雷火灸结合耳穴治疗气血虚弱型原发性痛经疗效观察

Curative effect observation on treatment of primary dysmenorrhea of qi and blood deficiency with thunder-fire moxibustion and ear points

目的:比较雷火灸结合耳穴与西药治疗气血虚弱型原发性痛经的临床疗效。方法:将76例气血虚弱型原发性痛经患者随机分为西药组(38例)与治疗组(38例,脱落1例),西药组患者出现痛经症状时,口服布洛芬缓释胶囊0.3g/次,早晚各1次,连续服用3d。治疗组于月经来潮前3天给予雷火灸结合耳穴治疗,雷火灸选穴中脘、关元、双侧足三里,每次每穴30min,每日1次,连续治疗3d。耳穴选取子宫、内分泌、神门、肝、肾,每个月经周期治疗1次。两组均治疗3个月经周期,比较两组患者治疗前后及随访时视觉模拟评分(VAS)、COX痛经症状量表(CMSS)评分及治疗前后血清前列腺素F_(2α)(PGF_(2α))、前列腺素E_(2)(PGE_(2))水平。结果:治疗组患者治疗后及随访时VAS评分、CMSS评分均显著降低(P<0.05),且治疗组患者评分显著低于西药组(P<0.05);治疗后两组患者血清PGF_(2α)水平均显著降低、血清PGE_(2)水平显著升高(P<0.05),且治疗组优于西药组(P<0.05)。结论:雷火灸结合耳穴可改善气血虚弱型原发性痛经患者的临床症状,其机制可能与调节PGE_(2)、PGF_(2α)水平有关。

Objective:To compare the clinical effects of thunder-fire moxibustion combined with ear points and western medicine in treating primary dysmenorrhea with qi and blood deficiency.Methods:A total of 76 patients of primary dysmenorrhea with qi and blood deficiency were randomly divided into a western medicine group(38 cases)and a treatment group(38 cases,1 case fell off).When the western medicine group had symptoms of dysmenorrhea,oral administration of ibuprofen sustainedrelease capsules 0.3 g/time,once in the morning and once in the evening,for 3 days.The treatment group was given thunder-fire moxibustion combined with ear point treatment 3 days before menstrual cramps.The thunder fire moxibustion selected points Zhongwan(CV 12),Guanyuan(CV 4),and double sides of Zusanli(ST 36),30 minutes per point each time,once a day for 3 consecutive days.Auricular points are selected from uterus,endocrine,Shenmen(TF 4),liver,and kidney,and are treated once per menstrual cycle.Both groups were treated for 3 menstrual cycles.The VAS score,CMSS score and serum prostaglandin F_(2α)(PGF_(2α))and prostaglandin E_(2)(PGE_(2))levels before and after treatment and during follow-up were compared between the two groups.Results:After treatment and during follow-up,the VAS scores and CMSS scores of the treatment group were reduced(P<0.05),and the scores of the patients in the treatment group were lower than those in the western medicine group(P<0.05);After treatment,serum PGF_(2α)level was decreased and serum PGE_(2) level was increased in both groups(P<0.05),and the effect of treatment group was better than that of western medicine group(P<0.05).Conclusion:Thunder-fire moxibustion combined with ear points can improve the clinical symptoms of patients with primary dysmenorrhea with weak qi and blood,and its mechanism may be related to the regulation of PGE_(2) and PGF_(2α)levels.