浮针结合附子饼灸治疗寒凝血瘀型原发性痛经:随机对照试验  

Fu's subcutaneous needling combined with monkshood cake-separated moxibustion for primary dysmenorrhea with cold congealing and blood stasis:a randomized controlled trial

作　　者：施佳欢 陈朝明[2] SHI Jiahuan;CHEN Zhaoming(Nanjing University of Chinese Medicine,Nanjing 210023,Jiangsu Province,China;Nanjing Hospital of CM,Nanjing University of Chinese Medicine,Nanjing 210000,Jiangsu Province)

机构地区：[1]南京中医药大学,江苏南京210023 [2]南京中医药大学附属南京中医院,江苏南京210000

出　　处：《中国针灸》2024年第8期905-909,共5页Chinese Acupuncture & Moxibustion

基　　金：江苏省中医药科技发展计划项目:YB2020028。

摘　　要：目的:观察浮针结合附子饼灸治疗寒凝血瘀型原发性痛经的临床疗效。方法:将60例寒凝血瘀型原发性痛经患者随机分为观察组(30例,脱落1例)和对照组(30例,脱落2例)。对照组于神阙、双侧子宫穴予附子饼灸治疗,观察组在对照组基础上行浮针治疗,分别在患者腹直肌、腹斜肌、股内收肌上触诊检查,确定患肌,在患肌外5~10 cm处进针,同时配合再灌注活动。于月经周期痛经第1天开始治疗,每天1次,连续治疗3 d,治疗3个月经周期。分别于治疗前及治疗2、3个疗程后观察两组患者疼痛视觉模拟量表(VAS)评分、COX痛经症状量表(CMSS)评分、中医证候评分,检测两组患者治疗前及治疗3个疗程后血清前列腺素F2α(PGF2α)含量,并评定两组临床疗效。结果:治疗2、3个疗程后,两组患者VAS评分、CMSS评分、中医证候评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。治疗3个疗程后,观察组血清PGF2α含量降低(P<0.05),且低于对照组(P<0.05)。观察组总有效率为96.6%(28/29),高于对照组的64.3%(18/28,P<0.05)。结论:浮针结合附子饼灸可以有效减轻寒凝血瘀型原发性痛经患者的疼痛程度、改善痛经临床症状、降低PGF2α水平。Objective To observe the clinical efficacy of Fu's subcutaneous needling combined with monkshood cake-separated moxibustion for primary dysmenorrhea with cold congealing and blood stasis.Methods Sixty patients with primary dysmenorrhea of cold congealing and blood stasis were randomly divided into an observation group(30 cases,1 case dropped out)and a control group(30 cases,2 cases dropped out).The control group received monkshood cake-separated moxibustion at Shenque(CV 8)and bilateral Zigong(EX-CA 1),while the observation group received Fu's subcutaneous needling based on the control group.The muscles were palpated and the affected muscles were determined.Needles were inserted 5-10 cm away from the affected muscles and reperfusion activity was performed simultaneously.All the treatment started on the first day of menstrual cycle pain,once a day,for 3 days,totaling for 3 menstrual cycles.The visual analogue scale(VAS)score,Cox menstrual symptom scale(CMSS)score,and traditional Chinese medicine(TCM)syndrome score in the two groups were observed before treatment,after 2 treatment courses and after 3 treatment courses.The serum prostaglandin F2α(PGF2α)levels before and after 3 treatment courses were measured,and the clinical efficacy of the two groups was evaluated.Results After 2 and 3 treatment courses,the VAS scores,CMSS scores,and TCM syndrome scores in the two groups were lower than those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After 3 treatment courses,the PGF2αlevel in the observation group was decreased(P<0.05),and were lower than that in the control group(P<0.05).The total effective rate was 96.6%(28/29)in the observation group,which was higher than 64.3%(18/28)in the control group(P<0.05).Conclusion Fu's subcutaneous needling combined with monkshood cake-separated moxibustion could effectively reduce the pain intensity,improve clinical symptoms of dysmenorrhea,and lower PGF2αlevel in patients with primary dysmenorrhea of cold

关 键 词：原发性痛经 寒凝血瘀型 浮针 附子饼灸 神阙穴 子宫穴 随机对照试验 

分 类 号：R246.3[医药卫生—针灸推拿学]