心理因素对针刺治疗原发性痛经疗效的影响

Efficacy impacts of psychological factors on primary dysmenorrhea treated with acupuncture

目的:探讨心理因素与针刺治疗原发性痛经疗效的关系。方法:观察60例原发性痛经的患者,针刺治疗前采用自制的信任度调查问卷评估患者对针灸疗效的信任程度;以直观模拟标尺法(VAS)让患者评估针刺时的紧张度;焦虑量表(SAS)和抑郁量表(SDS)评价患者的焦虑和抑郁情况;艾森克人格问卷(EPQ)和卡特尔16种人格因素问卷(16PF)评估患者的个性特征。记录针刺治疗前后患者的疼痛程度、疼痛持续时间及伴随症状来评估疗效。对心理因素与痛经疗效之间的相关性分析采用典型相关的分析方法。结果:治疗后痛经程度分级、疼痛程度分值、疼痛持续时间与治疗前相比差异均有统计学意义(均P<0.001);人格因素中的恃强性(r=0.679 7)、紧张性(r=-0.590 6)与疗效指标中的疼痛持续时间减少值(r=0.904 2)的标准化系数最大;心理因素指标与痛经疗效的典型变量之间的整体相关系数均偏低。结论:针刺治疗原发性痛经的疗效与患者人格因素中的恃强性和紧张性有一定的相关性,但心理因素在针刺治疗过程中不起主导作用。

Objective To explore the relationship between psychological factors and efficacy of acupuncture on primary dysrnenorrhea. Methods Sixty cases of primary dysmenorrhea were observed. Before acupuncture treatment, the self-designed confidence questionnaire was used to assess patients＇ confidence in acupuncture efficacy. Visual Analogue Scale （VAS） was adopted to assess patients＇ tension level during acupuncture. Self-rating anxiety scale （SAS） and self-rating depression scale （SDS） were applied to assess the situations of patients＇ anxiety and depression. Eysenck＇ s personality questionnaire （EPQ） and Cattell sixteen personality factors questionnaire （16PF） were provided to assess the personal characters of patients. Pain intensity, pain duration and accompanied symptoms were recorded before and after acupuncture treatment so as to assess the efficacy. Canonical correlation analysis was used to analyze the relationship between the psychological factors and acupuncture efficacy on primary dysmenorrhea. Results There were significant differences in grading of dysmenorrhea, pain intensity score and pain duration after treatment as compared statistically with those before treatment （all P〈0. 001）. The standardized coefficients of dominance （r=0. 679 7） and anxiety （r=-0. 590 6） in personality factors and the reduction of pain duration（r=0. 904 2） among efficacy indices were the highest. The overall correlation coefficients were all lower between the indices of psychological factors and canonical variables of dysmenorrhea efficacy. Conclusion Acupuncture efficacy on primary dysmenorrhea has a certain correlation with dominance and anxiety of patients＇ personality factors. But, the psychological factors do not play a leading role in acupuncture treatment.