隔药灸脐治疗寒凝血瘀型原发性痛经疗效观察

Observation on therapeutic effect of umbilical medicine moxibustion on primary dysmenorrhea with syndrome of cold coagulation and blood stasis

目的观察隔药灸脐法治疗寒凝血瘀型原发性痛经的临床疗效。方法将2018年3月—2019年5月山东青岛中西结合医院妇科就诊的90例寒凝血瘀型原发性痛经患者随机分成中药组、灸脐组和中药+灸脐组,每组30例。中药组给予丹桂祛症合剂口服,经前10 d给药,连续给药15 d;灸脐组给予自拟温经止痛散隔药灸脐治疗,非经期每10 d治疗1次,每个月经周期治疗3次;中药+灸脐组给予丹桂祛症合剂口服+隔药灸脐治疗。3组患者均连续治疗3个月经周期。观察3组患者治疗前后Cox痛经症状积分、中医症状积分、经期情绪异常积分、血清前列腺素F_(2α)(PGF_(2α))水平及凝血功能变化,统计3组疗效及药物安全性。结果治疗后,3组患者Cox痛经症状积分、中医症状积分、经期情绪异常积分及血清PGF_(2α)水平均显著降低(P均<0.05),灸脐组和中药+灸脐组凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)显著延长(P均<0.05),治疗过程中无不良事件发生。灸脐组中医症状积分、经期情绪异常积分均明显低于中药组(P均<0.05),中药+灸脐组Cox痛经症状积分、中医症状积分、经期情绪异常积分及血清PGF_(2α)水平均明显低于中药组和灸脐组(P均<0.05)。中药+灸脐组愈显率为63.3%(19/30),明显高于中药组和灸脐组的34.5%(10/29)和37.9%(11/29),差异有统计学意义(P均<0.05)。结论隔药灸脐治疗可以有效缓解寒凝血瘀型原发性痛经患者经行腹痛,较丹桂祛症合剂治疗可以更显著改善患者经期情绪异常和凝血功能,两种治疗方案联合应用疗效更佳。

Objective It is to investigate the clinical efficacy of umbilical medicine moxibustion in the treatment of primary dysmenorrhea(PD)with syndrome of cold coagulation and blood stasis.Methods Ninety patients with primary dysmenorrhea with syndrome of cold coagulation and blood stasis treated in the Department of Gynecology in Qingdao Hospital of Integrated Traditional Chinese and Western Medicine from March 2018 to May 2019 were randomly divided into traditional Chinese medicine group,umbilical moxibustion group and traditional Chinese medicine+umbilical moxibustion group(combination group),each group had 30 cases.The traditional Chinese medicine group was given Dangui Quzheng Mixture orally 10 days before menstruation,and continuously administered for 15 days;the umbilical moxibustion group was treated with umbilical medicine moxibustion with self-prepared Wenjingzhitong San,once every 10d during non-menstrual period,for 3 times in every menstrual cycle;the combination group was given Dangui Quzheng Mixture orally+umbilical medicine moxibustion.All the patients in the 3 groups were treated for 3 consecutive menstrual cycles.The changes of Cox dysmenorrhea symptom score,TCM symptom score,menstrual mood abnormality score,levels of serum prostaglandin F_(2α)(PGF_(2α))and blood coagulation function were observed before and after treatment in the three groups.The efficacy and drug safety of the three groups were assessed.Results After treatment,the Cox dysmenorrhea symptom score,traditional Chinese medicine symptom score,menstrual mood abnormality score and serum PGF_(2α)level of the three groups were significantly reduced(all P<0.05),and the PT and APTT of the moxibustion group and the combination group were significantly prolonged(all P<0.05),no adverse events occurred during the treatment.The scores of TCM symptoms and menstrual mood abnormalities in the moxibustion group were significantly lower than those in the traditional Chinese medicine group(all P<0.05),the Cox dysmenorrhea symptom scores,traditional Chinese medicine symptom scores,menstrual mood abnormalities score and serum PGF_(2α)levels in the combination group were significantly lower than those in the traditional Chinese medicine group and umbilical moxibustion group(all P<0.05).The healing rate of the combination group was 63.3%(19/30),which was significantly higher than the 34.5%(10/29)and 37.9%(11/29)of the traditional Chinese medicine group and the moxibustion group,the differences were statistically significant(all P<0.05).Conclusion Umbilical medicine moxibustion can effectively relieve menstrual abdominal pain in patients with primary dysmenorrhea with syndrome of cold coagulation and blood stasis.It can more significantly improve the emotional abnormalities and blood coagulation function of patients during menstrual period compared with Dangui Quzheng Mixture.The combined application of the two treatments has a better effect.