针刺单穴、多穴治疗中度痛经止痛作用时效规律的比较

Preliminary comparison on the time-effect rule of pain-relieving in the treatment of moderate dysmenorrhea between acupuncture on single-point and acupuncture on multi-point

目的:比较针刺单穴、多穴治疗中度痛经止痛作用的时效规律,为针刺单穴、多穴治疗本病确定最佳留针时间、针刺频次提供参考依据。方法:将63例中度痛经患者随机分为单穴组(31例)和多穴组(32例)。在痛经发作时单穴组针刺十七椎,多穴组针刺十七椎、地机、次髎、三阴交,均留针30 min,分别记录针刺前即刻,进针5 min、10 min、20 min、30 min及起针后30 min、60 min、120 min的疼痛视觉模拟评分(VAS)值。结果:针刺后,两组的止痛作用迅速产生,留针30 min内,两组患者的止痛作用均持续加强,直至起针;进针10 min时多穴组的即时止痛作用明显优于单穴组(P<0.05),这种效应一直维持到起针后2 h。起针后30 min针刺止痛作用减退到最低点。结论:单刺十七椎、针刺十七椎等多个穴位对中度原发性痛经患者均有明显的即时止痛作用,针刺多个穴位优于单刺十七椎;无论单刺十七椎还是针刺十七椎等多个穴位,留针时间不宜短于30 min,疼痛持续时间较长的中度疼痛患者以每天针刺2次为宜。

Objective To compare the time-effect rule of pain-relieving in moderate dysmenorrhea in the treatment between acupuncture on single-point and acupuncture on multi：point so as to determine the best time of needle retaining on single-point and multi-point as well as provide the reference evidences of acupuncture frequency in the treatment. Methods Sixty-three cases of moderate dysmenorrhea were randomized into a single-point group （31 cases） and a multi-point group （32 cases）. During the attack of dysmenorrhea, in single-point group, Shiqizhui （EX-B 8） was punctured; in multi-point group, Shiqizhui （EX-B 8）, Diji （SP 8）, Ciliao （BL 32） and Sanyinjiao （SP 6） were punctured and the needles were retained for 30min. Visual Analogue Scale （VAS） values were recorded in the immediate time before acupuncture, in 5 min, 10 min, 20 min and 30 min after needle insertion, as well as in 30 min, 60 min and 120 min after needle withdrawal separately. Results After needling, analgesia was generated rapidly in either group. During 30 min of needle retaining, analgesia was enhanced persistently till needle withdrawal in either group. In 10 min after needle insertion, the immediate analgesia in multi-point group was superior obviously to single-point group （P〈0.05） and this effect was maintained in 2 h after needle withdrawal. In 30 min after needle withdrawal, acupuncture analgesia was declined to the maximum. Conclusion Either single-point acupuncture at Shiqizhui （EX-B 8） or multi-point acupuncture at Shiqizhui （EX-B 8） and other acupoints has apparent immediate analgesia on primary dysmenorrhea of moderate degree, but the effect of multi-point acupuncture is better than that of acupuncture at Shiqizhui （EX-B 8）. No matter with acupuncture at Shiqizhui （EX-B 8） or at multi-point, the time of needle retaining should not be shorten than 30 min. It is suitable to give acupuncture, twice per day for the patients with moderate and persistent pain.