不同频次电针治疗围绝经期烘热症状的临床观察

Clinical Observation of Different Electro-acupuncture Frequency for Menopausal Hot Flushes

目的:评价电针治疗围绝经期烘热症状的疗效与频次的关系。方法:选取2015年6月至2016年8月于我院针灸科、妇科门诊的符合纳入标准的围绝经期综合征患者60例,随机分为试验组和对照组,各30例,其中试验组的针灸频次设为每周3次,隔日1次,共计24次,对照组针灸频次设为每周1次,共计8次。分别于治疗前、治疗第4周、第8周、随访第12周、随访第16周用平均24 h烘热积分、绝经症状评价量表进行评估,并于治疗第8周、随访第16周检查血清E2、FSH、LH水平变化情况。结果:就平均24 h烘热积分比较,试验组治疗第4、8周及随访第12、16周时烘热积分较治疗前显著减少(P<0.01),对照组治疗第4周、随访第12、16周时烘热积分较治疗前无明显变化,差异无统计学意义(P>0.05);评估绝经症状评价量表,试验组治疗4周及随访第12、16周时MRS评分与同组治疗前比较,差异具有显著统计学意义(P<0.01),对照组治疗第4周及随访第12周同治疗前比较,差异具有显著统计学意义(P<0.01),但其评分仍高于同时期的试验组分值;试验组治疗第8周及随访第16周时血清E2水平与对照组比较,差异具有统计学意义(P<0.05)。结论:采用每周3次与每周1次进行电针频次的比较,一周3次的近期及远期疗效显著优于一周1次。一周3次不仅能更好发挥针灸的即刻效应,且比一周1次的治疗能够更好地维持刺激量,较符合针灸后效应产生的持续的最佳治疗时间,值得临床推广。

Objective： To explore the relationship between efficacy and frequency of electro-acupuncture in the treatment of perimenopausal hot flushes. Methods： 60 perimenopausal patients were randomly divided into the observation group（ n = 30） and the control group（ n = 30）. The acupuncture frequency of the observation group was three times a week,once every other day,24 times in total; the acupuncture frequency of the control group was once a week,eight times in total. 24 h hot flushes scores and menopausal symptom rating scale were evaluated before the treatment,in 4 th,8 th,12 th,and 16 th week respectively; as well as serum levels of E2,FSH,and LH were detected in 8 th and 16 th week. Results： In terms of 24 h hot flushes score,it reduced greatly in 4 th,8 th,12 th,and 16 th week compared to that before the treatment in the observation group（ P〈0. 01）;whereas,it did not show significant difference in 4 th,12 th,and 16 th week when compared to that after the treatment（ P〈0. 05）. In terms of menopausal symptom rating scale,MRS score significantly improved in 4 th,12 th,and 16 th week compared to that before the treatment in the observation group（ P〈0. 01）; whereas in the control group it only showed significant difference in 4 th and 12 th week（ P〈0. 01）,but the score was still higher than that in the observation group at the same time point. There was statistical significance between the observation group and the control group in terms of serum levels of E2 in 8 th and 16 th week（ P〈0. 05）. Conclusion： The short-term and long-term effects of electro-acupuncture with the frequency of three times a week are better than that with the frequency of once a week. Electro-acupuncture of three times a week can not only exert the immediate acupuncture effect,but also maintain the amount of stimulation,which is more in line with the after-effect of acupuncture treatment,and it is worthy of clinical promotion.