低能量放散式体外冲击波治疗原发性痛经的临床研究  

THE CLINICAL RESEARCH OF LOW-ENERGY RADIAL EXTRACORPOREAL SHOCK WAVE FOR THE TREATMENT OF PRIMARY DYSMENORRHEA

作　　者：李涵[1] 伏春玲[1] 吕亚楠[1] 李亦梅[1] 

机构地区：[1]新疆医科大学第一附属医院疼痛科,乌鲁木齐830054

出　　处：《中国疼痛医学杂志》2017年第12期919-922,共4页Chinese Journal of Pain Medicine

摘　　要：目的:观察低能量放散式体外冲击波治疗原发性痛经(Primary Dysmenorrhea,PD)的疗效,以期为临床治疗PD提供新方法。方法:招募PD病人20例为试验组,正常无痛经女性20例作为提供正常血清前列腺素水平的对照组。试验组于排卵期前后1~2日,选取三阴交、足三里、关元穴位及腹直肌趾骨联合附着点、腹外斜肌等部位进行低能量放散式体外冲击波治疗。排卵期左右治疗1次为1个周期,治疗1个周期后随访6个月,评估疗效。试验组分别于治疗前后第1次月经来潮24~48小时内静脉采血;正常对照组于月经来潮24~48小时内静脉采血,测定血清前列腺素E2(PGE2)、前列腺素F2α(PGF2α)浓度,并比较二者在试验组治疗前后及与对照组浓度变化。采用视觉模拟疼痛评分法(visual analogue scale,VAS)评定疼痛程度。结果:(1)1个治疗周期后试验组总有效率为80%(16/20)。(2)试验组治疗后VAS评分均值较治疗前显著降低(P<0.01)。(3)治疗后PGE2浓度中位数(四分位间距)较治疗前显著增加(P<0.05),治疗后PGF2α浓度中位数(四分位间距)较治疗前显著降低(P<0.05)。(4)治疗后PGE_2、PGF_(2α)浓度与正常对照组中位数(四分位间距)相比无统计学差异。结论:低能量放散式体外冲击波治疗可降低PD病人经期PGF_(2α)浓度,提高PGE_2浓度,减轻疼痛症状,值得在临床上推广。Objective： in order to provide new ideas for clinical treatment of PD, we observed the curative effect of low-energy radial extracorporeal shock wave in the treatment of primary dysmenorrhea（PD）. Methods： We recruited 20 PD patients（experimental group） and 20 women who have never underwent dysmenorrhea since menarche（normal group）. The experimental group received shock wave treatment in sanyinjiao（SP6）, tsusanli, Guanyuan point, the rectus pubic symphysis attachment points, and the musculus obliquus externus abdominis during the ovulatory period（1-2 days around the ovulatory period）. The treatment of one menstrual cycle was one session and patients were followed up for 6 months after a treatment period. Pain degree was evaluated by visual analogue scale（VAS） before and after treatment. The changes of serum levels of prostaglandin E2（PGE2） and prostaglandin F2α（PGF2α） were also investigated before and after treatment. Results：（1） The total effective rate was 80%（16/20） in the experimental group after treatment.（2） In experimental group, the VAS score was significantly reduced after the treatment, compared with the VAS score before the treatment（P 〈 0.01）.（3） In experimental group, the PGE2 levels were significantly increased and the PGF2α levels were significantly reduced after the treatment, compared with these before the treatment（P 〈 0.05）.（4） After treatment, the serum levels of PGE2 and PGF2α in the experimental group and the control group had no statistically significant difference. Conclusions： The low-energy radial extracorporeal shock wave therapy achieves the superior short-term and long-term efficiencies in the treatment of PD, and it can adjust the serum levels of PGE2 and PGF2α, After the shock wave therapy, the symptoms of dysmenorrhea and pain were relieved.

关 键 词：原发性痛经 前列腺素 体外冲击波 

分 类 号：R711.51[医药卫生—妇产科学]