中药熨联合针刺干预原发性痛经即刻镇痛及远期疗效的临床研究

Clinical study on the immediate analgesia and long-term effect of the treatment of primary dysmenorrhea by traditional Chinese medicine ironing combined with acupuncture

目的观察中药熨联合针刺干预气滞血瘀型原发性痛经即刻镇痛效果及其远期疗效,并分析其作用机制。方法选取2018年1月至2019年12月在本院妇科门急诊就诊的气滞血瘀型原发性痛经患者60例,按随机数字表法分为两组:对照组、观察组,每组30例。对照组患者年龄(21.5±3.5)岁,观察组患者年龄(20.8±2.8)岁。在常规护理基础上,对照组予间苯三酚注射液肌肉注射以解痉止痛;观察组予中药热熨于下腹部加毫针针刺合谷穴(双)、三阴交(双)、足三里(双)穴。以1个月经周期为1个疗程,两组均治疗3个疗程,再继续观察3个月经周期。对比两组患者治疗后的临床症状、体征、腹痛改善情况。结果①两组患者在纳入的第一月经周期,因痛经就诊,干预后即时疗效比较,对照组和观察组总有效率分别为83.3%(25/30)和93.3%(28/30),两组间比较,差异有统计学意义(P<0.05);②两组患者治疗后观察期第一月经周期疗效比较,对照组和观察组总有效率分别为83.3%(25/30)和96.4%(27/28),两组间比较,差异有统计学意义(P<0.05);③两组患者治疗后观察期第二月经周期疗效比较,对照组和观察组总有效率分别为76.7%(23/30)和92.8%(26/28),两组间比较,差异有统计学意义(P<0.05);④两组患者治疗后观察期第三月经周期疗效比较,对照组和观察组总有效率分别为70.0%(21/30)和89.3%(25/28),两组间比较,差异有统计学意义(P<0.05)。结论中药熨联合毫针针刺能即刻缓解气滞血瘀型原发性痛经的症状、体征、腹痛情况,且不易复发,为临床提供一种新的痛经的中医外治法,值得临床应用推广。

Objective To observe the immediate analgesic effect and long-term effect of traditional Chinese medicine ironing combined with acupuncture on Qi stagnation and blood stasis type primary dysmenorrhea,and analyze its mechanism.Methods A total of 60 patients with Qi stagnation and blood stasis type primary dysmenorrhea who visited department of gynecological outpatient and emergency in our hospital from January 2018 to December 2019 were selected and were randomly divided into two groups:control group and observation group with 30 cases in each group.The age of patients in the control group was(21.5±3.5)years old,and(20.8±2.8)years old in the observation group.On the basis of routine nursing care,the control group received intramuscular injection of phloroglucinol for antispasmodic and pain relief;the observation group received hot ironing with traditional Chinese medicine on the hypogastrium plus acupuncture at Hegu(double),Sanyinjiao(double),Zusanli(double)points.Taking one menstrual cycle as a course of treatment,both groups were treated for 3 courses,and then continuously observed for 3 menstrual cycles.The improvement of clinical symptoms,signs,and abdominal pain of the two groups were compared after treatment.Results(1)In the first menstrual cycle,the two groups of patients saw doctors for dysmenorrhea.The immediate curative effects after intervention were compared.The total effective rates of the control group and the observation group were 83.3%(25/30)and 93.3%(28/30)respectively.The difference between the two groups was statistically significant(P<0.05).(2)The curative effect of the two groups of patients in the first menstrual cycle of the observation period after treatment were compared,the total effective rates of the control group and the observation group were 83.3%(25/30)and 96.4%(27/28)respectively,and the difference between the two groups was statistically significant(P<0.05).(3)The curative effect of the two groups of patients in the second menstrual cycle of the observation period after treatment were compared,the total effective rates of the control group and the observation group were 76.7%(23/30)and 92.8%(26/28)respectively.The difference between the two groups was statistically significant(P<0.05).(4)The curative effect of the two groups of patients in the third menstrual cycle of the observation period after treatment were compared,the total effective rates of the control group and the observation group were 70.0%(21/30)and 89.3%(25/28)respectively,and the difference between the two groups was statistically significant(P<0.05).Conclusions Traditional Chinese medicine ironing combined with filiform needle acupuncture can immediately relieve the symptoms,signs,and abdominal pain of primary dysmenorrhea of Qi stagnation and blood stasis type,and it is not easy to relapse.It provides a new external traditional Chinese medicine treatment that can treat dysmenorrhea,and it is worth being promoted in clinical practice.