者异位囊肿最大截面积均减小（P<0.05），且观察组减小程度大于对照组（P<0.05）。观察组总有效率为94.3%（33/35），高于对照组的71.4%（25/35，P<0.05）。结论：雷火灸联合米非司酮治疗肾虚血瘀型卵巢巧克力囊肿痛经可明显改善痛经症状、缩短痛经时间，促进卵巢异位囊肿萎缩，其机制可能与降低血清TGF-β1、IL-17水平有关。.