隔药灸治疗中重度原发性痛经临床疗效观察
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摘要
目的:以中重度原发性痛经患者为研究对象,以隔药灸为治疗方法,观察隔药灸治疗原发性痛经的临床疗效,并评价二者的疗效差异,为隔药灸的临床治疗提供证据。方法:将符合纳入标准的299例原发性痛经患者采用VAS评分分为中度和重度原发性痛经,以VAS评分、疼痛持续时间、止痛药使用率为观察指标,观察治疗前后及随访期改善情况。结果:(1)治疗及随访期间中重度原发性痛经VAS评分、疼痛持续时间均显著低于基线(P<0.05);治疗期间中重度原发性痛经VAS评分、疼痛持续时间随着治疗时间显著降低(P<0.05);重度原发性痛经组止痛药使用频率显著低于基线(P<0.05)。(2)重度原发性痛经患者隔药灸各时点治疗1个月经周期与基线、治疗2个月经周期与1个月经周期、4个月经周期与3个月经周期、5个月经周期与4个月经周期VAS差值较中度原发性痛经显著降低(P<0.05)。结论:隔药灸对中重度原发性痛经患者有一定的镇痛作用,尤重度原发性痛经止痛效果显著。
Objective:To observe the clinical effect of herb-partitioned moxibustion for patients with moderate and severe primary dysmenorrhea. Mehod: A total of 299 patients were treated by herb-partitioned moxibustion. Clinical indexes included VAS score,pain duration,frequency of analgesics,and they were evaluated at baseline and at the end of study. Results:( 1) After 3-month treatment and follow-up,VAS score and pain durion were significantly decreased than those of baseline( P < 0. 05). VAS score and pain duration decreased significantly with treatment time in moderate and severe primary dysmenorrhea patients( P < 0. 05). The frequency of analgesics in severe primary dysmenorrhea group was significantly lower than that of baseline( P < 0. 05).( 2) The VAS difference between 1 menstrual cycle and baseline,2 menstrual cycles and 1 menstrual cycle,4 menstrual cycles and 3 menstrual cycles,5 menstrual cycles and 4 menstrual cycles of severe primary dysmenorrhea patients treated with herb-partitioned moxibustion were significantly lower than those of moderate primary dysmenorrhea patients( P < 0. 05). Conclusion: Herb-partitioned moxibustion has analgesic effect on patients with moderate and severe primary dysmenorrhea,and the curative effect of severe primary dysmenorrhea is significant.
Objective:To observe the clinical effect of herb-partitioned moxibustion for patients with moderate and severe primary dysmenorrhea. Mehod: A total of 299 patients were treated by herb-partitioned moxibustion. Clinical indexes included VAS score,pain duration,frequency of analgesics,and they were evaluated at baseline and at the end of study. Results:( 1) After 3-month treatment and follow-up,VAS score and pain durion were significantly decreased than those of baseline( P < 0. 05). VAS score and pain duration decreased significantly with treatment time in moderate and severe primary dysmenorrhea patients( P < 0. 05). The frequency of analgesics in severe primary dysmenorrhea group was significantly lower than that of baseline( P < 0. 05).( 2) The VAS difference between 1 menstrual cycle and baseline,2 menstrual cycles and 1 menstrual cycle,4 menstrual cycles and 3 menstrual cycles,5 menstrual cycles and 4 menstrual cycles of severe primary dysmenorrhea patients treated with herb-partitioned moxibustion were significantly lower than those of moderate primary dysmenorrhea patients( P < 0. 05). Conclusion: Herb-partitioned moxibustion has analgesic effect on patients with moderate and severe primary dysmenorrhea,and the curative effect of severe primary dysmenorrhea is significant.
引文
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[9] 隋培森.隔药灸脐法治疗寒凝血瘀型原发性痛经患者的临床疗效观察[D].济南:山东中医药大学,2016.
[10] 郑敏.隔药灸脐法治疗中重度原发性痛经患者临床疗效观察[D].济南:山东中医药大学,2016.
[11] 刘照时,黄月娜,赵苏萍,等.隔药灸治疗前后不同证型原发性痛经患者生殖激素水平检测研究[J].中国妇幼保健,2016,31(4):779-781.
[12] Burnett M,Lemyre M.No.345-primary dysmenorrhea consensus guideline[J].J Obstet Gynaecol Can,2017,39(7):585-595.
[13] 李姝婧,潘亚辉,马凤君,等.艾灸对寒凝血瘀型痛经大鼠子宫香草酸受体相关蛋白的影响[J].中华中医药学刊,2018(11):2617-2620.
[14] 周鹿安,陆政日,刘姝娆,等.少腹逐瘀汤治疗寒凝血瘀型原发性痛经的Meta分析[J].药物评价研究,2016,39(5):858-864.
[15] Huang X,Su S,Duan JA,et al.Effects and mechanisms of Shaofu-Zhuyu decoction and its major bioactive component for Cold-Stagnation and Blood-Stasis primary dysmenorrhea rats[J].J Ethnopharmacol.2016,186:234-243.
[16] Su S,Duan J,Wang P,et al.Metabolomic study of biochemical changes in the plasma and urine of primary dysmenorrhea patients using UPLC-MS coupled with a pattern recognition approach[J].J Proteome Res,2013,12(2):852-865.
[17] Su S,Hua Y,Duan JA,et al.Inhibitory effects of active fraction and its main components of Shaofu Zhuyu decoction on uterus contraction[J].Am J Chin Med,2010,38(4):777-787.
[18] 周金山,晋志高,陶之理.关元一级感觉神经元在脊神经节的节段分布[J].上海针灸杂志,2001(3):40-41.
[19] 刘珍珍,张梅,章庆庆,等.艾灸不同穴位对寒凝证类痛经大叔疼痛反应及中枢内k受体mRNA表达的影响[J].辽宁中医杂志,2018,42(6):1352-1355.
[20] Seidman LC,Brennan KM,Rapkin AJ,et al.Rates of Anovulation in Adolescents and Young Adults with Moderate to Severe Primary Dysmenorrhea and Those without Primary Dysmenorrhea[J].J Pediatr Adolesc Gynecol,2018,31(2):94-101.
[2] Habibi N,Huang MS,Gan WY,et al.Prevalence of primary dysmenorrhea and factors associated with its intensity among undergraduate students:a cross-sectional study[J].Pain Manag Nurs,2015,16(6):855-861.
[3] Armour M,Smith CA,Steel KA,et al.The effectiveness of self-care and lifestyle interventions in primary dysmenorrhea:a systematic review and meta-analysis[J].BMC Complement Altern Med,2019,19(1):22.
[4] Iacovides S,Avidon I,Bentley A,et al.Reduced quality of life when experiencing menstrual pain in women with primary dysmenorrhea[J].Acta Obstet Gynecol Scand,2014,93(2):213-217.
[5] Oladosu FA,Tu FF,Hellman KM.Nonsteroidal antiinflammatory drug resistance in dysmenorrhea:epidemiology,cause,and treatment[J].Am J Obstet Gynecol,2018,218(4):390-400.
[6] Marjoribanks J,Ayeleke RO,Farquhar C,et al.Nonsteroidal anti-inflammatory drugs for dysmenorrhoea[J].Cochrane Database Syst Rev,2015(7):CD001751.
[7] Wong CL,Farquhar C,Roberts H,et al.Oral contraceptive pill as treatment for primary dysmenorrhoea[J].Cochrane Database Syst Rev,2009(2):CD002120.
[8] 孙晶,王昕.隔药灸治疗寒凝血瘀型原发性痛经临床观察[J].辽宁中医药大学学报,2018,20(6):165-167.
[9] 隋培森.隔药灸脐法治疗寒凝血瘀型原发性痛经患者的临床疗效观察[D].济南:山东中医药大学,2016.
[10] 郑敏.隔药灸脐法治疗中重度原发性痛经患者临床疗效观察[D].济南:山东中医药大学,2016.
[11] 刘照时,黄月娜,赵苏萍,等.隔药灸治疗前后不同证型原发性痛经患者生殖激素水平检测研究[J].中国妇幼保健,2016,31(4):779-781.
[12] Burnett M,Lemyre M.No.345-primary dysmenorrhea consensus guideline[J].J Obstet Gynaecol Can,2017,39(7):585-595.
[13] 李姝婧,潘亚辉,马凤君,等.艾灸对寒凝血瘀型痛经大鼠子宫香草酸受体相关蛋白的影响[J].中华中医药学刊,2018(11):2617-2620.
[14] 周鹿安,陆政日,刘姝娆,等.少腹逐瘀汤治疗寒凝血瘀型原发性痛经的Meta分析[J].药物评价研究,2016,39(5):858-864.
[15] Huang X,Su S,Duan JA,et al.Effects and mechanisms of Shaofu-Zhuyu decoction and its major bioactive component for Cold-Stagnation and Blood-Stasis primary dysmenorrhea rats[J].J Ethnopharmacol.2016,186:234-243.
[16] Su S,Duan J,Wang P,et al.Metabolomic study of biochemical changes in the plasma and urine of primary dysmenorrhea patients using UPLC-MS coupled with a pattern recognition approach[J].J Proteome Res,2013,12(2):852-865.
[17] Su S,Hua Y,Duan JA,et al.Inhibitory effects of active fraction and its main components of Shaofu Zhuyu decoction on uterus contraction[J].Am J Chin Med,2010,38(4):777-787.
[18] 周金山,晋志高,陶之理.关元一级感觉神经元在脊神经节的节段分布[J].上海针灸杂志,2001(3):40-41.
[19] 刘珍珍,张梅,章庆庆,等.艾灸不同穴位对寒凝证类痛经大叔疼痛反应及中枢内k受体mRNA表达的影响[J].辽宁中医杂志,2018,42(6):1352-1355.
[20] Seidman LC,Brennan KM,Rapkin AJ,et al.Rates of Anovulation in Adolescents and Young Adults with Moderate to Severe Primary Dysmenorrhea and Those without Primary Dysmenorrhea[J].J Pediatr Adolesc Gynecol,2018,31(2):94-101.