温经止痛汤联合推拿对原发性痛经患者的治疗价值  

Therapeutic Value of Wenjing Zhitong Decoction Combined with Tuina on Primary Dysmenorrhea Patients

作　　者：刘杨 薛小娜[1] 吕亚楠 国生[1] 刘晓芳[1] 魏培栋[1] LIU Yang;XUE Xiaona;LYU Yanan;GUO Sheng;LIU Xiaofang;WEI Peidong(Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China;Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100020,China)

机构地区：[1]北京中医药大学东方医院,北京100078 [2]北京中医药大学东直门医院,北京100020

出　　处：《世界中医药》2024年第19期2973-2977,共5页World Chinese Medicine

基　　金：国家自然科学基金项目(82004422);北京中医药大学东方医院推拿诊疗中心重点专科项目(040203002003)。

摘　　要：目的:探讨温经止痛汤联合推拿对原发性痛经患者的治疗价值。方法:选取2020年1月至2023年3月北京中医药大学东方医院收治的原发性痛经患者150例作为研究对象,采用随机数表法分为观察组和对照组,每组75例。对照组给予推拿治疗,观察组在对照组基础上联合温经止痛汤。比较2组临床疗效,同时评估其中医证候积分以及视觉模拟评分法(VAS),另外测定2组列腺素F_(2α)(PGF_(2α))、前列腺素E_(2)(PGE_(2))、β-内啡肽(β-EP)、P物质(SP)、多巴胺(DA)、5-羟色胺(5-HT)水平、子宫动脉血流搏动指数(PI)、血流阻力指数(RI)、收缩期峰值/舒张期峰值(S/D)。结果:观察组总有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后各中医证候评分评分低于对照组,差异有统计学意义(P<0.05);观察组治疗后VAS评分(1.21±0.15)分低于对照组(2.03±0.56)分,差异有统计学意义(t=12.249,P=0.000);观察组治疗后血清PGF_(2α)、SP、DA、5-HT水平低于对照组,血清PGE_(2)、β-EP水平高于对照组,观察组治疗后PI、RI、S/D指标低于对照组,差异有统计学意义(P<0.05)。结论:温经止痛汤联合推拿治疗原发性痛经不仅能有效改善患者临床症状、体征以及疼痛,还能改善其血清PGF_(2α)、疼痛相关因子水平以及子宫动脉血流动力学指标。Objective:To investigate the therapeutic value of Wenjing Zhitong Decoction combined with tuina in the treatment of primary dysmenorrhea.Methods:A total of 150 patients with primary dysmenorrhea who were admitted to Dongfang Hospital of Beijing University of Chinese Medicine from January 2020 to March 2023 were selected for this study.The patients were randomly divided into a control group and an observation group according to a random number table,with 75 cases in each group.The control group received tuina therapy,while the observation group received both tuina therapy and Wenjing Zhitong Decoction.The clinical efficacy of the two groups was compared,as well as the assessment of traditional Chinese medicine(TCM)syndrome scores,visual analog scale(VAS)scores,and levels of prostaglandin F_(2α)(PGF_(2α)),prostaglandin E_(2)(PGE_(2)),beta-endorphin(β-EP),substance P(SP),dopamine(DA),serotonin(5-HT).Additionally,uterine artery blood flow pulsatility index(PI),resistance index(RI),and systolic/diastolic peak ratio(S/D)were measured.Results:The total effective rate in the observation group was significantly higher than in the control group(P<0.05).The observation group had lower TCM syndrome scores after treatment than the control group(P<0.05).The VAS score in the observation group was(1.21±0.15),significantly lower than(2.03±0.56)of the control group(t=12.249,P=0.000).After treatment,serum levels of PGF_(2α),SP,DA,and 5-HT were lower in the observation group than in the control group,while serum levels of PGE_(2) andβ-EP were higher.Furthermore,the observation group showed significantly lower PI,RI,and S/D values than the control group(P<0.05).Conclusion:Wenjing Zhitong Decoction combined with tuina therapy effectively alleviates clinical symptoms,signs,and pain in patients with primary dysmenorrhea,and also improves serum levels of PGF_(2α),pain-related factors,and uterine artery hemodynamic indicators.

关 键 词：温经止痛汤 推拿 原发性痛经 前列腺素F_(2α) 疼痛介质 子宫动脉血流搏动指数 血流阻力指数 收缩期峰值/舒张期峰值 

分 类 号：R244.1[医药卫生—针灸推拿学] R944.61[医药卫生—中医临床基础]