腰骶松筋法对原发性痛经患者月经期次髎穴压痛反应及腰骶部压痛点的影响
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摘要
目的探究腰骶松筋法对原发性痛经患者月经期次髎穴压痛反应及腰骶部压痛点的影响。方法将40例年龄16～30岁未育原发性痛经患者随机分为松筋组20例与西药组20例,松筋组患者于每次月经期前3 d进行腰骶部松筋疗法治疗,每个压痛点治疗5 min,2次/d,共治疗3个月经周期。西药组患者于月经期前3 d给予布洛芬缓释片口服,2次/d,共治疗3个月经周期。测定2组患者第1次及第3次开始治疗前次髎穴压痛阈值,并记录腰骶部压痛点数量,采用视觉模拟评分(VAS)法评估2组患者初始治疗前及治疗第1,2,3个月经期第3天的疼痛情况。结果西药组患者第3次开始治疗前次髎穴痛阈值、腰骶部压痛点数量与第1次开始治疗前比较差异无统计学意义(P均> 0. 05);松筋组患者第3次开始治疗前次髎穴痛阈值明显增高(P <0. 05),腰骶部压痛点数量明显减少(P <0. 05),且次髎穴痛阈值明显高于西药组而腰骶部压痛点数量明显少于西药组(P均<0. 05)。松筋组患者治疗2次后腰骶部压痛点的解剖学位置及其与背俞穴的重合点均发生了较大变化,而西药组患者治疗2次后均未发生明显变化。2组患者治疗后VAS评分均呈明显下降趋势(P均<0. 05),但2组间第1,2个月经期第3天的VAS评分比较差异均无统计学意义(P均> 0. 05);松筋组患者治疗第3个月经期第3天的疼痛VAS评分明显低于同期西药组(P <0. 05)。结论腰骶松筋法可通过对腰骶部压痛点的刺激而起到疏通经络气血的作用,是一种治疗原发性痛经的安全有效方法。
Objective It is to investigate the effect of lumbosacral tendon-relaxing method on tenderness response of Ciliao acupoint and lumbosacral tenderness point in patients with primary dysmenorrhea at menstrual period. Methods Forty childless patients with primary dysmenorrhea aged from 16 to 30 years old were randomly divided into tendon-relaxing group and western medicine group,each group had 20 patients. The patients in tendon-relaxing group were treated with lumbosacral tendon-relaxing method at 3 days before each menstrual period,each tender point was treated for 5 min,2 times/d,and a total of 3 menstrual cycles were treated. The patients in the western medicine group was given ibuprofen sustained-release tablets orally twice a day at 3 days before the menstrual period,twice a day for a total of 3 menstrual cycles. Before the first and third treatment,the tenderness threshold of Ciliao acupoints were measured,and the number of tender points in the lumbosacral region was recorded in the two groups. The visual analog scale(VAS) method was used to evaluate the pain degree before the initial treatment and on the third day of the first,second and third treated menstrual period. Results There was no significant difference in the pain threshold of Ciliao acupoint and the number of lumbosacral tender points between the first pretreatment and the third pretreatment in the western medicine group(P > 0. 05). The pain threshold of Ciliao acupoints was significantly increased(P < 0. 05),and the number of tender points in the lumbosacral region was significantly decreased before the third treatment in tendon-relaxing group(P < 0. 05),the threshold was significantly higher and the number of tender points in the lumbosacral region was significantly less that those in the western medicine group(P <0. 05). In the tendon-relaxing group,the anatomical position of the lumbosacral tender point and the coincidence with the Beishu points were significantly changed after treatment for 2 times,but no obvious change was found in the western medicine group. The VAS scores of the two groups showed a significant downward trend after treatment(P < 0. 05),but there was no significant difference in the VAS scores on the third day of the first and second menstrual periods between the two groups(P > 0. 05). The pain VAS score of the third day of menstruation in the tendon-relaxing group was significantly lower than that of the western medicine group(P < 0. 05). Conclusion The lumbosacral tendon-relaxing method can effectively clear the meridian Qi and blood by stimulating the tender point of the lumbosacral region. It is a safe and effective method for the treatment of primary dysmenorrhea.
Objective It is to investigate the effect of lumbosacral tendon-relaxing method on tenderness response of Ciliao acupoint and lumbosacral tenderness point in patients with primary dysmenorrhea at menstrual period. Methods Forty childless patients with primary dysmenorrhea aged from 16 to 30 years old were randomly divided into tendon-relaxing group and western medicine group,each group had 20 patients. The patients in tendon-relaxing group were treated with lumbosacral tendon-relaxing method at 3 days before each menstrual period,each tender point was treated for 5 min,2 times/d,and a total of 3 menstrual cycles were treated. The patients in the western medicine group was given ibuprofen sustained-release tablets orally twice a day at 3 days before the menstrual period,twice a day for a total of 3 menstrual cycles. Before the first and third treatment,the tenderness threshold of Ciliao acupoints were measured,and the number of tender points in the lumbosacral region was recorded in the two groups. The visual analog scale(VAS) method was used to evaluate the pain degree before the initial treatment and on the third day of the first,second and third treated menstrual period. Results There was no significant difference in the pain threshold of Ciliao acupoint and the number of lumbosacral tender points between the first pretreatment and the third pretreatment in the western medicine group(P > 0. 05). The pain threshold of Ciliao acupoints was significantly increased(P < 0. 05),and the number of tender points in the lumbosacral region was significantly decreased before the third treatment in tendon-relaxing group(P < 0. 05),the threshold was significantly higher and the number of tender points in the lumbosacral region was significantly less that those in the western medicine group(P <0. 05). In the tendon-relaxing group,the anatomical position of the lumbosacral tender point and the coincidence with the Beishu points were significantly changed after treatment for 2 times,but no obvious change was found in the western medicine group. The VAS scores of the two groups showed a significant downward trend after treatment(P < 0. 05),but there was no significant difference in the VAS scores on the third day of the first and second menstrual periods between the two groups(P > 0. 05). The pain VAS score of the third day of menstruation in the tendon-relaxing group was significantly lower than that of the western medicine group(P < 0. 05). Conclusion The lumbosacral tendon-relaxing method can effectively clear the meridian Qi and blood by stimulating the tender point of the lumbosacral region. It is a safe and effective method for the treatment of primary dysmenorrhea.
引文
[1]乐杰.妇产科学[M]. 7版.北京:人民卫生出版社,2010:318
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[7]王秀芳,李居怡,邓柏颖.针灸治疗原发性痛经的机理研究述评[J].中医学报,2013,28(3):454-456
[8]王宁华,张传汉,南登崑.实验痛评测方法之一:压痛阈[J].国外医学物理医学与康复学分册,2004,24(3):97-98
[9] Granot M,Yarnitsky D,Itskovitz-Eldor J,et al. Pain perception in women with dysmenorrhea[J]. Obstet Gynecol,2001,98(3):407-411
[10]Bajaj P,Bajaj P,Madsen H,et al. A comparison of modality-specific somatosensory changes during menstruation in dysmenorrheic and nondysmenorrheic women[J]. Clin J Pain,2002,18(3):180-190
[11]张炎华,刘文静.针药结合治疗原发性痛经的疗效观察[J].当代医学,2012,18(22):148-149
[12]于素珍.针刺背俞穴治疗痛经28例[J].内蒙古中医药,1985,4(1):31
[13]贲卉,荣培晶,李艳华,等.胃溃疡患者皮肤压痛阈及辨别阈的观察[J].上海针灸杂志,2011,30(1):62-63
[14]白宇,原林,黄泳,等.经络的解剖学发现——筋膜学新理论[J].世界科学技术-中医药现代化,2010,12(1):20-24
[2] Harel Z. Dysmenorrhea in adolescents and young adults:etiology and management[J]. J Pediatr Adolesc Gynecol,2006,19(6):363-371
[3]中华人民共和国卫生部.中药新药临床研究指导原则[S].北京:人民卫生出版社,1993:263-266
[4]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:61-62
[5]赵俊,李树人,宋文阁.疼痛诊断治疗学[M].郑州:河南医科大学出版社,1999:201-202
[6]唐宏亮,庞军,杨扬.从《内经》“以痛为输”看中医经络诊疗的运用[J].辽宁中医杂志,2011,38(10):2065-2066
[7]王秀芳,李居怡,邓柏颖.针灸治疗原发性痛经的机理研究述评[J].中医学报,2013,28(3):454-456
[8]王宁华,张传汉,南登崑.实验痛评测方法之一:压痛阈[J].国外医学物理医学与康复学分册,2004,24(3):97-98
[9] Granot M,Yarnitsky D,Itskovitz-Eldor J,et al. Pain perception in women with dysmenorrhea[J]. Obstet Gynecol,2001,98(3):407-411
[10]Bajaj P,Bajaj P,Madsen H,et al. A comparison of modality-specific somatosensory changes during menstruation in dysmenorrheic and nondysmenorrheic women[J]. Clin J Pain,2002,18(3):180-190
[11]张炎华,刘文静.针药结合治疗原发性痛经的疗效观察[J].当代医学,2012,18(22):148-149
[12]于素珍.针刺背俞穴治疗痛经28例[J].内蒙古中医药,1985,4(1):31
[13]贲卉,荣培晶,李艳华,等.胃溃疡患者皮肤压痛阈及辨别阈的观察[J].上海针灸杂志,2011,30(1):62-63
[14]白宇,原林,黄泳,等.经络的解剖学发现——筋膜学新理论[J].世界科学技术-中医药现代化,2010,12(1):20-24