百笑灸配合针刺治疗痛经寒凝血瘀证临床研究  

Clinical study on Baixiao moxibustion combined with acupuncture for the patients with dysmenorrhea of cold coagulation and blood stasis

作　　者：马艳华 徐雯 黄素英[3] Ma Yanhua;Xu Wen;Huang Suying(Department of Acupuncture and Massage,Huangpu Branch,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of General Practice,Jiangning Road Community Health Service Center,Shanghai 200070,China;Shanghai Literature Institute of Traditional Chinese Medicine,Shanghai 200020,China)

机构地区：[1]上海交通大学医学院附属第九人民医院黄浦分院针灸推拿科,上海200011 [2]上海市江宁路街道社区卫生服务中心全科,上海200070 [3]上海市中医文献馆,上海200020

出　　处：《国际中医中药杂志》2022年第6期641-644,共4页International Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局全国中医学术流派传承工作室第二轮建设项目(国中医药人教函〔2019〕62号);上海市卫健委中医药事业发展三年行动计划(2018年-2020年)项目(ZY(2018-2020)-CCCX-1015)。

摘　　要：目的评价百笑灸配合针刺治疗痛经寒凝血瘀证患者的疗效。方法将符合入选标准的2019年1月-2020年1月上海交通大学医学院附属第九人民医院黄浦分院痛经寒凝血瘀证患者90例,按随机数字表法分为观察组47例和对照组43例,对照组单纯针刺治疗,观察组在对照组基础上配合百笑灸。2组均治疗3个月经周期,随访3个月。分别于治疗前后进行中医证候评分,采用VAS量表评估疼痛程度,采用超声诊断仪进行子宫血流动力学检测,记录搏动指数(PI),阻力指数(RI)及收缩期峰值/舒张期峰值(S/D)比值。评价临床疗效。结果观察组总有效率为97.87%(46/47)、对照组为81.40%(35/43),2组比较差异有统计学意义(χ^(2)=6.77,P=0.009)。观察组治疗后下腹疼痛、经黯血块、畏寒肢冷、恶心呕吐评分及VAS评分均低于对照组(t值分别为3.61、5.60、6.22、8.02、10.36,P值均<0.01)。观察组治疗后RI[(1.45±0.55)比(1.86±0.53),t=3.59]、PI[(0.61±0.14)比(0.77±0.13),t=5.60]及S/D比值[(5.28±1.18)比(7.23±1.22),t=7.71]低于对照组(P<0.01)。结论百笑灸配合针刺可有效减轻患者疼痛症状,改善中医证候,促进子宫血液循环。Objective To evaluate the efficacy of Baixiao moxibustion combined with acupuncture in the treatment of patients with dysmenorrhea of cold coagulation and blood stasis.Methods A total of 90 patients with dysmenorrhea of cold coagulation and blood stasis who were treated in Huangpu Branch of Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine and met the inclusion criteria were enrolled between January 2019 and January 2020,and they were divided into observation group(47 patients)and control group(43 patients)according to the random number table method.The control group was treated by acupuncture,while the observation group combined Baixiao moxibustion with acpuncture treatment.Both groups were treated for 3 menstrual cycles.Before and after treatment,TCM syndromes were scored,Visual Analogue Scale(VAS)was used to evaluate pain intensity,and uterine hemodynamics were detected by ultrasonic diagnostic apparatus.The pulsatility index(PI),resistance index(RI)and ratio of peak systole/peak diastole(S/D)were recorded and the clinical efficacy was assessed.Results The total effective rate was 97.87%(46/47)in observation group and that in control group was 81.40%(35/43),and the difference between two groups were significant(χ^(2)=6.77,P=0.009).After treatment,the scores of lower abdominal pain,dark blood clots,intolerance of cold and cold limbs and nausea and vomiting as well as VAS scores in the observation group were significantly lower than those in the control group(t=3.61,5.60,6.22,8.02,10.36,all Ps<0.01).After treatment,the RI(1.45±0.55 vs.1.86±0.53,t=3.59),PI(0.61±0.14 vs.0.77±0.13,t=5.60)and S/D(5.28±1.18 vs.7.23±1.22,t=7.71)in observation group were significantly lower than those in control group(P<0.01).Conclusion Baixiao moxibustion combined with acupuncture can relieve the pain symptoms,improve the TCM syndromes and promote the uterine blood circulation.

关 键 词：痛经 寒凝血瘀 百笑灸 中医症状体征和证候 子宫 血流动力学 

分 类 号：R246.3[医药卫生—针灸推拿学]