逆灸法治疗女兵原发性痛经疗效观察及对PGE、β-EP水平的调节作用

Reverse-moxibustion treatment of primary dysmenorrhea in female soldiers and its effect on β-endorphin levels

目的研究逆灸法治疗女兵原发性痛经疗效观察及对血浆前列腺素(PGE)、β-内啡肽(β-EP)水平的调节作用。方法选择2014年6月—2017年6月于空军特色医学中心(原空军总医院)诊断为原发性痛经气滞血瘀型并接受治疗女兵192例,按照随机数字表法分为艾灸组(n=87)及逆灸组(n=105),2组患者分别给予传统艾灸和逆灸法,治疗周期均为3个疗程,治疗后随访3个月经周期。比较2组患者治疗好转率;于开始治疗前1个月月经周期的第1天及第5天,结束治疗后下1个月月经周期开始第1天及第5天抽取静脉血检测患者血浆前列腺素-2(PGE2)、前列腺素-2α(PGE2α)及β-EP,记录其变化值并进行比较;记录2组患者治疗中发生的不良反应,并对不良反应发生情况进行比较。结果逆灸组治疗好转率高于艾灸组(P<0.05);逆灸组患者治疗后PGE2上升值及PGE2α下降值高于艾灸组,而β-EP上升值低于艾灸组(P<0.05);2组患者不良反应发生率差异无统计学意义(P>0.05)。结论逆灸法治疗能有效地降低患者血浆PGE2α的同时,升高其PGE2,减轻患者疼痛,从而引起β-EP分泌减少,而且治疗效果较好,可以推广应用于原发性痛经的治疗。

Objective To study the therapeutic effect of reverse-moxibustion against female primary dysmenorrhea and its regulation onβ-endorphin levels.Methods One hundred and ninety-two female soldiers were selected who were diagnosed as primary dysmenorrhea qi stagnation and blood stasis between June 2014 and June 2017 in Air Force General Hospital.According to the random number table,the patients were divided into the moxibustion group(n=87)and reverse-moxibustion group(n=105).Patients of both groups were given traditional moxibustion and reverse-moxibustion.The treatment cycle was 3 courses,and follow-up lasted through three menstrual cycles.The rates of improvement in the two groups were compared.On the first day and the fifth day of the first menstrual cycle prior to treatment,the plasma prostaglandin PGE2,PGE2αandβ-EP were recorded,and their changes were recorded and compared.Adverse reactions were recorded during the treatment and compared between the two groups.Results The rate of improvement in the reverse-moxibustion group was significantly higher than that in the moxibustion group(P<0.05).In the moxibustion group,the increase of PGE2 and the decrease of PGE2αwere significantly higher than in the reverse-moxibustion group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Reverse-moxibustion treatment can effectively reduce plasma PGE2αin patients while increasing PGE2,thus reducing pain and resulting in decreasedβ-EP secretion.This treatment has a good effect and can be widely applied to the treatment of primary dysmenorrhea.