CLINICAL OBSERVATION ON THE TREATMENT OF LUMBAR VERTEBRA HYPEROSTEOGENY WITH ELECTRO- AND HYDRO-ACUPUNCTURE

In the present study, 121 patients with lumbar vertebra hyperosteogeny were dividedinto following four groups for treatment and comparison: intense electro-acupuncture group (Group1), hydro-acupuncture group (Group 2), electro-acupuncture plus hydro-acupuncture group (Group3) and analgesic liquid for spur group (Group 4). It is indicated that the effect of electro-acupunctureplus hydro-acupuncture is the best in the treatment of lumbar vertebra hyperosteogeny.

COMBINED TREATMENT OF HEBETIC SCANTY MENSTRUATION WITH ACUPUNCTURE AND DRUGS

According to a random distribution table, 60 cases of scanty menstruation patients were evenly divided into 3 groups: A) estrin (n = 20), B) acupuncture (n = 20), and C) acupuncture +estrin (n = 20) for comparing their therapeutic effect. Results showed that after treatment, 5 cases in estrin group, 12 cases in acupuncture group and 14 cases in acupuncture + estrin group respectively had an ovulation response. Statistical analysis displayed significant differences between acupuncture group or acupuncture + estrin group and estrin group. (P < 0.05, P <0.05 ); and between acupuneture and acupuncture + estrin groups in the estradiol level of the early phase of follicles in patients with ovulation and without ovulation (P < 0. 05, P < 0.01 ). The fact indicates a close interrelation between acupuncture-induced ovulatory effect and the estradiol level of the patient’s body.

Relationships of Handgrip Strength with Menstruation-Related Symptoms in Female University Students in Japan

Introduction: Some somatic and psychological disorders have been associated with handgrip strength, which is an easy, inexpensive and noninvasive method for assessment of muscle strength. We conducted a cross-sectional study to clarify the relationship of handgrip strength and menstruation-related symptoms. Material and Methods: Handgrip strength was measured and a self-administered questionnaire was performed in female university students in Japan. Results: Handgrip strength did not significantly differ among the menstrual phases. The mean handgrip strength level (n = 260) was 26.0 ± 3.9 kg. We divided the subjects into three groups according to the handgrip strength level. Handgrip strength was associated with degrees of depression and anxiety during menstruation. Conclusion: This can be used as fundamental data in further clarifying the relationship between muscle strength and menstruation-related symptoms.

Possible Effect of COVID-19 Vaccines on Menstruation in Cape Coast, Ghana, West Africa: Case Series Report

Covid-19 was declared a global pandemic by the World Health Organization;it has caused more than 4,697,099 deaths worldwide. Since the discovery of Vaccines, the rate of infections and deaths are declining in countries that were able to conduct mass vaccination, making the vaccines the most effect tool in the fight against Covid-19. However, there is still vaccination skepticism. The side effects of vaccines could fuel more skepticism. There are emerging possible new side effects such as abnormal uterine bleeding post Covid-19 vaccination, for which health care providers and the population should be aware. In this paper, we are reporting three (3) cases of abnormal uterine bleeding which seems to be linked to Covid-19 vaccines. We reported two incidents of heavy menstrual bleeding and one incident of inter-menstrual bleeding which are likely associated with COVID 19 vaccination, even though the causality could not be confirmed. Also both types of vaccines, Messenger RNA and Adenovirus vector could possibly be associated with abnormal uterine bleeding. As research is still ongoing, more knowledge would be available, meanwhile, healthcare providers and the population should be made aware of the new possible side effects of Covid-19 vaccines.

Effectiveness of menstruation hygiene skills training for adolescents with autism

BACKGROUND Adolescents with autism spectrum disorder(ASD)may encounter many difficulties with their menstrual cycles.Potential challenges that adolescents with ASD may face include understanding physical changes,coping with symptoms,emotional sensitivity,communication,personal care,and hygiene.AIM To evaluate the effect of menstrual hygiene skills training given to adolescents with ASD on their menstrual hygiene skills.METHODS The study was conducted with 15 adolescents diagnosed with ASD by the single group pre-test and post-test model in three special education centers in Türkiye.Data were collected with the Adolescent and Parent Information Form and the Adolescent-Specific Menstrual Hygiene Skill Registration Form.RESULTS While the mean age of adolescents was 16.06±0.88 years,the mean age of individuals responsible for adolescent care was 43.66±5.56 years.While 60.0%of the adolescents noticed the onset of bleeding before training,this rate was 93.3%after training.The Adolescent-Specific Menstrual Hygiene Skill Registration Form showed a statistically significant increase in the application steps after the training.The difference between the menstrual hygiene skill scores of adolescents CONCLUSION The menstrual hygiene skills training given to adolescents with ASD was beneficial in increasing their menstrual hygiene skills.These individuals must take responsibility during menstruation and independently manage their continuous care activities.

Associations between Sensitivity to Cold, Menstruation-Related Symptoms and Handgrip Strength in Female University Students in Japan

Sensitivity to cold, which is a popular symptom in Japanese women, is associated with various symptoms such as shoulder stiffness and general fatigue. However, an association of sensitivity to cold with muscle strength has not been reported. The aim of the study was to clarify the associations of sensitivity to cold with handgrip strength and with menstruation-related symptoms in female university students in Japan. We recruited 278 female university students in Japan. Sensitivity to cold and menstruation-related symptoms including physical and psychological symptoms were assessed by using a self-administered questionnaire that we designed. Handgrip strength was measured by using a handgrip strength dynamometer. We received responses from 269 students. The prevalence rate of sensitivity to cold in the subjects was 54.3%. The students who had sensitivity to cold had a lower handgrip strength level (25.5 ± 3.8 kg) than did the students who did not have sensitivity to cold (26.7 ± 3.9 kg) (p = 0.017). Sensitivity to cold was associated with low body mass index. In addition, the students who had sensitivity to cold tended to have low back pain and constipation during menstruation. In conclusion, sensitivity to cold is an important symptom associated with muscle strength as well as menstruation-related symptoms for young women.

Differences in Physical and Psychological Condition, Sleeping Status and Menstruation-Related Symptoms before and after Smartphones Use in Young Female Students in Japan

Smartphones use for a long period of time can cause health problems including physical condition, psychological condition and sleeping status. In addition, smartphones use may affect menstruation related symptoms. This study was conducted using a self-administered questionnaire between June and November in 2016 to clarify the differences in physical and psychological condition, sleeping status and menstruation-related symptoms before and after starting to use smartphones in female university students in Japan. We recruited 273 female nursing students and the response rate was 95.2%. We found significant changes after starting to use smartphones regarding eyestrain (p < 0.001), posture (p = 0.002), stiffness of neck, back and shoulders (p < 0.001), level of outdoor activity (p < 0.001), difficulty concentrating (p < 0.001), lack of motivation (p < 0.001), and sensitivity to stress (p = 0.005). Moreover, we also found that fatigue before menstruation and headache/low back pain during menstruation were higher after starting to use smartphones. The proportions of students with irritability and depressive feeling as emotional premenstrual symptoms appeared higher after starting to use smartphones. These results imply that young women should refrain from using smartphones if they have visual display terminal-related symptoms, disturbance of sleep pattern and menstruation-related symptoms before and during menstruation.

Clinical study on fire needle acupuncture treating irregular menstruation with spleen deficiency syndrome

Objective:To observe the clinical efficacy of fire needle acupuncture in treating irregular menstruation with spleen deficiency syndrome.Methods:60 patients with spleen deficiency-irregular menstruation were randomly divided into treatment group and control group of 30 each.In the treatment group,fire needle acupuncture was used to insert into Guanyuan,Qihai,Pishu,Sanyinjiao,Zusanli and Taibai points,while the filiform needle was used to needle the corresponding acupoints in the control group.After 8 weeks of treatment,menstrual cycle,menstrual period,menstrual volume,irregular menstrual symptom score and spleen deficiency symptom score were recorded.Results:Both treatments could effectively improve the menstrual cycle,menstrual period and menstrual volume,but there was no statistical significance between the two groups(P>0.05).Both treatments were effective in regulating the symptoms of menstruation,and fire needle acupuncture was better than filiform needle(P<0.05).Both treatments relieved the symptoms of spleen deficiency,and fire needle acupuncture was better than filiform needle(P<0.05).In terms of overall curative effect,the curative effect of fire needle acupuncture therapy was significantly better than filiform needle therapy,and the difference was statistically significant(P<0.05).Conclusion:Fire needle acupuncture therapy could effectively regulate menstrual volume of patients with irregular menstruation of spleen deficiency syndrome,and relieve the symptoms of traditional Chinese medicine.

温经汤联合揿针治疗虚寒证月经后期的效果

目的:探讨温经汤联合揿针对虚寒证月经后期的治疗效果。方法:选取2020年1—12月江西省妇幼保健院收治的160例虚寒证月经后期患者作为研究对象。根据随机数字表法分为研究组、A组、B组和C组,每组40例。研究组采取温经汤联合揿针进行治疗,A组给予患者服用温经汤,B组采用揿针治疗,C组采用西药激素疗法。比较四组临床效果,子宫血流动力学指标[收缩期峰值流速(PSV)、阻力指数(RI)、搏动指数(PI)],雌激素(卵泡刺激素、黄体生成素和雌二醇),复发率及不良反应(肝功能异常、恶心呕吐、皮疹、肾功能损伤)发生情况。结果:研究组总有效率为97.50%,高于A组、B组、C组(P<0.05),A组、B组、C组之间治疗总有效率比较,差异均无统计学意义(P>0.05)。治疗后,四组RI、PI水平及卵泡刺激素、黄体生成素水平均较治疗前有所下降,且研究组均低于A组、B组、C组(P<0.05),四组PSV水平和雌二醇水平均较治疗前有所升高,且研究组均高于A组、B组、C组,差异均有统计学意义(P<0.05),治疗后,A组、B组、C组的子宫血流动力学指标及雌激素水平比较,差异均无统计学意义(P>0.05)。治疗结束后3个月随访,研究组复发率低于A组、B组、C组,差异均有统计学意义(P<0.05)。研究组不良反应总发生率与A组、B组、C组比较,差异均无统计学意义(P>0.05)。结论:温经汤联合揿针能够有效治疗虚寒证月经后期,改善子宫血流动力学和血清雌激素水平,降低复发的可能性,安全性良好。

针刺联合补肾健脾法治疗多囊卵巢综合征效果观察

目的:探究针刺腹部穴位联合补肾健脾法对多囊卵巢综合征(PCOS)患者月经周期、血清鸢尾素水平及卵巢功能的影响。方法:选取90例多囊卵巢综合征(PCOS)患者为研究对象,随机分为西药组(30例)、中药组(30例)及联合组(30例),其中西药组给予炔雌醇环丙孕酮片治疗,中药组给予补肾健脾法治疗,联合组在中药组的基础上给予腹针治疗。比较治疗后3组月经周期、血清鸢尾素水平及卵巢功能。结果:联合组的总有效率(96.67%)显著高于西药组(73.33%)、中药组(76.67%)(P<0.05);与治疗前比较,治疗后3组促黄体生成素(LH)、睾酮(T)水平显著降低,月经周期显著缩短,且联合组显著低于西药组、中药组(P<0.05);治疗后3组卵泡刺激素(FSH)、雌二醇(E2)水平均显著升高,且联合组显著高于西药组、中药组(P<0.05);与治疗前比较,三组血清鸢尾素水平显著降低,且联合组显著低于西药组、中药组(P<0.05);与治疗前比较,治疗后3组卵巢体积、卵泡个数均显著降低,且联合组显著低于西药组、中药组(P<0.05);与治疗前比较,治疗后3组内膜厚度、搏动指数(PI)均显著增大,且联合组显著大于西药组、中药组(P<0.05);治疗后3组阻力指数(RI)显著降低,且联合组显著低于西药组、中药组(P<0.05);治疗后,随访3组患者6个月,联合组月经正常率、妊娠率均显著高于西药组、中药组(P<0.05)。结论:腹针联合补肾健脾法可有效调节患者性激素水平,促使月经周期恢复正常,促进卵泡发育成熟、正常排卵及妊娠,改善子宫内膜容受性,降低血清鸢尾素水平,效果显著。

针刺联合中西药治疗肝郁肾虚型月经后期的疗效观察

目的 观察针刺联合中西药治疗肝郁肾虚型月经后期的临床疗效。方法 将88例肝郁肾虚型月经后期患者随机分为对照组(29例)、针刺组(29例)和联合组(30例)。对照组给予雌孕激素序贯疗法,针刺组在对照组基础上给予疏肝补肾针刺法,联合组在针刺组基础上给予疏肝益肾通瘀方治疗。观察3组治疗前后中医证候积分、性激素水平[雌二醇(estradial, E2)、促卵泡生成素(follicle-stimulating hormone, FSH)、促黄体生成素(luteinizing hormone, LH)水平、睾酮(testosterone, T)和催乳素(prolactin, PRL)]、卵巢功能(卵巢体积、卵泡最大直径、卵泡数量)和磷脂酰肌醇3-激酶(phosphoinositide 3-kinase, PI3K)/蛋白激酶B(protein kinase B, AKT)/哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin, mTOR)信号通路相关蛋白的变化,并比较3组临床疗效及安全性。结果 联合组总有效率为96.7%,高于对照组的72.4%(P<0.05);联合组与针刺组、针刺组与对照组比较,差异无统计学意义(P>0.05)。3组治疗后经色暗淡、腰骶酸痛、头晕耳鸣、性欲淡漠及烦躁易怒积分均低于治疗前(P<0.05);且联合组治疗后经色暗淡、腰骶酸痛、头晕耳鸣、性欲淡漠及烦躁易怒积分低于针刺组和对照组(P<0.05),针刺组低于对照组(P<0.05)。3组治疗后E2水平均高于治疗前(P<0.05),FSH、T、LH、PRL水平均低于治疗前(P<0.05);且联合组治疗后E2水平高于针刺组和对照组(P<0.05),针刺组高于对照组(P<0.05);联合组治疗后FSH、T、LH、PRL水平低于针刺组和对照组(P<0.05),针刺组低于对照组(P<0.05)。3组治疗后卵泡最大直径和卵泡数量均大于治疗前(P<0.05);且联合组治疗后卵泡最大直径和卵泡数量大于针刺组和对照组(P<0.05),针刺组大于对照组(P<0.05)。3组治疗前后卵巢体积比较,差异无统计学意义(P>0.05)。3组治疗后PI3K、Akt和m TOR蛋白表达浓度均高于治疗前(P<0.05);且联合组治疗后PI3K、Akt和mTOR蛋白表达浓度高于针刺组和对照组(P<0.05),针刺组高于对照组(P<0.05)。3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 针刺联合中西药可有效改善月经后期患者临床症状,调节性激素水平与卵巢功能,疗效显著,且安全性高,这可能与调控PI3K/Akt/m TOR信号通路有关。

金哲辨治未破裂卵泡黄素化综合征经验

总结金哲教授治疗未破裂卵泡黄素化综合征(LUFS)经验。根据B超下卵泡大小,LUFS可分为小卵泡型、卵泡滞留型和卵泡持续增大型,其中卵泡滞留型多合并子宫内膜异位症和多囊卵巢综合征,不同分型的LUFS各有其特点,金教授认为应分型辨证。治疗上,需总体把握种子调经这一核心思想辨证论治,并根据月经周期的阴阳消长规律进行分期论治。创立“育卵三法”分期论治小卵泡型LUFS;卵泡滞留型LUFS合并子宫内膜异位症者,以化瘀为首,合并多囊卵巢综合征者,以利湿化痰、散瘀调经为主;对于持续增长型LUFS,则以化痰消癥为法,分期治疗。

基于“伏阳”理论探讨多囊卵巢综合征所致不孕症

多囊卵巢综合征以排卵障碍、高雄激素血症及胰岛素抵抗为主要临床表现,其病因病机复杂,为导致妇女排卵障碍而不孕的最常见因素,严重影响育龄期妇女的身心健康及生活。现代医学对本病以对症治疗为主,但多囊卵巢综合征的发病机制尚未明确,对症治疗多为激素用药,治疗周期长且常伴随一定的不良反应和风险,应用存在一定局限性。中医学能够辨证论治,整体调理,对多囊卵巢综合征所致不孕症有较好的临床疗效,发挥中医药优势治疗本病逐渐受到患者青睐。“伏阳”为机体局部或整体因痰、湿、瘀等而化气不足,阳气困于内部则郁,同时五脏及气血津液的生理功能不得发挥而呈现病理状态。文章基于“伏阳”理论,从肝、脾、肾气血痰瘀等方面分析多囊卵巢综合征所致不孕症的病因病机,探讨多囊卵巢综合征所致不孕症的治疗,认为“伏阳”是多囊卵巢综合征所致不孕症的病机核心,该病本虚标实,治疗时应标本同治、先后天同调以调经种子,既体现了中医辨证论治的理论特色,又结合了患者的切实需求。从“伏阳”理论出发,可为多囊卵巢综合征所致不孕症的临床诊疗开拓思路,为广大患者带来福音,提高患者满意度。

陈自明辨治月经病经验采撷

陈自明认为月经病的基本病机是冲任损伤,治疗时首先注重调理冲任、气血,用药寒温并用,偏重于温。临证时根据月经的期量色质及全身症状辨寒、热、瘀、虚,辨寒治以温经、辨热治以清经、辨瘀治以通经、辨虚治以固经。

青春期异常子宫出血的多维评估方法

青春期异常子宫出血(abnormal uterine bleeding)常表现为闭经、月经过多及月经不规律,严重的异常子宫出血是影响青少年生活质量与身心健康的常见原因。明确异常子宫出血的病因有助于提高青春期异常子宫出血诊断与治疗的准确性。临床工作中,应根据青春期异常子宫出血患者的月经出血模式及相关病史、体格检查,初步确定诊疗思路,而后为患者选择恰当的实验室检查、影像学检查、阴道内镜检查和基因测序检查等辅助检查进一步明确具体病因,指导后续治疗。综述近年关于青春期异常子宫出血多维度评估方法的应用研究进展,以期为青春期异常子宫出血评估方法的选择提供一定参考,为深入研究青春期异常子宫出血的临床诊治提供新思路。

肝豆状核变性合并月经不调中医证候调查及其相关因素分析

目的通过研究女性肝豆状核变性合并月经不调中医证候特征,为肝豆状核变性合并月经不调中医诊治提供参考。方法按照肝豆状核变性和月经不调的临床诊断标准,采用流行病学调查问卷对294例女性肝豆状核变性患者的月经情况进行调查,根据有无合并月经不调将294例肝豆状核变性患者分为研究组(合并月经不调)213例和对照组(无合并月经不调)81例,分析并比较两组中医证候分布特征,并通过对研究组进一步调查,分析合并月经不调患者中医证候分布与年龄、临床分型的关联情况。结果213例合并月经不调的肝豆状核变性患者月经不调的类型分布相对广泛,其中以月经后期、月经过少、月经过多最为常见,月经先期、月经先后无定期、痛经相对常见,而合并崩漏者较为少见。研究组频率最高的十个中医症状依次为腹部胀痛、腰膝酸软、五心烦热、言语謇涩、张口流涎、食欲不振、头目昏眩、四肢震颤、喜温喜按、口中臭秽;对照组频率最高的十个中医症状依次为:言语謇涩、头目昏眩、腹部胀痛、四肢震颤、口中臭秽、张口流涎、食欲不振、腰膝酸软、五心烦热、喜温喜按。研究组中医证型以肝肾阴虚证、痰瘀互结证、脾肾阳虚证为主。对照组以痰瘀互结证、湿热内蕴证为主。与对照组比较,研究组肝肾阴虚证、脾肾阳虚证分布率显著高于对照组(P<0.05);对照组痰瘀互结证、湿热内蕴证分布率显著高于研究组(P<0.05);痰湿阻络证、气虚血瘀证、痰火扰心证分布率差异无统计学意义(P>0.05)。研究组的年龄分布主要分布在26~35岁,其临床分型主要以混合型为主。结论肝豆状核变性患者月经不调的分类以月经后期、月经过少、月经过多为主,肝肾阴虚证、痰瘀互结证、脾肾阳虚证为女性肝豆状核变性患者合并月经不调常见中医证候,各证型分布与患者年龄、临床分型无明显差别。

固定式与支架式宫内节育器的有效性、安全性和续用率比较

目的:观察固定式宫内节育器(IUD)在育龄女性中的安全性、有效性和续用情况。方法:以2022年1-6月使用国家免费IUD的育龄妇女为研究对象,随访置入后1、3个月的IUD避孕效果、不良反应和续用情况。多因素logistic回归分析有宫颈松弛、宫颈宽大、既往IUD脱落史、分娩后或人工流产后即时放置IUD等特征的“特殊人群”使用不同类型IUD对随访结局的影响。结果:纳入使用固定式或支架式IUD者分别为1060人和1589人,固定式IUD组中特殊人群535例(占50.5%),支架式式IUD组中特殊人群288例(占18.1%)。放置后3个月特殊人群中固定式IUD月经改变和白带异常的发生率较支架式IUD组低(16.8%比18.8%,3.0%比3.5%,均P<0.05),续用率较支架式IUD组高(97.7%比92.8%,P<0.001)。多因素logistic回归分析显示,在一般人群中,放置后1个月固定式IUD发生月经改变的风险相较于放置支架式IUD低(OR=0.62,95%CI0.45~0.85);放置后3个月固定式IUD组发生白带异常的风险均较低(一般人群OR=0.50,95%CI0.29~0.80;特殊人群OR=0.43,95%CI0.24~0.72);发生IUD脱落/异位的风险增加无统计学意义(一般人群OR=1.41,95%CI0.52~3.53;特殊人群OR=1.57,95%CI0.61~3.83)。结论:固定式IUD在白带异常和月经改变方面的表现较优于传统的支架式IUD;在一般人群和特殊人群中,固定式IUD均为一种安全有效的避孕方式。

穴位埋线联合耳穴贴压治疗寒凝血瘀型痛经临床观察

目的运用随机对照基本研究方法比较穴位埋线联合耳穴贴压疗法及常规西药治疗寒凝血瘀型原发性痛经的临床效果。方法将长春中医药大学附属第三临床医院收治的寒凝血瘀型原发性痛经患者60例随机分为治疗组和对照组,每组30例。治疗组采用穴位[三阴交(双)、地机(双)、合谷(双)、太冲(双)、关元]埋线联合耳穴贴压治疗,对照组采用西药治疗。1个疗程为1个完整的月经周期,共3个疗程。观察两组疗效与治疗前后视觉模拟量表(VAS)评分。结果治疗组总有效率96.67%(29/30)明显优于对照组的80.00%(24/30),差异有统计学意义(P<0.05)。治疗后,治疗组VAS评分低于对照组,差异有统计学意义(P<0.05)。结论穴位埋线联合耳穴贴压治疗寒凝血瘀型痛经,临床效果显著。

杨正望教授运用金匮温经汤辨治月经后期用药规律

杨正望临证擅于将经方理论体系与妇科辨治体系相结合,尤在应用《金匮要略》温经汤时,明确常用加味药物为鸡血藤、香附、葛根、陈皮、柴胡、白芷、仙鹤草等,联合组方为逍遥散、当归四逆汤、当归芍药散,通过总结温经汤组方及随证加减用药规律,以期为中医临床运用金匮温经汤提供参考。

月经相关性特征与子宫内膜癌发病的研究进展

绝经前规律性子宫内膜撤退性出血可避免子宫内膜癌的发生,但当子宫内膜无法规则性彻底性撤退时,子宫内膜病变的风险开始出现,但因月经自身的生理学特征,允许在一定范围内发生改变,这一范围将是临床区别和预防子宫内膜癌发生的最重要依据。该文将对子宫内膜癌发病的月经相关性特征总结为月经模式、女性性激素、内分泌代谢三大类,对其研究进展进行了综述,并探讨了不同文献对此主题的观点和结论。