西医联合温通刮痧治疗寒凝血瘀型原发性痛经效果及对血清前列腺素水平影响

Effect of the western medicine combined with Wentong scraping for treating patients with primary dysmenorrhea symptoms caused of cold coagulation and blood stasis type and its influence on the serum prostaglandin levels

目的:分析温通刮痧对寒凝血瘀型原发性痛经效果及对血清前列腺素F2ɑ(PGF2α)、前列腺素E2(PGE_(2))水平影响。方法:选取2022年5月-2023年6月本院收治的原发性痛经患者90例为研究对象,按照完全随机设计程序分为3组各30例,分别在经期给予布洛芬缓释胶囊口服(西医组)、月经干净后予以单纯的温通刮痧治疗(中医组)及西医基础上加以温通刮痧治疗(中西医组);比较3组临床疗效、中医证候积分、视觉模拟评分法(VAS)、COX痛经症状评分量表(CMSS)、PGF2α、PGE_(2)以及腹部疼痛持续时间。结果:治疗后,临床总有效率西医组(63.3%)、中医组(83.3%)、中西医组(90.0%)依次升高;3组小腹冷痛、肢体畏寒、腰骶酸痛等中医证候积分较治疗前均下降且中西医组、中医组均低于西医组;3组VAS、CMSS评分下降,且中西医组(3.60±0.77分、17.16±5.08分)低于西医组(4.67±0.83分、26.45±6.17分)和中医组(4.47±0.84分、23.60±5.94分);3组PGF2α水平、PGF2α/PGE_(2)下降,PGE_(2)水平升高,且中西医组、中医组变化幅度大于西医组;3组腹部疼痛持续时间均下降且西医组(2.03±1.01d)、中医组(1.56±0.79d)、中西医组(1.14±0.55d)依次降低(均P<0.05)。结论:西医联合温通刮痧可有效减轻寒凝血瘀型原发性痛经患者的痛经症状,降低血清PGF2α、PGE_(2)水平,提高临床有效率。

Objective:To analyze the effect of Wentong scraping for treating patients with primary dysmenorrhea symp-toms of cold coagulation and blood stasis type,and to study its influence on the serum prostaglandin F2 alpha and pros-taglandin E2 levels of the patients.Methods:From April 2022 to April 2023,90 patients with primary dysmenorrhea were selected as the research subjects.These patients were divided into three groups(30 cases in each group)according to a completely randomized design program.The patients in group A received routine western medicine treatment dur-ing menstruation,including oral ibuprofen controlled-release capsule.The patients in group B received W entong scrap-ing treatment alone after menstruation.And the patients in group C received routine western medicine combined with Wentong scraping treatment.The clinical efficacy,the traditional Chinese medicine(TCM)syndrome score,the scores of visual analogue scale(VAS)and COX menstrual symptom scale(CMSS),the levels of PGF2a and PGE_(2)and the duration of abdominal pain of the patients were compared among the three groups.Results:After treatment,the total.clinical effective rate of the patients in group A(63.3%),in group B(83.3%)and in group C(90.0%)had increased gradually.The TCM syndrome scores of abdominal cold and pain,the limbs chilly and the lumbosacral ache of the pa-tients in the three groups after treatment had decreased significantly,and which of the patients in group C and in group B were significantly lower than those of the patients in group A.The VAS and CMSS scores of the patients in the three groups after treatment had decreased significantly,and which of the patients in group C(3.60±0.77 points and 17.16±5.08 points)were significantly lower than those(4.67±0.83 points and 26.45±6.17 points)of the patients in group A and those(4.47±0.84 points and 23.60±5.94 points)of the patients in group B.The PGF2a level and PGF2α/PGE_(2)ratio of the patients in the three groups after treatment had decreased significantly,while the PGE_(2)level of the patients in the three groups after treatment had increased significantly,and the changes of which of the patients in group C and in group B were significantly more than those of the patients in group A.The duration of abdominal pain of the patients in the three groups after treatment had decreased significantly,and which of the patients in group A(2.03±1.01d),in group B(1.56±0.79d)and in group C(1.14±0.55d)had decreased gradually(all P<0.05).Con-clusion:The western medicine combined with W entong scraping for treating the patients with primary dysmenorrhea symptoms of cold coagulation and blood stasis type can alleviate their dysmenorrhea symptoms effectively,decrease their serum PGF2a and PGE_(2)levels,and improve their clinical efficacy.