电针三阴交、悬钟、非穴对原发性痛经患者累积镇痛效应的比较研究

Cumulative Analgesic Effect of Electroacupuncture at Sanyinjiao(SP6), Xuanzhong(GB39) and Non-acupoint for Primary Dysmenorrhea: A Comparative Study

目的比较电针三阴交、悬钟、非穴对原发性痛经患者的累积镇痛效应差异。方法采用多中心随机对照的研究方法,将北京中医药大学附属东直门医院、中日友好医院、首都医科大学附属北京中医医院、天津中医药大学第一附属医院、北京中医药大学附属护国寺中医医院、山东中医药大学门诊的原发性痛经患者501例,随机分成三阴交组、悬钟组、非穴组,每组167例。在患者痛经开始发作并且疼痛视觉模拟评分(visual analogue scale,VAS)≥40 mm时进行电针治疗,频率2/100Hz,强度以患者能够耐受为度,每次30 min,每日1次,连续治疗3 d。分别在第1次治疗前、第1次起针后30 min及第2、3次治疗前以VAS测量疼痛程度。同时分别在第1次治疗前、第1次起针即刻及第2、3次治疗前记录患者的痛经总体伴随症状严重程度(retrospective symptom scale,RSS-COX2总分)。结果三阴交组VAS值降低程度显著大于悬钟组及非穴组(MD=﹣2.92 mm,P=0.028;MD=﹣3.47 mm,P=0.009),悬钟组与非穴组比较差异无统计学意义(MD=﹣0.56 mm,P=0.674);3组RSS-COX2总分组间比较差异无统计学意义(P=0.086)。结论三阴交穴对原发性痛经患者的累积镇痛效应优于悬钟穴、非穴,悬钟穴与非穴累积镇痛效应无差异。

Objective To compare the cumulative analgesic effects of electroacupuncture at Sanyinjiao（SP6）, Xuanzhong（GB39） and non-acupoint in treating primary dysmenorrhea. Method By adopting a multi-centered randomized controlled study method, 501 patients recruited from Dongzhimen Hospital of Beijing University of Chinese Medicine, China-Japan Friendship Hospital, Beijing Hospital of Traditional Chinese Medicine of Capital Medical University, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Huguosi Hospital of Chinese Medicine of Beijing University of Chinese Medicine and the Outpatient of Shandong University of Traditional Chinese Medicine were randomized into a Sanyinjiao group, a Xuanzhong group, and a non-acupoint group, 167 subjects in each group. The electroacupuncture intervention was applied when dysmenorrhea flared up and the Visual Analogue Scale（VAS） ≥40 mm, with frequency at 2/100 Hz and intensity during patient＇s endurance, 30 min each time, once a day, and for successive 3 d. Before the first treatment, 30 min after the first treatment, and respectively prior to the second and third treatment, VAS was used to measure the pain intensity. Meanwhile, the Retrospective Symptom Scale（RSS-COX 2） was investigated before the first treatment, right after the removal of needles for the first treatment, before the second and third treatment. Result The decrease of VAS in Sanyinjiao group was more significant than that in Xuanzhong group and non-acupoint group（MD=﹣2.92 mm, P=0.028; MD=﹣3.47 mm, P=0.009）, while there was no significant difference between Xuanzhong group and non-acupoint group（MD=﹣0.56 mm, P=0.674）; there were no significant differences in comparing the RSS-COX2 total score among the three groups（P=0.086）. Conclusion Sanyinjiao（SP6） can produce a more significant cumulative analgesic effect for primary dysmenorrhea patient than Xuanzhong and non-acupoint, and the effects of Xuanzhong and non-acupoit are equivalent.