隔药灸不同时长对寒湿凝滞型痛经患者生殖内分泌表达水平影响
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摘要
目的 :观察不同隔药灸时长对寒湿凝滞型痛经患者治疗后生殖内分泌表达水平的影响。方法 :将40例寒湿凝滞型痛经患者根据完全随机法分成4组,各组10例。每组采用时长分别为15 min、30 min、45 min、60 min进行隔药灸,于每次月经周期前7 d开始治疗,直至月经来潮后停止治疗,连续治疗3个月经周期。治疗完成后利用VAS评分评价各组治疗前后痛经改善情况,检测治疗前后每组血清雌二醇(E2)、孕酮(P)、前列腺素(PGF2α)表达水平。结果:各组治疗后与治疗前比较,痛经疼痛程度均有所缓解,检查生殖内分泌结果提示E2、PGF2α表达下降,P表达升高(P<0.05)。各组治疗后比较,45 min与60 min时长与其他两组比较E_2、PGF2α下降水平明显,P升高水平明显(P<0.05)。45 min与60 min两组组间比较差异不显著(P>0.05)。结论 :隔药灸能够改善寒湿凝滞型痛经患者的生殖内分泌表达水平,且通过下调E2、PGF2α表达水平,上调P表达水平起到缓解痛经症状的作用,而选择45～60 min隔药灸时长效果更佳。
Objective :To observe the effect of different duration of drug separated moxibustion on reproductive endocrine expression in dysmenorrhea patients with cold-dampness stagnation. Methods :40 cases of dysmenorrhea with cold-dampness stagnation were divided into 4 groups according to the complete random method,10 cases in each group. Each group was treated with drug separated moxibustion for 15,30,45 and 60 min respectively. The treatment began 7 days before each menstrual cycle and stopped after menstruation. The treatment lasted 3 menstrual cycles continuously. After treatment,VAS score was used to evaluate the improvement of dysmenorrhea before and after treatment,and the levels of serum estradiol,progesterone and prostaglandin were detected before and after treatment. Results :Compared with before treatment,dysmenorrhea was relieved in all groups. The results of reproductive endocrine examination showed that the expression of estradiol and prostaglandin in serum was decreased and the expression of progesterone was increased(P<0.05). After treatment,the serum estradiol and prostaglandin levels decreased significantly and the progesterone levels increased significantly(P<0.05). There was no significant difference between the two groups of 45 min and 60 min(P>0.05).Conclusion :Drug separated moxibustion can improve the reproductive endocrine expression level of patients with cold-dampness stagnation dysmenorrhea,and alleviate the symptoms of dysmenorrhea by lowering the expression levels of serum estradiol and prostaglandin,and up-regulating the expression level of progesterone.
Objective :To observe the effect of different duration of drug separated moxibustion on reproductive endocrine expression in dysmenorrhea patients with cold-dampness stagnation. Methods :40 cases of dysmenorrhea with cold-dampness stagnation were divided into 4 groups according to the complete random method,10 cases in each group. Each group was treated with drug separated moxibustion for 15,30,45 and 60 min respectively. The treatment began 7 days before each menstrual cycle and stopped after menstruation. The treatment lasted 3 menstrual cycles continuously. After treatment,VAS score was used to evaluate the improvement of dysmenorrhea before and after treatment,and the levels of serum estradiol,progesterone and prostaglandin were detected before and after treatment. Results :Compared with before treatment,dysmenorrhea was relieved in all groups. The results of reproductive endocrine examination showed that the expression of estradiol and prostaglandin in serum was decreased and the expression of progesterone was increased(P<0.05). After treatment,the serum estradiol and prostaglandin levels decreased significantly and the progesterone levels increased significantly(P<0.05). There was no significant difference between the two groups of 45 min and 60 min(P>0.05).Conclusion :Drug separated moxibustion can improve the reproductive endocrine expression level of patients with cold-dampness stagnation dysmenorrhea,and alleviate the symptoms of dysmenorrhea by lowering the expression levels of serum estradiol and prostaglandin,and up-regulating the expression level of progesterone.
引文
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[3]何诗雯,郭亚茹,陈偶英,等.隔药灸治疗原发性痛经的研究现状与治疗进展[J].护理研究,2018,32(8):1176-1178.
[4]罗颂平.中医妇科学[M].2版.北京:人民卫生出版社,2016:105.
[5]张玉珍.中医妇科学[M].北京:中国中医药出版社,2004:126-127.
[6]谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013:362-363.
[7]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.
[8]孙晓理,杜彩素.原发性痛经的影响因素及干预研究进展[J].中国社会医学杂志,2017,34(3):262-264.
[9]贾小红,巩海亮,宋兰英,等.针刺治疗对原发性痛经患者性激素及前列腺素分泌的调节作用[J].中国医药导报,2016,13(7):76-79.
[10]王煜婷.原发性痛经发病机制及口服药物治疗进展[J].医学信息,2018,7(13):56-58.
[11]潘野清,张健安.原发性痛经的发病机制及治疗进展[J].安徽预防医学杂志,2017,23(2):113-116.
[12]张荆柳.中医针灸治疗原发性痛经的研究进展[J].中国中医药现代远程教育,2013,11(9):147-151.
[13]黄潇,苗芙蕊,叶子维,等.隔药灸法研究进展概况[J].光明中医,2014,29(10):2231-2233.
[14]郝明耀,杨星月,郭新,等.隔药灸脐法治疗原发性痛经机制研究[C]//山东针灸学会.2014年学术年会论文集.山东针灸学会.济南:2014针药并用及穴位用药学术研讨会:597-600.
[15]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.
[16]李继俊.妇产科内分泌治疗学[M].北京:人民军医出版社,2005:341.
[17]寇小平,邵莹,卢占斌.前列腺素F2α受体与原发性痛经关系[J].现代仪器与医疗,2016,22(2):110-112.