药物铺灸治疗寒湿凝滞型原发性痛经及对患者子宫动脉血流的影响

Effect of drug-spreading moxibustion for primary dysmenorrheal with cold-damp stagnation and its uterine artery blood flow

目的:观察药物铺灸与口服美洛昔康治疗寒湿凝滞型原发性痛经的临床疗效差异,并探讨其作用机制。方法:将101例原发性痛经患者随机分为两组,铺灸组52例采用药物铺灸治疗,先铺灸腰骶部穴区再小腹部穴区,于月经前5d开始治疗,至经期第3d停止,每3d灸1次。西药组49例采用口服美洛昔康片治疗,每天1次,每次7.5mg,在月经来潮前1d开始服用,连服3d,比较两组1个疗程(3个月经周期)后的临床疗效;并通过彩色多普勒超声检测两组治疗前后子宫动脉和弓状动脉阻力指数(RI)、搏动指数(PI)的变化情况。结果:1个疗程后,铺灸组总有效率为92.3%(48/52),优于西药组的67.3%(33/49,P<0.05);1个疗程后,铺灸组子宫动脉及弓状动脉的RI、PI值较治疗前均明显下降(均P<0.05),且均优于西药组(均P<0.05),而西药组子宫动脉及弓状动脉的RI、PI值均无明显下降(均P>0.05)。结论:药物铺灸能改善原发性痛经寒湿凝滞型患者的临床症状,疗效优于美洛昔康片,其作用与可改善患者子宫的血供情况有关。

Objective To observe the effect difference between drug-spreading moxibustion and the oral administration of meloxicam for primary dysmenorrheal with cold stagnation and to explore its mechanism.Methods A total of 101 patients with primary dysmenorrheal were randomly assigned into a drug-moxibustion group（52cases）and a western medication group（49cases）.Drug-spreading moxibustion was used on the lumbosacral acupoints area and then around lower abdominal five days before menstruation until the 3rd day of menstruation,once three days,while western medicine meloxicam was prescribed one day before menstruation,7.5mg at a time,once a day and continuously for three days.The clinical effects after one course,namely three menstrual cycles,were compared between the two groups.Meanwhile,the resistance index（RI）and the pulsatility index（PI）of uterine artery and arcus arteriarum were examined through color Doppler ultrasound before and after treatment.Results After onecourse treatment,the effective rate was 92.3%（48/52）in the drug-spreading moxibustion group,which was better than 67.3%（33/49）in the western medication group（P〈0.05）.Also,all the RI and PI in the drug-spreading moxibustion group were obviously decreased than those before treatment（all P〈0.05）,and the ones were superior to those of the western medication group（all P〈0.05）,which showed no apparent decrease after treatment（all P〈0.05）.Conclusion Drug-spreading moxibustion can improve the symptoms of primary dysmenorrheal with cold-damp stagnation,and the effect is better than that of meloxicam.The mechanism may be related to improve the blood supply to the uterus.