温经疏肝化瘀通络法联合针灸对气滞血瘀型原发性痛经患者血清前列腺素和β-内啡肽的影响

Effect of Wenjing Shugan Huayu Tongluo method combined with acupuncture on serum prostaglandin andβ-endorphin in patients with primary dysmenorrhea oftype of Qi stagnation and blood stasis

目的观察温经疏肝化瘀通络法联合针灸治疗对气滞血瘀型原发性痛经患者血清前列腺素和β-内啡肽(β-EP)的影响。方法将2018年2—12月在唐山市中医医院治疗的130例辨证为气滞血瘀型原发性痛经患者随机分为观察组与对照组,每组65例。对照组患者应用益母草冲剂治疗,观察组患者应用自拟温经疏肝、化瘀通络汤联合针灸治疗,2组均连续治疗3个月经周期。观察2组患者治疗后痛经疼痛程度(痛经评分)、疼痛持续时间及治疗前后患者血清前列腺素E 2(PGE 2)、前列腺素F 2α(PGF 2α)、β-EP水平变化情况,评估治疗措施的效果及安全性。结果治疗后2组患者PGE 2及β-EP水平较治疗前明显增高(P均<0.05),PGF 2α水平较治疗前明显降低(P均<0.05),观察组患者上述指标改善幅度较对照组更大(P均<0.05)。治疗后2组患者痛经评分明显降低(P均<0.05),疼痛持续时间明显缩短(P均<0.05),且观察组患者痛经评分明显低于对照组(P<0.05),疼痛持续时间明显短于对照组(P<0.05)。观察组患者治疗总有效率为93.85%(61/65),对照组为78.46%(51/65),观察组显著高于对照组(P<0.05)。2组患者均无明显不良反应发生。结论温经疏肝、化瘀通络汤联合针灸治疗气滞血瘀型原发性痛经患者疗效更好,可明显减轻患者围月经期疼痛程度及缩短痛经持续时间,可能与明显调节血清前列腺素和β-EP水平密切相关。

Objective It is to observe the effects of Wenjing Shugan Huayu Tongluo therapy combined with acupuncture on serum prostaglandin andβ-endorphin(β-EP)in patients with primary dysmenorrhea of type of Qi stagnation and blood stasis.Methods 130 patients with primary dysmenorrhea differentiated as type of Qi stagnation and blood stasis were randomly divided into observation group and control group,with 65 cases in each group.The patients in the control group were treated with Yimucao granules,and the ones in the observation group were treated with self-made Wenjing Shugan,Huayu Tongluo decoction combined with acupuncture.Both groups were treated continuously for 3 menstrual cycles.The pain degree of dysmenorrhea(dysmenorrhea score),pain duration,and the changes of serum prostaglandin E 2(PGE 2),prostaglandin E 2α(PGE 2α)andβ-endorphin(β-EP)before and after treatment were observed in the two groups,and the effect and safety of the treatment measures were evaluated.Results After treatment,the levels of PGE 2 andβ-EP were significantly higher and the level of PGF 2αwas significantly lower than those before treatment in the two groups(P<0.05),the improvements of the above indicators were more significant in the observation group than those in the control group(P<0.05).After treatment,the dysmenorrhea scores were significantly reduced(P<0.05),the duration of pain was significantly shortened in the two groups(P<0.05),and the dysmenorrhea scores in the the observation group were lower while the the duration of pain was shorter than that in the control group(P<0.05).The total effective rate was 93.85%(61/65)in the observation group,which was significantly higher than that 78.46%(51/65)in the control group(P<0.05).No significant adverse reactions occurred in the two groups.Conclusion Wenjing Shugan,Huayu Tongluo decoction combined with acupuncture which can significantly relieve the pain degree and duration of dysmenorrhea at perimenstrual period is more effective in the treatment of patients with primary dysmenorrhea of type of Qi stagnation and blood stasis.The mechanism may be closely related to the obvious regulation of serum levels of prostaglandin andβ-EP.