低能量体外冲击波联合“三元气血针法”针刺治疗原发性痛经气滞血瘀证的临床观察

Clinical Observation on Low-energy Extracorporeal Shock Wave Therapy Combined with Sanyuan Qixue Acupuncture Therapy for the Treatment of Primary Dysmenorrhea with Qi Stagnation and Blood Stasis Syndrome

【目的】观察基于行气活血法应用低能量体外冲击波联合“三元气血针法”针刺治疗原发性痛经气滞血瘀证患者的临床疗效。【方法】将67例原发性痛经气滞血瘀证患者随机分为对照组33例和试验组34例。对照组给予“三元气血针法”针刺治疗,试验组给予低能量体外冲击波联合“三元气血针法”针刺治疗,连续治疗3个月经周期并随访2个月。观察2组患者治疗前后疼痛视觉模拟量表(VAS)评分、COX痛经症状评价量表(CMSS)评分、健康调查简表(SF-36)评分和中医证候积分的变化情况,并评价2组患者的中医证候疗效、复发情况和安全性。【结果】(1)治疗3个月经周期后,试验组的总有效率为97.06%(33/34),对照组为84.85%(28/33),组间比较,试验组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的中医证候积分、疼痛VAS评分及CMSS量表的严重程度评分和持续时间评分均较治疗前明显改善(P<0.05),且试验组对中医证候积分、疼痛VAS评分及CMSS量表的严重程度评分和持续时间评分的改善作用均明显优于对照组(P<0.05)。(3)治疗后,2组患者SF-36量表的一般健康、躯体疼痛、精力、生理机能、生理职能评分及量表总积分均较治疗前明显改善(P<0.05),而2组患者的精神健康、情感职能、社会功能评分改善不明显(P>0.05);随访时,2组患者SF-36量表的各维度评分与治疗后比较均无明显变化(P>0.05)。组间比较,试验组在治疗后对SF-36量表的一般健康、躯体疼痛、精力、生理机能、生理职能评分及量表总积分的改善作用均优于对照组(P<0.05)。(4)疗程结束后2个月随访,试验组的复发率为14.71%(5/34),明显低于对照组48.48%(16/33),差异有统计学意义(P<0.01)。(5)研究期间,2组患者均未出现瘀斑、疼痛、麻木、晕针等不良反应,且患者的各项安全性指标均在正常范围内。【结论】基于行气活血法应用低能量体外冲击波联合“三元气血针法”针刺治疗原发性痛经气滞血瘀证患者疗效显著。

Objective To observe the clinical efficacy of low-energy extracorporeal shock wave therapy(ESWT)combined with Sanyuan Qixue acupuncture therapy for the treatment of primary dysmenorrhea(PD)with qi stagnation and blood stasis syndrome.Methods A total of 67 patients with PD of qi stagnation and blood stasis syndrome were randomly divided into the control group(33 cases)and the trial group(34 cases).The control group was given Sanyuan Qixue acupuncture therapy,while the trial group was given low-energy ESWT combined with Sanyuan Qixue acupuncture therapy.The patients of both groups were treated for 3 continuous menstrual cycles and then were followed up for 2 months.The pain visual analogue scale(VAS)score,the COX menstrual symptom scale(CMSS)score,36-item short-form health survey(SF-36)score and traditional Chinese medicine(TCM)syndrome score in the two groups were observed before and after treatment.Meanwhile,the TCM syndrome efficacy,recurrence and safety in the two groups were evaluated.Results(1)After 3 menstrual cycles of treatment,the overall effective rate in the trial group was 97.06%(33/34)and that in the control group was 84.85%(28/33).The intergroup comparison showed that the efficacy of the trial group was significantly superior to that of the control group(P<0.05).(2)After treatment,the TCM syndrome score,pain VAS score,and severity score and duration score of CMSS scale in the two groups were significantly improved compared with those before treatment(P<0.05),and the effect on improving the scores in the trial group was significantly superior to that in the control group(P<0.05).(3)After treatment,the scores of general health,bodily pain,vitality,physical functioning,and physical role functioning,as well as the total SF-36 scores in the two groups were significantly improved(P<0.05),while the scores of the mental health,emotional role functioning and social functioning in the two groups were not significantly improved compared with those before treatment(P>0.05).At the follow-up,the scores of each section of the SF-36 in the two groups did not differ from those after treatment(P>0.05).The intergroup comparison showed that the trial group showed obvious improvement in the scores of general health,bodily pain,vitality,physical functioning,and physical role functioning as well as the total SF-36 scores in comparison with those in the control group after treatment(P<0.05).(4)At the 2-month follow-up after the treatment course,the recurrence rate in the trial group was 14.71%(5/34),which was significantly lower than that in the control group[48.48%(16/33)],and the difference was statistically significant(P<0.01).(5)During the trial,there were no adverse reactions such as ecchymosis,pain,numbness,and fainting during acupuncture occurring in the two groups,and the values of all of the safety indicators were within the normal range.Conclusion Low-energy ESWT combined with Sanyuan Qixue acupuncture therapy for promoting qi and activating blood exerts significant effect in treating PD patients with qi stagnation and blood stasis syndrome.