Clinical research of postpartum pantalgia treated with individualized moxibustion

Objective:To evaluate the clinical therapeutic effect and safety of individualized moxibustion in treatment of postpartum pantalgia.Methods:A total of 99 patients with postpartum pantalgia were divided into three group at the ratio of 1:1:1 according to random number table,i.e.an individualized moxibustion group,a quantitative moxibustion group and a voltaren group.The same acupoints were selected in the individualized moxibustion group and the quantitative moxibustion group.With the patient in supine,Zhongwǎn(中脘CV12),Guānyuán(关元CV4),bilateral Tiānshū(天枢ST25),bilateral Xuèhǎi(血海SP10),bilateral Yanglingquan(阳陵泉GB34),bilateral Zúsānlǐ(足三里ST36) and bilateral Sānyīnjiāo(三阴交SP6) were selected.With the patient in prone,Dàzhuī(大椎GV14),bilateral Géshū(膈俞BL17),bilateral Píshū(脾俞BL20),bilateral Shènshū(肾俞BL23),Mìngmén 命门(GV4),bilateral Wěizhōng(委中BL40) and bilateral Yǒngquán(涌泉KI1) were selected.In the individualized moxibustion group,the moxibusion dose was determined by patient’s constitution and conditions as well as no occurrence of dry throat,thirst and local skin lesion.In the quantitative moxibustion group,the moxibustion dose was fixed as 1 cone at each acupoint in treatment.In these two groups,the treatment was given once every two days,three times a week and the treatment for 2 weeks was as 1 course.Totally,2 courses of treatment were required.In the voltaren group,voltaren ointment was used externally at the pain area,once a day,for 4 weeks totally.Separately,before treatment,at the end of treatment course and in follow-up,the symptom score of traditional Chinese medicine(TCM),pain score of visual analogue scale(VAS) and patient’s treatment satisfaction score were observed in the patients of the three groups.Results:In comparison within group,TCM symptom score,VAS score and the treatment satisfaction score at the end of treatment were all reduced obviously as compared with those before treatment in each of the three groups(P <0.05).In 4,12 and 24 weeks of followup after treatment,the differences in these data were not significant as compared with those at the end of treatment in the individualized moxibustion group and the quantitative moxibustion group respectively(all P> 0.05).In the voltaren group,these data were not different as compared with those at the end of treatment in 4 weeks of follow-up(all P> 0.05),but these data were all increased as compared with those at the end of treatment in 12 and 24 weeks of follow-up(all P <0.05).In comparison among three groups,at the end of treatment and in 4,12 and 24 weeks of followup,the above-mentioned three therapeutic effect indicators were all different significantly(all P <0.05).In comparison between two groups,in the individualized moxibustion group,TCM symptom score,VAS score and the patient’s treatment satisfaction score were all lower than those in the quantitative moxibustion group at the end of treatment and at each time point of follow-up successively,indicating the significant differences(all P <0.05).Conclusion:Individualized moxibustion and quantitative moxibustion improve the short-term and longterm therapeutic effect on postpartum pantalgia as compared with the external application of voltaren ointment.The therapeutic effect and patient’s satisfaction of individualized moxibustion for replenishing kidney and nourishing blood are better than the quantitative moxibustion.The individualized moxibustion therapy for replenishing kidney and nourishing blood achieves a satisfactory effect on postpartum pantalgia and is excelled to voltaren ointment that is strongly recommended in modern medicine.Individualized moxibustion is an external therapy of TCM with optimal short-term and long-term therapeutic effect and reliable safety.Hence,it deserves to be promoted in practice.

黄芪桂枝五物汤合独活寄生汤加减治疗产后身痛的临床观察

目的:通过对黄芪桂枝五物汤合独活寄生汤进行加减,用于气血亏虚兼风寒湿证的产后身痛患者的治疗,统计分析其临床疗效。方法:90例随机分为治疗组45例和对照组45例,治疗组选择黄芪桂枝五物汤合独活寄生汤加减;对照组口服玄七通痹胶囊。10d为一个疗程,共治疗3个疗程。结果:治疗组的有效率明显高于对照组(P<0.05),等级指标的差异有统计学意义(P<0.05)。两组患者无不良反应。结论:黄芪桂枝五物汤合独活寄生汤加减治疗气血亏虚兼风寒湿证的产后身痛患者获得了令人满意的疗效,值得加强临床和基础实验进一步深入研究。

武权生老师应用黄芪桂枝五物汤治疗产后身痛经验

武权生老师运用黄芪桂枝五物汤治疗产后身痛,注重产褥期多虚多瘀的特点,益气养血以治本,祛除风寒湿邪以治标,取得较好疗效。

灸法治疗产后身痛临床辨经取穴规律研究

目的:总结分析灸法治疗产后身痛的现代临床文献经络穴位选用规律。方法:对1990至2017年中国学术期刊全文数据库、中文科技期刊全文数据库、万方数据知识服务平台中符合灸法或者灸法配合其他疗法治疗产后身痛的相关文献进行检索分析,提取纳入文献信息建立灸法治疗产后身痛文献数据库,统计作者、患者一般资料、经络、穴位等信息。结果:纳入文献25篇,涉及产后身痛患者1363例,使用经络10条穴位39个。其中单独采用督脉灸的文献有9篇,其余16篇中选用经络应用频次最常见的为督脉、膀胱经、胃经、任脉,选用穴位最常见的为足三里、大椎、肾俞、命门。结论:灸法治疗产后身痛所选经络主要集中在督脉、膀胱经、胃经,穴位以足三里、大椎、肾腧最为常见。

养坤祛痛方联合督灸治疗产后身痛临床观察

目的:观察督灸联合养坤祛痛方对产后身痛患者的临床疗效。方法:选择符合纳入标准的患者60例,随机分为两组各30例。对照组予养坤祛痛方治疗;治疗组予口服养坤祛痛方加督灸治疗,疗程结束后分别记录两组患者治疗前后的VAS评分。结果:治疗组总有效率为90.00%,明显高于对照组总有效率76.67%(P﹤0.05);治疗后,两组VAS总评分均较治疗前下降,差异有统计学意义(P﹤0.05);且治疗组高于对照组(P﹤0.05)。治疗后两组各部位VAS评分均较治疗前下降(P﹤0.01);腰部及膝关节、踝关节积分改善治疗组优于对照组(P﹤0.05)。结论:养坤祛痛方联合督灸对产后身痛的症状有明显改善作用。

身痛逐瘀汤联合针灸治疗腰椎间盘突出症临床疗效及对相关指标的影响观察

目的观察身痛逐瘀汤联合针灸治疗腰椎间盘突出症临床疗效及对相关指标的影响。方法将2018年3月至2019年8月我院收治的68例腰椎间盘突出患者随机分为研究组和对照组,两组均为34例。对照组给予针刺治疗,研究组给予身痛逐瘀汤联合针刺治疗,对比两种治疗方法疼痛感觉(VAS)、直腿抬高度。结果研究组患者腿痛评分、腰骶痛评分低于对照组(P<0.05);直腿抬高度高于对照组(P<0.05)。治疗前两组患者VAS评分无差异(P>0.05)。治疗后1日、2周、4周,研究组患者VAS评分低于对照组(P<0.05)。研究组患者在经过身痛逐瘀汤联合针灸治疗后,能够有效提高治疗有效率,与对照组相比差异明显(P<0.05)。可以发现身痛逐瘀汤联合针灸治疗后,研究组患者炎症因子与血浆血栓素含量均低于对照组,差异明显(P<0.05)。结论身痛逐瘀汤联合针灸治疗效果显著,可改善肢体活动功能,减轻疼痛感,促进康复。

三伏天隔药督灸治疗产后身痛:随机对照试验

目的:观察三伏天隔药督灸治疗产后身痛的疗效。方法:将64例产后身痛患者随机分为观察组和对照组,每组32例。两组患者均予隔药督灸治疗,对照组在非三伏天进行,观察组在三伏天进行。两组均隔3 d灸1次,3次为1个疗程,共3个疗程。在治疗前、治疗后、治疗后1个月及冬至前后进行45区体表面积评分、视觉模拟量表(VAS)评分以评估患者疼痛范围及疼痛程度;采用修订版纤维肌痛综合征影响问卷调查(FIQR)对患者生活质量进行评估。治疗后比较两组临床疗效。结果:研究过程中观察组脱落2例,对照组剔除2例。治疗后观察组总有效率为93.3%,高于对照组的76.6%(P<0.05)。与治疗前比较,治疗后、治疗后1个月及冬至前后两组患者的疼痛部位个数、疼痛面积均减少(P<0.05),FIQR评分降低(P<0.05),且观察组各项评分均低于对照组(P<0.05)。与治疗前比较,观察组治疗后、治疗后1个月及冬至前后VAS评分均降低(P<0.01),且低于同时间点对照组(P<0.05)。结论:隔药督灸可改善产后身痛患者的疼痛范围与程度,提高患者的生活质量。在三伏天施灸的总体疗效优于在非三伏天治疗,且疗效更持久。

《伤寒论》六经身痛证治规律

身痛是临床常见症状之一。《伤寒论》中对身痛有诸多论述,分析解读后发现其身痛多属外感,其病在筋脉,肌肉,骨节间,皆属在表,未涉及脏腑之里证,六经皆有身痛,且以表证为主。三阳经身痛从麻黄汤峻汗解表散寒,到柴胡桂枝汤微汗和解营卫,最后狂汗出,痛自解。三阴经身痛,皆有本经不足,邪气乘虚而入,尚未入脏腑之里。治疗上有扶正祛邪并用。

身痛逐瘀汤的配方及镇痛机制

身痛逐瘀汤是中国古老的名方，出自清代名医王清任的《医林改错》，有行气补血、化瘀镇痛的作用，临床上广泛应用于肩痛、臂痛、腰腿痛，或周身疼痛经久不愈者的治疗。随着动物实验的开展和临床研究的不断深入，身痛逐瘀汤的研究也不断深入，现经查阅文献，汇总关于身痛逐瘀汤镇痛作用机制的研究概况。