刺痛感对寒湿凝滞型痛经患者针刺疗效的影响

Clinical Trials for Observing the Influence of Acupuncture Needle-stimulation Induced Sharp Pain on Curative Effect in Primary Dysmenorrhea Patients

目的:探讨针刺过程中刺痛感对寒湿凝滞型痛经患者针刺疗效的影响。方法:96例寒湿凝滞型原发性痛经患者,随机分为期望得气组和期望不得气组,于痛经发作第1天,且腹痛视觉模拟评分(VAS)≥40mm时,予针刺双侧三阴交穴30min,其中期望得气组予粗针、深刺、平补平泻的手法,期望不得气组予细针、浅刺、不施手法。采用VAS评价针刺前后以及起针后10min患者主观疼痛程度,并于针刺后记录患者有无刺痛感。结果:期望得气有刺痛组起针即刻VAS评分较针刺前降低,且起针后10min VAS评分较起针即刻降低(P<0.05);期望得气无刺痛组、期望不得气有刺痛组和期望不得气无刺痛组起针即刻、起针后10min VAS评分较针刺前降低(P<0.05),但起针后10min VAS评分较起针即刻降低差异无统计学意义(P>0.05)。期望得气有刺痛组与期望得气无刺痛组组间各时点VAS差值比较差异均无统计学意义(P>0.05),期望不得气有刺痛组与期望不得气无刺痛组组间各时点VAS差值比较差异均无统计学意义(P>0.05)。结论:无论是粗针、深刺、行平补平泻手法还是细针、浅刺、不施手法针刺三阴交穴,有无刺痛感对寒湿凝滞型原发性痛经镇痛效应的影响无明显区别,均有较好的针刺即刻镇痛效应。

Objective To observe the influence of acupuncture needle stimulation-induced sharp pain on the curative effect of acupuncture therapy for primary dysmenorrhea（PD）patients with cold damp stagnation syndrome（CDSS）.MethodsA total of 87 PD patients with CDSS experiencing abdominal pain（≥40mm in visual analogue scale,VAS）were randomly assigned to deqi-expectation group and no-deqi-expectation group which were further divided into deqi-expectation＋sharp pain（n=31）,deqi-expectation＋no-sharp pain（n=12）,no-deqi-expectation ＋sharp pain（n=17）,no-deqi-expectation ＋nosharp pain（n=27）groups.On the first day of abdominal pain attack,bilateral Sanyinjiao（SP 6）were punctured respectively with thicker needles with deeper insertion for deqi-expectation patients and thin filiform needles with shallow insertion for no-deqiexpectation patients.The needles were manipulated for 30 swith uniform reinforcing-reducing method for all the deqi-expectation patients,which was repeated once again every 10 min during 30 min of needle retention.The VAS was used to evaluate the patients＇ abdominal pain severity before treatment and 0,10 min after acupuncture needle withdrawal.Results Following acupuncture stimulation of SP 6,the VAS scores of menstrual pain at both 0min and 10 min after withdrawing acupuncture needles were significantly decreased in the deqi-expectation＋ sharp pain group,deqi-expectation＋ no-sharp pain group,no-deqi-expectation＋sharp pain group and no-deqi-expectation ＋ no-sharp pain group（P0.05）,and that of 10 min post-needle withdrawal was markedly lower than that of 0min in the deqi-expectation＋ sharp pain group（P0.05）.No significant differences were found in the VAS difference values at different time-points between deqi-expectation plus sharp pain and deqi-expectation＋no-sharp pain groups,and between no-deqi-expectation＋sharp pain and no-deqi-expectation＋no-sharp pain groups（P0.05）.Conclusion Acupuncture stimulation of SP 6has an immediate analgesic effect in PD women with cold damp stagnation syndrome,which was not affected by needling-induced sharp pain,deqi-expectation,and thicker or thinner needle with shallow and deeper insertion.