分期穴位埋线治疗原发性痛经：随机对照研究

Primary dysmenorrhea treated with staging acupoint catgut embedment therapy:a randomized controlled trial

目的：观察分期穴位埋线治疗原发性痛经的近期及远期疗效，为寻找简便、疗效持久的治疗方法提供临床研究依据。方法：将70例原发性痛经患者随机分为穴位埋线组及西药组各35例。穴位埋线组于经前3天及经间期（月经第12-14天）各埋线一次，经前期以关元、子宫、地机、次髎为主穴；经间期以肾俞、肝俞、脾俞为主穴；西药组采用口服芬必得，每次300mg，每日2次，于经前3日开始口服，致疼痛缓解。一个月经周期为一个疗程，连续治疗三个周期，分别于第三个周期结束后及停止治疗三个月后进行近期及远期疗效评定。采用《中药新药临床研究指导原则》所拟定的痛经评分进行疗效评定，分别使用疼痛视觉模拟评分（Visual Analogue Scale,VAS）及健康调查简表（ the Mos 36-item Short Form Health Survey） （SF-36）对疼痛程度及生命质量进行评价。结果：①三个周期后埋线组总有效率为91.4%（32/35），优于西药组74.3%（26/35）；随访期埋线组总有效率为91.4%（32/35），优于西药组40.0%（14/35），近期及远期疗效比较差异均有统计学意义（均P〈0.01）。②两组第一、二周期治疗后痛经及VAS评分组间比较，差异无统计学意义（均P〉0.05）；第三周期、随访期埋线组痛经及VAS评分均较西药组下降明显（P〈0.05、P〈0.01）；西药组在随访期出现反弹。④埋线组第三周期、随访期生活质量总分的改善均明显优于西药组（P〈0.05、P〈0.01）结论：分期穴位埋线法治疗原发性痛经的近期及远期疗效均优于口服西药芬必得。随着痛经症状及疼痛的改善，生活质量也随之改善。

OBSTACT Objective To observe the short-term and long-term therapeutic effect of acupoint catgut embedment therapy for Primary Dysmenorrhea by stage . Dysmenorrhea. Methods Seventy patients were divided randomly into acupoint Catgut embedment group （treatment group）and west medicine group（control group）, each of which had 35 patients. For the cases of treatment group ,who were embedded the catgut in guanyuan, zigong, ciliao, diji three days before menstrual period; and were embedded the catgut in shenshu, ganshu,pishu on intermenstruum （the twelfth to forth day of menstrual period）. For the cases of control group, who oral Fenbid, dysmenorrheal attack take two times a day，every time 300mg.One menstrual period was one course of treatment. Treatment was given three menstrual periods continuously. The follow-up visit was performed in three months after the end of treatment. The score of dysmenorrheal main symptoms, VAS and SF-36 were recorded at every course treatment. Results ① After the third course and follow-up visit, The total effective rate was 91.4%（32/35）in the treatment group , that of the control group was 74.3%（26/35）and 40.0%（14/35）.Comparison among both groups showed that the short-term and long-term effect of treatment group were significantly superior to that of control group（P〈0.01）.②In the third course and follow-up visit, both scores were significant statistically in group comparison（P〈0.05，P〈0.01）.③In the third course and follow-up visit the total score of SF-36 of treatment group were higher as compared with those of the control group（P〈0.05、P〈0.01）.Conclusion The short-term and long-term therapeutic effect of acupoint catgut embedment therapy for Primary Dysmenorrhea by stage was significant better than oral Fenbid.