不同灸次对原发性痛经患者血清PGE_2、PGF_(2α)影响的临床研究

Clinical Research on Effects of the Treatment of Primary Dysmenorrhea With Moxibustion in Different Times

目的比较不同灸次艾灸关元穴治疗原发性痛经(Primary Dysmenorrhea,PD)的疗效,确定灸法治疗PD的较佳灸次,并从生殖内分泌角度探讨灸法治疗PD的作用机制。方法将符合诊断标准的60例患者随机分为A组、B组,每组各30例。两组均以清艾条温和灸关元穴,1次/日,A组从月经来潮前5天灸至月经来潮前1天(5次/周期),B组从月经来潮前5天灸至经期第2天(7次/周期),连续治疗3个周期,观察两组腹痛程度变化,并采集治疗前后肘静脉血(经期第2天),比较治疗前后前列腺素F2α(PGF2α)和前列腺素F2α(PGF2α)/前列腺素E2(PGE2)。结果两组腹痛评分(VAS平均分)均有良好改善作用(P<0.05),组间比较差异无统计学意义(P>0.05),两组治疗前后外周血中PGF2α含量及PGF2α/PGE2比值差异均有统计学意义(P<0.05);两组治疗前后外周血PGE2含量比较差异无统计学意义(P>0.05),两组临床疗效相比差异无统计学意义(P>0.05)。结论艾灸关元穴治疗原发性痛经有效,临床治疗可选择从经前5天至月经来潮前1天施灸治疗,即5次/周期,两组均能降低外周血中的PGF2α及PGF2α/PGE2比值,这可能是艾灸治疗原发性痛经有效的机理。

Objective To identify the best times of treating PD in guan yuan acupoint by comparing the therapeutic effects with moxibustion in different times, and expect to find out the functional mechanism in the field of reproduction ＆ endocrine. Methods 60 cases of PD were divided into group A and group B at random, with 30 cases in each group. The two groups were treated in guan yuan acupoint with moxibustion. A group from 5 days before menstruation to one day befor menstruation （5 times/cycle）, and B group from 5 days prior to the second day of menstruation （7 times/cycle）. All of them were treated three menstruation. Then observed the changes of the pain in groups. Collected the blood （the second day of the menstrual periods） and prostaglandin F2α （PGF2α） and prostaglandin F2α （PGF2α）/prostaglandin E2 （PGE2） were compared before and after treatment. Results Both of the two groups have curative effect（P 〈 0.05） in pain （VAS） without distinction （P 〉 0.05）. Comparison with the test of PGF2α and PGF2α/PGE2 before and after therapy, the two groups had signifcant differences （P 〈 0.05）, but there were no signifcant differences （P 〉 0.05） of PGE2 in vein blood before and after therapy, no statistically signifcant clinical difference between the two groups （P 〉 0.05）. Conclusion Both of the treat times have very good curative effect. We can choose the times of from 5 days prior the menstruation to oneday before menstruation. We can come to the conclusion that moxibustion can decrease PGF2α and PGF2α/PGE2 in vein blood, and that possibly is the curative mechanism of treating PD with moxibustion.