Acupuncture and moxibustion for functional hypothalamic amenorrhea by establishing artificial cycle:a controlled trial  

针灸建立人工周期治疗功能性下丘脑闭经(英文)

作　　者：许素瑜[1] 李艳[1] 吴菲远[1] 卓晓云[1] 

机构地区：[1]湛江中心人民医院中医部

出　　处：《World Journal of Acupuncture-Moxibustion》2016年第1期7-13,共7页世界针灸杂志（英文版）

摘　　要：Objective To observe the clinical efficacy of acupuncture and moxibustion in treatment of functional amenorrhea by establishing artificial cycle.Method One hundred and twelve eligible patients with functional amenorrhea were divided into an acupuncture-moxibustion group（64 cases） and a western medication group（48 cases） by adopting random method.According to the pattern differentiation of amenorrhea of traditional Chinese medicine,the patients in the acupuncture-moxibustion group were classified into two types：amenorrhea due to blood depletion and amenorrhea due to stagnation of blood.For patients with amenorrhea due to blood depletion,Guanyuan（关元 CV4）,Zhongji（中极CV 3）,GuiTlai（归来ST 29）,Geshu（膈俞 BL 17）,Ganshu（肝俞BL 18）,Pishu（脾俞 BL 20） and Shenshu（肾俞 BL 23） were selected.At first,BL 17,BL 18,BL 20 and BL 23 were needled;after deqi,reinforcing method was applied,and the needles were not retained.Then,warmingneedle moxibustion was applied at CV 4,CV 3 and ST 29,and the needles were retained for 30 min.For patients with amenorrhea due to stagnation of blood,CV 3,Qihai（气海CV 6）,Xuehai（血海 SP 10）,Sanyinjiao（三阴交 SP 6）and Xingjian（行间 LR 2） were selected,reducing method was applied,and the needles were retained for 30 min.The treatment was performed once a day,and treatment for 15 consecutive days were the 1st cycle.The 2nd and3 rd cycles started from the 5th day of menstruation（for the patients still not menstruating,the 2nd and 3rd cycles started from the 29 th and 57 th days since the 1st day of treatment）,and the treatment lasted for 15 days.Three cycles were needed.In the western medicine group,estrogen-progestogen was taken orally for 21 days（one cycle） to establish a artificial cycle.The levels of FSH and LH were tested and compared on the 3rd day of menstruation before treatment and after the 3rd cycle of treatment,and the adverse effects were analyzed statistically.Follow-up visit was conducted for the patients 目的:观察针灸建立人工周期治疗功能性下丘脑闭经的临床疗效。方法:采用随机方法将符合条件的112例功能性闭经患者分为针灸组和(64例)和西药组(48例)。针灸组根据中医针灸经闭的辨证分型,分为血枯经闭和血滞经闭2类。血枯经闭者选用关元、中极、归来、膈俞、肝俞、脾俞、肾俞。首先针刺膈俞、肝俞、脾俞、肾俞穴,得气后行补法,不留针;然后针刺关元、中极、归来穴,温针灸,留针30 min。血滞经闭者选用中极、气海、血海、三阴交、行间,针用泻法,留针30 min。治疗每日1次,连续治疗15 d,此为第一个周期。第2、3个周期均是在月经经行第5天开始(若仍未行经者,则自治疗第1天算起第29、57天开始第2、3个周期的治疗),连续治疗15日,共治疗3个周期。西药组采用口服雌孕激素建立人工周期的方法连续服药21天为一个周期。在治疗前和治疗3个周期后的经行第3天对两组患者的卵泡刺激素(FSH)、黄体生成素(LH)进行测试比较,并对试验过程中产生的不良反应进行统计,然后对完成3个周期治疗的患者随访6个月,计算其复发率。结果:针灸建立人工周期治疗可显著提高功能性闭经患者的FSH和LH水平,两组患者的有效率差异无统计学意义(P>0.05),但针灸组的不良反应率(1.49%)及复发率(25.0%)均低于西药组的不良反应率(4.14%)及复发率(69.8%)(均P<0.05)。结论:针灸建立人工周期治疗可显著提高功能性闭经患者的FSH和LH水平,针灸建立人工周期治疗功能性闭经的疗效与口服雌孕激素建立人工周期的疗效相当,但不良反应和6个月内的复发率低。

关 键 词：functional amenorrhea acupuncture and moxibustion artificial cycle controlled trial 

分 类 号：R246.3[医药卫生—针灸推拿学]