电针治疗原发性痛经的临床研究
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摘要
研究目的
原发性痛经即功能性痛经,不伴明显的盆腔器质性疾病,因其病因复杂,容易反复而成为妇科的疑难病症之一,给妇女的身心健康和工作学习带来了严重的影响,而目前对其防治尚无重大突破,针灸治疗痛经,疗效确切、操作简便、价格低廉、无毒副作用,易于被广大患者接受。但目前针灸临床治疗痛经选穴笼杂、规范的穴位研究较少,给临床治疗痛经的选穴带来一定的难度。
通过与中药对照组治疗原发性痛经疗效的比较,初步观察通过电针治疗原发性痛经的疗效,为运用针灸治疗原发性痛经提供科学的研究基础。
研究方法
治疗组：电针穴位处方：三阴交、气海、关元、合谷、太冲,电针频率采用疏密波,疏波频率为2HZ,密波频率100HZ,疏密交替频率5Hz；强度以患者耐受为度,留针30分,经前7天开始治疗,连续10天,连续3个月经周期；对照组：采用活血化瘀、行气止痛的少腹逐瘀汤为主。药物组成：当归9g、川芎6g、赤芍6g、、五灵脂6g(炒)、小茴香(炒)7粒,干姜(炒)0.6g、没药(研)6g、蒲黄9g。将上述中药煎煮成药汁后,再加以浓缩干燥制成药粉,加上适量赋型剂(淀粉)制成科学中药。经前7天服药开始服用至月经第3天,每次50g/包,每日3次,水冲服,连服3个月经周期。两组患者分别于治疗前后进行疼痛调查问卷(MQP)评分、血浆PGF2α及PGE2检测、健康调查简表(SF-36)评分,计量资料采用t检验或方差分析,计数资料采用X2检验,临床等级资料比较采用Ridit分析。所用计量资料均用表示,所有数据采用SPSS统计软件(SPSS12)进行分析。
研究结果
两组治疗后患者疼痛感觉方面总分、疼痛情感方面总分、疼痛总分VAS评分、现在疼痛状况评分均降低,与治疗前比较,均P<0.01,差异均有统计学意义；治疗后两组间患者疼痛感觉方面总分、疼痛情感方面总分、疼痛总分、VAS评分、现在疼痛状况评分比较,P<0.05,差异均有统计学意义；治疗后两组血浆PGF2。值均有明显下降,两组间比较,P<0.01,差异有统计学意义；治疗后两组血浆PGE2值均有明显升高,两组间比较,P<0.01,差异有统计学意义。治疗组治疗后SF-36精神健康及身体健康评分与治疗前比较,均P<0.01,差异均有统计学意义；对照组SF-36精神健康及身体健康评分与治疗前比较,均P<0.01,差异均有统计学意义；治疗后治疗组SF-36精神健康及身体健康评分与对照组治疗后比较,均P<0.05,差异均有统计学意义。
研究结论
1.电针和少腹逐瘀汤均可改善痛经患者疼痛感觉、情感等症状,降低疼痛的程度,减轻患者痛苦,且电针效果更佳。
2.电针和少腹逐瘀汤均可降低痛经患者PGF2α水平,升高PGE2水平,改善患者激素分泌异常状况,且电针效果优于少腹逐瘀汤。
3.电针和少腹逐瘀汤均能提高痛经患者SF-36精神及身体健康评分,改善痛经患者生存质量,且治疗组作用优于对照组。
Objective
Primary dysmenorrhea which refers to functional dysmenorrheal, is not associated with significant pelvic organic diseases. Due to its complex causes and easy relapse, it has become a difficult gynecological disease and brings serious impact on women's physical and mental health as well as their work and study. So far, there is still no major breakthrough in its prevention and treatment. Acupuncture has proved to be effective in treating dysmenorrhea, what is more, acupuncture is not expensive, easy to perform and has no side effects, therefore, it can be easily accepted by most patients. But many acupoints have been used to treat dysmenorrhea, and there is few relative standardized study about acupoints, which has caused difficulty in selecting acupoints for clinical treatment of dysmenorrheal.
Treating primary dysmenorrhea by applying EA on Sanyinjiao together with other acupoints based on differentiation, and was compared with control group treated by traditional Chinese medicine. To initially observe the therapeutic effect of Sanyinjiao and to further investigate the specificity of acupuncture points in treating dysmenorrheal.
Object and Methods:60 patients who met the diagnostic criteria of primary dysmenorrhea were included in the study in order, and they were randomly divided into two groups:treatment group treated by electroacupuncture on sanyinjiao and control group treated by Chinese medicine, there were 30 patients in each group, and they were given either Chinese medicine or electroacupuncture according to stochastic programs.
Method
Treatment group:Patients were given EA on Sanyinjiao together with other acupoints based on Differential Treatment of primary dysmenorrheal. Points that were selected were as follows:Sanyinjiao, Ciliao, seventeenth vertebra, Hegu, Taichong, if the patient had nausea and vomiting, gong-sun and Neiguan would be added, if the patient's limbs were not warm, and had a pale countenance, Shenshu and Yaoyangguan would be added; if the patient suffered foot fatigue and dizziness, Geshu, Pishu would be added. EA frequency was 2/100HZ, and its degree of intensity was mainly determined by the patient's tolerance. The treatment lasted for 30 minutes each time, starting 7 days before menstruation, and lasted for 10 consecutive days for three consecutive menstrual cycles.
Control group:Patients were given Gexiazhuyutang which had the function of activating blood circulation, transforming blood stasis and relieving pain by activating movement of qi. Drugs contained in the formula were as follows: Angelica, Chuanxiong, red peony, Danpi, peach kernel (smashed), safflower, Yuan Hu, aggregata, Wulingzhi (fried), Cyperus rotundus, Citrus aurantium, licorice.if the patient had nausea and vomiting, pinellia and ginger would be added, if the patient's limbs were not warm, and had a pale countenance, Aiye and cumin would be added; if the patient suffered foot fatigue and dizziness, Radix and Millettia would be added. Decoction of those herbs was dried and made into concentrated powder. Then the powder was made into scientific medicine by adding appropriate excipients (starch). Patients started taking medicine 7 days before the menstruation until the third day of the menstruation,50g (one bag) each time,3 times a day, for three menstrual cycles. Patients in both groups before and after treatment were scored by MQP, SF-36 and given plasma PGF2a and PGE2 detection. The measured data given t test or analysis of variance while count data was given X2 test, clinical grade Data was given Ridit analysis. All the data was analyzed by SPSS statistical software (SPSS12).
Results
After treatment, patients'total pain score, total emotional score, VAS score and present pain scores all decreased compared with that before treatment, with P<0.01, the differences were statistically significant; compared total pain score, total emotional score, VAS score and present pain scores between the two groups, the differences were statistically significant,with P<0.05;After treatment, the value of plasma PGF2a of patients in two groups all decreased significantly, the difference between the two groups was statistically significant, P<0.01, the values of plasma PGE2 were significantly higher after treatment, the difference between the two groups was statistically significant P<0.01. Comparing the SF-36 score in treatment group before and after treatment, the differences were all statistically significant P<0.01; Comparing the SF-36 score in control group before and after treatment, the differences were all statistically significant P<0.01; The comparison of SF-36 score of patients in two groups after treatment, the differences were statistically significant, P<0.05.
Conclusion
1.Electroacupuncture and Gexiazhuyutang both can improve pain feeling and emotional discomfort of patients with dysmenorrhea, and they can reduce their pains. EA was better.
2.Electroacupuncture and Gexiazhuyutang can reduce the level of PGF2a in patients with dysmenorrhea, and can increase PGE2 levels therefore can improve abnormal hormone secretion, and EA was better than Gexiazhuyutang.
3.Electroacupuncture and Gexiazhuyutang can improve SF-36 scores of patients with dysmenorrheal, therefore can improve the quality of their life and the treatment group had better effect than the control group.
原发性痛经即功能性痛经,不伴明显的盆腔器质性疾病,因其病因复杂,容易反复而成为妇科的疑难病症之一,给妇女的身心健康和工作学习带来了严重的影响,而目前对其防治尚无重大突破,针灸治疗痛经,疗效确切、操作简便、价格低廉、无毒副作用,易于被广大患者接受。但目前针灸临床治疗痛经选穴笼杂、规范的穴位研究较少,给临床治疗痛经的选穴带来一定的难度。
通过与中药对照组治疗原发性痛经疗效的比较,初步观察通过电针治疗原发性痛经的疗效,为运用针灸治疗原发性痛经提供科学的研究基础。
研究方法
治疗组：电针穴位处方：三阴交、气海、关元、合谷、太冲,电针频率采用疏密波,疏波频率为2HZ,密波频率100HZ,疏密交替频率5Hz；强度以患者耐受为度,留针30分,经前7天开始治疗,连续10天,连续3个月经周期；对照组：采用活血化瘀、行气止痛的少腹逐瘀汤为主。药物组成：当归9g、川芎6g、赤芍6g、、五灵脂6g(炒)、小茴香(炒)7粒,干姜(炒)0.6g、没药(研)6g、蒲黄9g。将上述中药煎煮成药汁后,再加以浓缩干燥制成药粉,加上适量赋型剂(淀粉)制成科学中药。经前7天服药开始服用至月经第3天,每次50g/包,每日3次,水冲服,连服3个月经周期。两组患者分别于治疗前后进行疼痛调查问卷(MQP)评分、血浆PGF2α及PGE2检测、健康调查简表(SF-36)评分,计量资料采用t检验或方差分析,计数资料采用X2检验,临床等级资料比较采用Ridit分析。所用计量资料均用表示,所有数据采用SPSS统计软件(SPSS12)进行分析。
研究结果
两组治疗后患者疼痛感觉方面总分、疼痛情感方面总分、疼痛总分VAS评分、现在疼痛状况评分均降低,与治疗前比较,均P<0.01,差异均有统计学意义；治疗后两组间患者疼痛感觉方面总分、疼痛情感方面总分、疼痛总分、VAS评分、现在疼痛状况评分比较,P<0.05,差异均有统计学意义；治疗后两组血浆PGF2。值均有明显下降,两组间比较,P<0.01,差异有统计学意义；治疗后两组血浆PGE2值均有明显升高,两组间比较,P<0.01,差异有统计学意义。治疗组治疗后SF-36精神健康及身体健康评分与治疗前比较,均P<0.01,差异均有统计学意义；对照组SF-36精神健康及身体健康评分与治疗前比较,均P<0.01,差异均有统计学意义；治疗后治疗组SF-36精神健康及身体健康评分与对照组治疗后比较,均P<0.05,差异均有统计学意义。
研究结论
1.电针和少腹逐瘀汤均可改善痛经患者疼痛感觉、情感等症状,降低疼痛的程度,减轻患者痛苦,且电针效果更佳。
2.电针和少腹逐瘀汤均可降低痛经患者PGF2α水平,升高PGE2水平,改善患者激素分泌异常状况,且电针效果优于少腹逐瘀汤。
3.电针和少腹逐瘀汤均能提高痛经患者SF-36精神及身体健康评分,改善痛经患者生存质量,且治疗组作用优于对照组。
Objective
Primary dysmenorrhea which refers to functional dysmenorrheal, is not associated with significant pelvic organic diseases. Due to its complex causes and easy relapse, it has become a difficult gynecological disease and brings serious impact on women's physical and mental health as well as their work and study. So far, there is still no major breakthrough in its prevention and treatment. Acupuncture has proved to be effective in treating dysmenorrhea, what is more, acupuncture is not expensive, easy to perform and has no side effects, therefore, it can be easily accepted by most patients. But many acupoints have been used to treat dysmenorrhea, and there is few relative standardized study about acupoints, which has caused difficulty in selecting acupoints for clinical treatment of dysmenorrheal.
Treating primary dysmenorrhea by applying EA on Sanyinjiao together with other acupoints based on differentiation, and was compared with control group treated by traditional Chinese medicine. To initially observe the therapeutic effect of Sanyinjiao and to further investigate the specificity of acupuncture points in treating dysmenorrheal.
Object and Methods:60 patients who met the diagnostic criteria of primary dysmenorrhea were included in the study in order, and they were randomly divided into two groups:treatment group treated by electroacupuncture on sanyinjiao and control group treated by Chinese medicine, there were 30 patients in each group, and they were given either Chinese medicine or electroacupuncture according to stochastic programs.
Method
Treatment group:Patients were given EA on Sanyinjiao together with other acupoints based on Differential Treatment of primary dysmenorrheal. Points that were selected were as follows:Sanyinjiao, Ciliao, seventeenth vertebra, Hegu, Taichong, if the patient had nausea and vomiting, gong-sun and Neiguan would be added, if the patient's limbs were not warm, and had a pale countenance, Shenshu and Yaoyangguan would be added; if the patient suffered foot fatigue and dizziness, Geshu, Pishu would be added. EA frequency was 2/100HZ, and its degree of intensity was mainly determined by the patient's tolerance. The treatment lasted for 30 minutes each time, starting 7 days before menstruation, and lasted for 10 consecutive days for three consecutive menstrual cycles.
Control group:Patients were given Gexiazhuyutang which had the function of activating blood circulation, transforming blood stasis and relieving pain by activating movement of qi. Drugs contained in the formula were as follows: Angelica, Chuanxiong, red peony, Danpi, peach kernel (smashed), safflower, Yuan Hu, aggregata, Wulingzhi (fried), Cyperus rotundus, Citrus aurantium, licorice.if the patient had nausea and vomiting, pinellia and ginger would be added, if the patient's limbs were not warm, and had a pale countenance, Aiye and cumin would be added; if the patient suffered foot fatigue and dizziness, Radix and Millettia would be added. Decoction of those herbs was dried and made into concentrated powder. Then the powder was made into scientific medicine by adding appropriate excipients (starch). Patients started taking medicine 7 days before the menstruation until the third day of the menstruation,50g (one bag) each time,3 times a day, for three menstrual cycles. Patients in both groups before and after treatment were scored by MQP, SF-36 and given plasma PGF2a and PGE2 detection. The measured data given t test or analysis of variance while count data was given X2 test, clinical grade Data was given Ridit analysis. All the data was analyzed by SPSS statistical software (SPSS12).
Results
After treatment, patients'total pain score, total emotional score, VAS score and present pain scores all decreased compared with that before treatment, with P<0.01, the differences were statistically significant; compared total pain score, total emotional score, VAS score and present pain scores between the two groups, the differences were statistically significant,with P<0.05;After treatment, the value of plasma PGF2a of patients in two groups all decreased significantly, the difference between the two groups was statistically significant, P<0.01, the values of plasma PGE2 were significantly higher after treatment, the difference between the two groups was statistically significant P<0.01. Comparing the SF-36 score in treatment group before and after treatment, the differences were all statistically significant P<0.01; Comparing the SF-36 score in control group before and after treatment, the differences were all statistically significant P<0.01; The comparison of SF-36 score of patients in two groups after treatment, the differences were statistically significant, P<0.05.
Conclusion
1.Electroacupuncture and Gexiazhuyutang both can improve pain feeling and emotional discomfort of patients with dysmenorrhea, and they can reduce their pains. EA was better.
2.Electroacupuncture and Gexiazhuyutang can reduce the level of PGF2a in patients with dysmenorrhea, and can increase PGE2 levels therefore can improve abnormal hormone secretion, and EA was better than Gexiazhuyutang.
3.Electroacupuncture and Gexiazhuyutang can improve SF-36 scores of patients with dysmenorrheal, therefore can improve the quality of their life and the treatment group had better effect than the control group.
引文
[1]全国妇女月经生理常数协作组中.中国妇女月经生理常数的调查分析.中华妇产科杂志,1980,15(4)：219
[2]罗元恺,罗颂平.中国百年百名中医临床家丛书,罗元恺.北京：中国中医药出版社,2001,60-64
[3]许逸民,李庆峰.中国百年百名中医临床家丛书·许玉山.北京：中国中医药出版社,2001,156-159.
[4]姜春营.中药针灸治疗痛经简介[J]农垦医学,1999
[5]张嘉男痛经从肝论治举隅.四川中医[J],1999,9(17)：41-43.
[6]于庆松.痛经临证要义[J].新中医,1999,3(31)：3-6.
[7]孙世发.痛经论治方药的比较研究[J].江西中医药,1996：(3)：43
[8]员清亮.痛经用药思路与心得[J].山东中医杂志.1997：(7)：291
[9]哈荔田.哈荔田妇科医案医话选.天津：天津科学技术出版社.1982：72-76
[10]罗元恺.女科述要.新中医,1992,24(3)：17
[11]邓海霞.王采文治疗原发性痛经特色探析.中国中医药信息杂志,2001,8(5)：71
[12]刘卫平,廉凤叶.妇科痛证机理之管见.中医药研究,1996,(4)：8-9
[13]周晓爱.活血化瘀为主治疗痛经的临床疗效与甲皱微循环观察.广西中医药,1992,15(6)：1-3
[14]匡继林.谢剑南教授辨证化瘀法治疗原发性痛经经验.湖南中医药报,2002,8(9)：548,551
[15]黄素英.蔡小荪妇科临证善取通法的经验.上海中医药杂志,1999(2)：30-31
[16]邓海霞.王采文治疗原发性痛经经验.浙江中医杂志,2001(3)：711
[17]李惠娟.分期辨治痛经50例.安徽中医临床杂志,2002,14(5)：337-33
[18]李能霞.辨证治疗痛经62例小结.甘肃中医,2005,18(2)：22-24.
[19]张淑琴,李锦鹏,等.辨证治疗痛经96例.陕西中医,2005,26(5)：396-397
[20]齐津丽.辨证治疗原发性痛经60例.辽宁中医杂志,2006,33(3)：323-324.8
[21]邢章颖.辨证治疗原发性痛经160例临床观察.浙江中医药大学学报,2006,30(4)：395,397.
[22]丁树栋,管恩兰.辨证治疗原发性痛经156例.光明中医,2006,21(10)：58-59.
[23]王琨,陈康.玄灵汤加减治疗原发性痛经疗效观察.辽宁中医学院学报,2005,7(2)：147-148.
[24]唐华伟.温阳化瘀法治疗痛经56例临床疗效观察.云南中医中药杂志,2005,26(4)： 12.
[25]李莲藕,胡志明,等.调经汤治疗气滞血瘀型痛经58例.湖南中医杂志,2005,21(5)： 51.
[26]罗楚兵.加味血府逐瘀汤治疗痛经的临床疗效观察.湖北中医杂志,2006,28(11)：33.
[27]杜嫦燕.失笑散加味治疗原发性痛经68例.中国民族民间医药杂志,2000(3)；135
[28]王霞灵,曹大农,单志群,等.艾附暖宫汤为主治疗痛经的临床研究.中医药学刊,2003,21(5)：668
[29]龙瑛,龙敏利,唐志村.少腹逐瘀汤加减治疗痛经136例.湖南中医学院学报,1999,19 (3)： 48
[30]丁月芳.血府逐瘀汤加减治疗气滞血瘀型痛经62例.新疆中医药,2003,21(3)：10-11
[31]高晓俐.加味温经汤治疗原发性痛经80例.陕西中医2004,25(11)：963-964.
[32]吴晓明,李鸿娟.加味当归芍药散治疗原发性痛经45.辽宁中医药大学学报,2006,8(5)： 91.
[33]缪乔.桃红四物汤加味治疗原发性痛经临床观察.中药学刊.2006,24(10)：1926.
[34]付延玲.少腹逐瘀汤加味治疗原发性痛经60例.中国社区医师,2006,8(149)：75.
[35]江伟华,叶美玲.补肾化瘀方治疗痛经121例.上海中医药杂志,2003,37(5)：44-45
[36]杨令娟.痛经方治疗原发性痛经89例.山西中医,2004,20(5)：19.
[37]丁卫红.调经止痛汤治疗原发性痛经40例.江苏中医药,2004,25(10)：29.
[38]杨春晓.自拟痛经舒治疗原发性痛经56例.国医论坛,2004,19(6)：39-40.
[39]朱平东,彭树英.解郁拈痛散治疗原发性痛经.四川中医,2006,24(2)：81-82.
[40]许金珠,赵勤勇,潘成平.痛经汤治疗原发性痛经59例.实用中医药杂志,2006,22(4)：216.
[41]彭宪镇.活血疏肝祛痛汤治疗原发性痛经132例.陕西中医2006,27(6)：675-676.
[42]范京国,周东民,齐向华.化瘀镇痛汤治疗原发性痛经100例研究.医药产业资讯,2006,3(17)：285-286.
[43]段连昌.月月舒冲剂治疗妇女痛经80例.The Practical Journal of Integrating Chinese with Modern Medicine,1997,10(14):1402
[44]孙卫华,赵琳,田小平,等.桂枝茯苓胶囊治疗原发性痛经90例临床观察.中国中西医结合杂志,2004,24(12)：1121-1122
[45]王素萍,裴丽华.独一味胶囊治疗痛经80例临床观察.山西中医学院学报,2001,4：27-30.
[46]高铁祥,易生富.田大夫田七痛经胶囊治疗痛经的实验研究.中国中医药科技,1999,6(4)：233-234
[47]赵纯.化瘀通经胶囊治疗原发性痛经318例临床疗效观察.中医药管理杂志,2006,14(10)：67-68.
[48]蒙文炳.血府逐瘀胶囊治疗原发性痛经40例分析.北京中医,2005,24(4)：255.
[49]李莉,等.月痛安胶囊治疗原发性痛经的临床观察.湖北中医杂志,2007,29(1)：37-38.
[50]巴图德力根,白音仓,图雅,等.少腹逐瘀止痛汤治疗原发性痛经141例.中国民间疗法,1998,6(6)：38
[51]张永洛,侯光明.薏苡仁对重度功能性痛经镇痛作用的序贯试验观察.中医杂志,1998,39(10)：599
[52]江伟华,叶一萍,黄志华.中西医结合治疗痛经154例.浙江中西医结合杂志,2001,1(10)：645
[53]刘维庆.中西医结合治疗原发性痛经66例.四川中医,2004,22,(8)；65-66.
[54]郑素英.加味生化汤配合654-2片治疗原发性痛经68例.陕西中医,2004,25(11)：964-965.
[55]王晓君,宋新龙,高鹏,等.中西医结合治疗原发性痛经60例疗效观察,世界中西医结合杂志,2008,3(11)：666-667.
[56]邓江萍,张翠红.针灸治疗原发性痛经72例.中华实用中西医杂志,2006,19(13)：1683-1684.
[57]刘宝瑛.针灸治疗原发性痛经39例疗效观察.山西中医学院学报.2007,8(6)：40-41.
[58]陈兵,涂小华.针刺治疗原发性痛经疗效观察,上海针灸杂志2008,27(6)：15-16
[59]陈建华,索世云.针刺加TDP治疗原发性痛经30例,中国中医急症.2009,18(1)：129
[60]孙立虹,葛建军,佘延,等.隔物灸治疗寒湿凝滞型原发性痛经103例疗效观察.河北中医,2008,30(2)：170-171
[61]袁静.针药结合治疗原发性痛经50例临床观察.光明中医,2006,21,(9)：27-28.
[62]郑岚,李艳.活血汤配合针刺三阴交治疗气滞血瘀型原发性痛经40例临床观察.中国中医药科技,2008,15(5)：350-351
[63]王铠,潘文宇,段颖华.耳针治疗原发性痛经的临床研究.广东医学,2005,26(2)：1728-1729.
[64]段颖华,李艳慧.耳针治疗原发性痛经的疗效及其对血清PGE2影响的观察,浙江中医杂志,2007,42(3)：168-170
[65]孙东华,李晓春.平衡针疗法治疗原发性痛经67例.现代保健：医学创新研究,2008, 5(6)190.
[66]牛文民,刘智斌.头皮发际区微针法治疗原发性痛经的临床研究,陕西中医学院学报,2008,31(5)：56-58
[67]周玉娣,魏秋玻,周萍.中药敷脐治疗原发性痛经的效果观察.护理学杂志,2006,21(12)：11-12.
[68]陈爱兰,吕连凤,徐正莉.药灸神阙穴治疗原发性痛经52例.河北中医药学报,2006,21(4)： 26.
[69]黄荷凤,何赛男.子宫前列腺素研究进展.国外医学：妇产科学分册,1995,22(5)：265-268.
[70]Benedetto C. Eieosanoids in primary dysmenorrhea, endometriosis and menstrual migraine.Gynecol Endocrinol.1998,3 (1):71
[71]华永庆,洪敏,朱荃.原发性痛经研究进展.南京中医药大学学报,2003,19(1)：62-64
[72]Dingfelder JR. Primary dysmenorrhea treatment with prostauglandin inhibiters:a review. AmJ Obstet Gynecol,1981,140 (8):8747
[73]杨惠玲.高级病理生理学.科学出版社,1998：24-34
[74]刘德麟.分子网络紊乱与调节.清华大学出版社,1999：63
[75]党海珍,滕久样,彭芝配等.九气拈痛胶囊对痛经大鼠子宫组织内皮素和一氧化氮影响的实验研究.中国中医药科技,2001,8(3)：150-151
[76]FacchinettiF, SgarbiL, PiccininiF, etal.A comparison of glyceryl trinitrate with diclcfenac for the treatmeat of primary dysmenorrhea: anopen, randomized, cross-overtrial. Gynecol Endocrinol,2002,16 (1):39-43
[77]王淑贞.实用妇产科学.人民卫生出版社.1987：803
[78]韩秦.原发性痛经病因研究进展.国外医学妇幼保健分册,1997,8 (1)：1-2
[79]BancroftJ, etal. PsyhosomMed,1995;57 (5):445-452
[80]HalbreichU, etal. JcliPsychiatry,1991:52(1):15-16
[81]HolmlundU. JPsychiatry,1991;5 (4):232-239
[82]IzzoA, etal.ClinExpobstetGy-necol,1991; 18(2):109-116
[83]曹泽毅.中华妇产科学,人民卫生出版社,1999第一版：2217-2219
[84]李晓玉,周卫国.髓后孔阻滞治疗原发性痛经88例临床分析[J].中国社区医师,2005,7：112：24
[85]中华人民卫生部药政管理局编.中药新药临床研究指导原则(第一辑).1993,263-265
[86]乐杰.妇产科学(第五版).北京北京人民卫生出版社.2000,380
[87]马宝璋.中医妇科学(第六版).上海上海科学技术出版社,1997,79-83
[88]王怀义.医林改错发挥.山西科学技术出版社,1999, (8)：56、60
[89]吴锐等.研究血瘀挟寒型功能性痛经.中国临床医生,2001, (3)：25-26
[90]归绥琪.中国中西结合杂志,1993,1：60
[91]高树中一针疗法[M].1版.山东：济南出版社,2006：168-170
[92]张培林.神经解剖学[M],北京：人民卫生出版社,1987年,第1版：116-164
[93]沈雪勇.经络输穴学[M].北京：中国中医药出版社,第1版2003,1：250.
[94]龚萍,张明敏,王棋等.针刺三阴交对痛经患者脑葡萄糖代谢的影响[J].中国针灸,2006：1(26)51-55
[95]苏永利,刘风娥,和瑞欣.针刺次髎穴治疗痛经[J].河南中医,2000;22(4)：51-52
[2]罗元恺,罗颂平.中国百年百名中医临床家丛书,罗元恺.北京：中国中医药出版社,2001,60-64
[3]许逸民,李庆峰.中国百年百名中医临床家丛书·许玉山.北京：中国中医药出版社,2001,156-159.
[4]姜春营.中药针灸治疗痛经简介[J]农垦医学,1999
[5]张嘉男痛经从肝论治举隅.四川中医[J],1999,9(17)：41-43.
[6]于庆松.痛经临证要义[J].新中医,1999,3(31)：3-6.
[7]孙世发.痛经论治方药的比较研究[J].江西中医药,1996：(3)：43
[8]员清亮.痛经用药思路与心得[J].山东中医杂志.1997：(7)：291
[9]哈荔田.哈荔田妇科医案医话选.天津：天津科学技术出版社.1982：72-76
[10]罗元恺.女科述要.新中医,1992,24(3)：17
[11]邓海霞.王采文治疗原发性痛经特色探析.中国中医药信息杂志,2001,8(5)：71
[12]刘卫平,廉凤叶.妇科痛证机理之管见.中医药研究,1996,(4)：8-9
[13]周晓爱.活血化瘀为主治疗痛经的临床疗效与甲皱微循环观察.广西中医药,1992,15(6)：1-3
[14]匡继林.谢剑南教授辨证化瘀法治疗原发性痛经经验.湖南中医药报,2002,8(9)：548,551
[15]黄素英.蔡小荪妇科临证善取通法的经验.上海中医药杂志,1999(2)：30-31
[16]邓海霞.王采文治疗原发性痛经经验.浙江中医杂志,2001(3)：711
[17]李惠娟.分期辨治痛经50例.安徽中医临床杂志,2002,14(5)：337-33
[18]李能霞.辨证治疗痛经62例小结.甘肃中医,2005,18(2)：22-24.
[19]张淑琴,李锦鹏,等.辨证治疗痛经96例.陕西中医,2005,26(5)：396-397
[20]齐津丽.辨证治疗原发性痛经60例.辽宁中医杂志,2006,33(3)：323-324.8
[21]邢章颖.辨证治疗原发性痛经160例临床观察.浙江中医药大学学报,2006,30(4)：395,397.
[22]丁树栋,管恩兰.辨证治疗原发性痛经156例.光明中医,2006,21(10)：58-59.
[23]王琨,陈康.玄灵汤加减治疗原发性痛经疗效观察.辽宁中医学院学报,2005,7(2)：147-148.
[24]唐华伟.温阳化瘀法治疗痛经56例临床疗效观察.云南中医中药杂志,2005,26(4)： 12.
[25]李莲藕,胡志明,等.调经汤治疗气滞血瘀型痛经58例.湖南中医杂志,2005,21(5)： 51.
[26]罗楚兵.加味血府逐瘀汤治疗痛经的临床疗效观察.湖北中医杂志,2006,28(11)：33.
[27]杜嫦燕.失笑散加味治疗原发性痛经68例.中国民族民间医药杂志,2000(3)；135
[28]王霞灵,曹大农,单志群,等.艾附暖宫汤为主治疗痛经的临床研究.中医药学刊,2003,21(5)：668
[29]龙瑛,龙敏利,唐志村.少腹逐瘀汤加减治疗痛经136例.湖南中医学院学报,1999,19 (3)： 48
[30]丁月芳.血府逐瘀汤加减治疗气滞血瘀型痛经62例.新疆中医药,2003,21(3)：10-11
[31]高晓俐.加味温经汤治疗原发性痛经80例.陕西中医2004,25(11)：963-964.
[32]吴晓明,李鸿娟.加味当归芍药散治疗原发性痛经45.辽宁中医药大学学报,2006,8(5)： 91.
[33]缪乔.桃红四物汤加味治疗原发性痛经临床观察.中药学刊.2006,24(10)：1926.
[34]付延玲.少腹逐瘀汤加味治疗原发性痛经60例.中国社区医师,2006,8(149)：75.
[35]江伟华,叶美玲.补肾化瘀方治疗痛经121例.上海中医药杂志,2003,37(5)：44-45
[36]杨令娟.痛经方治疗原发性痛经89例.山西中医,2004,20(5)：19.
[37]丁卫红.调经止痛汤治疗原发性痛经40例.江苏中医药,2004,25(10)：29.
[38]杨春晓.自拟痛经舒治疗原发性痛经56例.国医论坛,2004,19(6)：39-40.
[39]朱平东,彭树英.解郁拈痛散治疗原发性痛经.四川中医,2006,24(2)：81-82.
[40]许金珠,赵勤勇,潘成平.痛经汤治疗原发性痛经59例.实用中医药杂志,2006,22(4)：216.
[41]彭宪镇.活血疏肝祛痛汤治疗原发性痛经132例.陕西中医2006,27(6)：675-676.
[42]范京国,周东民,齐向华.化瘀镇痛汤治疗原发性痛经100例研究.医药产业资讯,2006,3(17)：285-286.
[43]段连昌.月月舒冲剂治疗妇女痛经80例.The Practical Journal of Integrating Chinese with Modern Medicine,1997,10(14):1402
[44]孙卫华,赵琳,田小平,等.桂枝茯苓胶囊治疗原发性痛经90例临床观察.中国中西医结合杂志,2004,24(12)：1121-1122
[45]王素萍,裴丽华.独一味胶囊治疗痛经80例临床观察.山西中医学院学报,2001,4：27-30.
[46]高铁祥,易生富.田大夫田七痛经胶囊治疗痛经的实验研究.中国中医药科技,1999,6(4)：233-234
[47]赵纯.化瘀通经胶囊治疗原发性痛经318例临床疗效观察.中医药管理杂志,2006,14(10)：67-68.
[48]蒙文炳.血府逐瘀胶囊治疗原发性痛经40例分析.北京中医,2005,24(4)：255.
[49]李莉,等.月痛安胶囊治疗原发性痛经的临床观察.湖北中医杂志,2007,29(1)：37-38.
[50]巴图德力根,白音仓,图雅,等.少腹逐瘀止痛汤治疗原发性痛经141例.中国民间疗法,1998,6(6)：38
[51]张永洛,侯光明.薏苡仁对重度功能性痛经镇痛作用的序贯试验观察.中医杂志,1998,39(10)：599
[52]江伟华,叶一萍,黄志华.中西医结合治疗痛经154例.浙江中西医结合杂志,2001,1(10)：645
[53]刘维庆.中西医结合治疗原发性痛经66例.四川中医,2004,22,(8)；65-66.
[54]郑素英.加味生化汤配合654-2片治疗原发性痛经68例.陕西中医,2004,25(11)：964-965.
[55]王晓君,宋新龙,高鹏,等.中西医结合治疗原发性痛经60例疗效观察,世界中西医结合杂志,2008,3(11)：666-667.
[56]邓江萍,张翠红.针灸治疗原发性痛经72例.中华实用中西医杂志,2006,19(13)：1683-1684.
[57]刘宝瑛.针灸治疗原发性痛经39例疗效观察.山西中医学院学报.2007,8(6)：40-41.
[58]陈兵,涂小华.针刺治疗原发性痛经疗效观察,上海针灸杂志2008,27(6)：15-16
[59]陈建华,索世云.针刺加TDP治疗原发性痛经30例,中国中医急症.2009,18(1)：129
[60]孙立虹,葛建军,佘延,等.隔物灸治疗寒湿凝滞型原发性痛经103例疗效观察.河北中医,2008,30(2)：170-171
[61]袁静.针药结合治疗原发性痛经50例临床观察.光明中医,2006,21,(9)：27-28.
[62]郑岚,李艳.活血汤配合针刺三阴交治疗气滞血瘀型原发性痛经40例临床观察.中国中医药科技,2008,15(5)：350-351
[63]王铠,潘文宇,段颖华.耳针治疗原发性痛经的临床研究.广东医学,2005,26(2)：1728-1729.
[64]段颖华,李艳慧.耳针治疗原发性痛经的疗效及其对血清PGE2影响的观察,浙江中医杂志,2007,42(3)：168-170
[65]孙东华,李晓春.平衡针疗法治疗原发性痛经67例.现代保健：医学创新研究,2008, 5(6)190.
[66]牛文民,刘智斌.头皮发际区微针法治疗原发性痛经的临床研究,陕西中医学院学报,2008,31(5)：56-58
[67]周玉娣,魏秋玻,周萍.中药敷脐治疗原发性痛经的效果观察.护理学杂志,2006,21(12)：11-12.
[68]陈爱兰,吕连凤,徐正莉.药灸神阙穴治疗原发性痛经52例.河北中医药学报,2006,21(4)： 26.
[69]黄荷凤,何赛男.子宫前列腺素研究进展.国外医学：妇产科学分册,1995,22(5)：265-268.
[70]Benedetto C. Eieosanoids in primary dysmenorrhea, endometriosis and menstrual migraine.Gynecol Endocrinol.1998,3 (1):71
[71]华永庆,洪敏,朱荃.原发性痛经研究进展.南京中医药大学学报,2003,19(1)：62-64
[72]Dingfelder JR. Primary dysmenorrhea treatment with prostauglandin inhibiters:a review. AmJ Obstet Gynecol,1981,140 (8):8747
[73]杨惠玲.高级病理生理学.科学出版社,1998：24-34
[74]刘德麟.分子网络紊乱与调节.清华大学出版社,1999：63
[75]党海珍,滕久样,彭芝配等.九气拈痛胶囊对痛经大鼠子宫组织内皮素和一氧化氮影响的实验研究.中国中医药科技,2001,8(3)：150-151
[76]FacchinettiF, SgarbiL, PiccininiF, etal.A comparison of glyceryl trinitrate with diclcfenac for the treatmeat of primary dysmenorrhea: anopen, randomized, cross-overtrial. Gynecol Endocrinol,2002,16 (1):39-43
[77]王淑贞.实用妇产科学.人民卫生出版社.1987：803
[78]韩秦.原发性痛经病因研究进展.国外医学妇幼保健分册,1997,8 (1)：1-2
[79]BancroftJ, etal. PsyhosomMed,1995;57 (5):445-452
[80]HalbreichU, etal. JcliPsychiatry,1991:52(1):15-16
[81]HolmlundU. JPsychiatry,1991;5 (4):232-239
[82]IzzoA, etal.ClinExpobstetGy-necol,1991; 18(2):109-116
[83]曹泽毅.中华妇产科学,人民卫生出版社,1999第一版：2217-2219
[84]李晓玉,周卫国.髓后孔阻滞治疗原发性痛经88例临床分析[J].中国社区医师,2005,7：112：24
[85]中华人民卫生部药政管理局编.中药新药临床研究指导原则(第一辑).1993,263-265
[86]乐杰.妇产科学(第五版).北京北京人民卫生出版社.2000,380
[87]马宝璋.中医妇科学(第六版).上海上海科学技术出版社,1997,79-83
[88]王怀义.医林改错发挥.山西科学技术出版社,1999, (8)：56、60
[89]吴锐等.研究血瘀挟寒型功能性痛经.中国临床医生,2001, (3)：25-26
[90]归绥琪.中国中西结合杂志,1993,1：60
[91]高树中一针疗法[M].1版.山东：济南出版社,2006：168-170
[92]张培林.神经解剖学[M],北京：人民卫生出版社,1987年,第1版：116-164
[93]沈雪勇.经络输穴学[M].北京：中国中医药出版社,第1版2003,1：250.
[94]龚萍,张明敏,王棋等.针刺三阴交对痛经患者脑葡萄糖代谢的影响[J].中国针灸,2006：1(26)51-55
[95]苏永利,刘风娥,和瑞欣.针刺次髎穴治疗痛经[J].河南中医,2000;22(4)：51-52