温针灸结合耳穴贴压治疗寒凝湿滞型肩周炎临床疗效及安全性研究

肩周炎以肩关节疼痛和活动不便为主要症状,好发于50岁左右人群,若不能及时治疗,会严重影响肩关节功能^([1])。其病因可能与肩周受凉、慢性劳损、外伤等因素有关,早期肩部酸痛,后期组织粘连,出现严重功能障碍^([2])。目前西医多采用止痛药物治疗,但病情严重者会出现关节活动受限类后遗症^([3])。

艾灸治疗寒凝湿滞型原发性痛经的临床研究

目的:观察艾灸对寒凝湿滞型原发性痛经的临床治疗效果。方法:将符合纳入标准的72例患者随机分为药物组和艾灸组两组,每组各36例。药物组于患者月经来潮时,口服布洛芬镇痛治疗,连续服用3天;艾灸组采用灸盒温灸,从月经来潮前1周即施灸,连续灸至月经来潮时停用。3个月经周期后依据视觉模拟评分(VAS)、COX痛经症状量表积分、临床疗效进行评价。结果:两组治疗前后VAS评分、COX痛经症状量表积分比较,均P<0.01,表明两组方法对痛经均有效果,但艾灸组对以上指标的改善优于药物组(均P<0.05);临床疗效比较显示艾灸组明显优于药物组(P<0.01)。结论:艾灸对寒凝湿滞型原发性痛经治疗效果确切,值得临床上进一步推广。

乌头汤联合温针灸治疗寒凝湿滞型肩周炎30例

笔者采用乌头汤加减联合温针灸治疗寒凝湿滞型肩周炎,疗效确切,现报道如下。1临床资料1.1一般资料:选取本院2020年7月~2021年10月就诊的属寒凝湿滞型肩周炎患者60例,随机分为观察组和对照组各30例。观察组男14例,女16例;平均年龄53.1±8.1岁;平均病程37.7±47.2天;单侧肩痛20例,双侧肩痛10例。对照组男12例,女18例;平均年龄55.3±5.4岁,平均病程40.3±30.1天。

观察隔盐灸对寒凝湿滞型原发性痛经的临床治疗效果

目的:分析隔盐灸对寒凝湿滞型原发性痛经的治疗效果。方法:选取50例寒凝湿滞型原发性痛经患者,随机选取其中25例患者划分为参照组并给予布洛芬治疗,另外25例划分为研究组并给予隔盐灸治疗,比较两组患者的治疗效果。结果:治疗前两组的VAS评分、痛经严重程度和痛经持续时间均基本一致(P>0.05),治疗后研究组的VAS评分、痛经严重程度和痛经持续时间均明显低于参照组(P<0.05);与参照组治疗总有效率相比,研究组明显偏高(P<0.05)。结论:给予寒凝湿滞型原发性痛经患者隔盐灸治疗能够有效缓解患者的疼痛程度,能够显著改善患者的痛经症状。

隔药饼灸联合圆利针伞形刺治疗寒凝湿滞型慢性肩周炎疗效观察

目的:探讨治疗寒凝湿滞型慢性肩周炎的有效疗法。方法:选择寒凝湿滞型慢性肩周炎患者90例,随机分为针灸组、隔药饼灸组、常规康复组,各30例。常规康复组予口服双氯芬酸钠缓释片(每次0.1 g,早餐后服用),配合康复功能训练,每日1次;在常规康复组治疗基础上,隔药饼灸组于患侧肩髃、肩髎、肩贞行隔药饼灸,每日1次;针灸组在隔药饼灸组治疗基础上,加用圆利针伞形针刺,穴取患侧肩髃、肩髎、肩贞、臑会、肩前、巨骨等,隔日1次。各组均治疗10 d,比较各组患者治疗前后疼痛视觉模拟量表(VAS)评分、肩关节日常生活能力(ADL)评分及肩关节活动变化程度,并比较各组临床疗效。结果:各组患者治疗后疼痛VAS评分均下降(P<0.05),肩关节ADL评分均升高(P<0.05);针灸组治疗后疼痛VAS评分低于隔药饼灸组与常规康复组(P<0.05),隔药饼灸组低于常规康复组(P<0.05);针灸组治疗后ADL评分高于隔药饼灸组与常规康复组(P<0.05),隔药饼灸组高于常规康复组(P<0.05)。针灸组肩关节活动变化程度大于隔药饼灸组与常规康复组(P<0.05),隔药饼灸组大于常规康复组(P<0.05)。针灸组总有效率为93.3%(28/30),高于隔药饼灸组的83.3%(25/30)与常规康复组的73.3%(22/30,P<0.05)。结论:在常规康复训练基础上,隔药饼灸联合圆利针伞形刺治疗寒凝湿滞型慢性肩周炎能明显减轻肩关节疼痛及改善肩关节功能。

消肿止痛贴中医贴敷疗法治疗原发性痛经的临床疗效观察

目的:探讨消肿止痛贴中医穴位贴敷疗法治疗原发性痛经的临床疗效。方法:选取2019年6月-2021年9月甘肃省妇幼保健院收治的120例符合纳入与排除标准的原发性痛经患者作为本研究对象,按随机数字表法将其分为治疗组(60例)和对照组(60例)。对照组根据中医证型(寒凝湿滞证、气滞血瘀证、湿热瘀结证、气血两虚证、肝肾不足证)分别口服对应中成药治疗,直至疼痛缓解停服;治疗组根据中医证型(证型同对照组),分别进行不同药物、不同穴位的贴敷治疗,两组患者均连续治疗3个月经周期。观察两组患者治疗前后疼痛视觉模拟评分法评分、原发性痛经程度评分、中医症状评分,并评价两组患者临床疗效。结果:中医贴敷疗法治疗寒凝湿滞证、气滞血瘀证、湿热瘀结证原发性痛经优于对照组(P<0.05),在气血两虚证、肝肾不足证原发性痛经上与对照组没有显著性差异(P>0.05)。结论:中医贴敷疗法治疗原发性痛经具有一定可行性,尤其体现在治疗寒凝湿滞证、气滞血瘀证、湿热瘀结证原发性痛经方面。

中药辨证治疗痛经139例临床观察

目的观察中药辨证治疗痛经的临床疗效。方法将231例患者随机分为中药组139例、中成药组45例及西药组47例。中药组患者按照气滞血瘀证、寒湿凝滞证、湿热瘀阻证、气血虚弱证及宿瘀内结证给予中药辨证治疗,西药组给予散利痛片,中成药组给予血府逐瘀颗粒。各组均连续用药3个月经周期为1个疗程。观察各组中医证候及临床疗效,并分别于治疗前后对患者痛经及其他主要临床症状、生活质量进行评分。结果中药组、中成药组、西药组中医证候总有效率分别为91.37%、75.56%、40.43%,临床疗效总有效率分别为82.01%、71.11%、8.51%,中药组及中成药组疗效均优于西药组(P<0.01)。治疗后各组患者痛经程度及生活质量评分均较治疗前明显改善(P<0.01);中药组其他主要临床症状评分均较治疗前明显降低(P<0.05或P<0.01),中成药组仅乳房胀痛、冷汗淋漓评分较治疗前降低(P<0.05),西药组仅冷汗淋漓评分较治疗前降低(P<0.05)。结论中药辨证治疗痛经有较好疗效,且具有较好的远期疗效。

Effect of instant moxibustion on the levels of prostaglandin and arginine vasopressin in the uterine tissues of dismenorrhea rats with cold-damp congealing and stagnation type

Objective To observe the effect of instant moxibustion on the levels of prostaglandin E_2（PGE_2）,prostaglandin F2α（PGE_（2α）） and arginine vasopressin（AVP） in the uterine tissues of dismenorrhea rats with cold-damp congealing and stagnation type and to explore its possible mechanism.Methods Female Wistar rats were randomly divided into blank group,model group,herble medicine group,pre-moxibustion group and instant moxibustion group,with 9 rats in each group.Cold-damp congealing and stagnation type primary dismenorrhea models were established by adopting（0±1）℃ ice waterextraction method combined with estradiol benzoate injection method.After modeling on the 8th day,in herble medicine group,Tongjingbao granules was given to the rats by intragastric administration.In pre-moxibustion group,mild moxibustion was carried out at ＂Shénquè＂（神阙 CV 8） and ＂Guānyuán＂（关元 CV 4） of the rats for 10 min at each acupoint.In instant moxibustion group,moxibustion as that in pre-moxibustion group was conducted for once after injection with oxytocin on the 11 th day.ELISA was adopted to detect the levels of PGE_2 and PGE_（2α） in the uterine tissues of rats,and radioimmunoassay was used for detection of AVP level in the uterine tissues of rats.Results Compared with the model group,the latent period of rats in herbal medicine group,premoxibustion group and instant moxibustion group obviously prolonged,the number of times of torsion reduced,and the total score of torsion decreased（P0.01）;compared with herbal medicine group,the latent period of rats in instant moxibustion group obviously prolonged,and the total score of torsion decreased（P0.05 or P0.01）;compared with pre-moxibustion group,the number of times of torsion of rats in instant moxibustion group reduced,and the total score of torsion decreased（P0.01）.Compared with blank group,the levels of PGE_（2α） and AVP and the ratio of PGE_（2α） and PGE_2 in the uterine tissues of rats in model group significantly increased（P0.01）,and the PGE_2 level significantly reduced（P0.01）;compared with model group,the PGE_（2α） level and the ratio of PGE_（2α） and PGE_2 in the uterine tissues of rats in herble medicine group,pre-moxibustion group and instant moxibustion group obviously reduced（P0.05 or P0.01）,the PGE_2 level obviously increased（P0.01）,and the AVP level in the uterine tissues of rats in pre-moxibustion group and instant moxibustion group obviously reduced（P0.05 or P0.01）;compared with herbal medicine group,the levels of PGE_（2α） and AVP and the ratio of PGE_（2α） and PGE_2 in the uterine tissues of rats in instant moxibustion group significantly reduced（P0.05 or P0.01）;compared with pre-moxibustion group,the PGE_（2α） level and the ratio of PGE_（2α） and PGE_2 in the uterine tissues of rats in instant moxibustion group obviously reduced（P0.05）,and the PGE_2 level obviously increased（P0.01）.Conclusion Both pre-moxibustion and instant moxibustion can obviously inhibit spasmodic uterine smooth muscle contraction of rats with dismenorrhea,regulate imbalanced levels of PGE_（2α） and PGE_2,reduce the AVP level,so as to improve the uterine hypoxia-ischemia,and play a role in alleviating pain.The efficacy of instant moxibustion was superior to that of pre-moxibustion.

Therapeutic effect of moxibustion on primary dysmenorrhea due to damp-cold retention

Objective To observe the therapeutic effect of moxibustion on primary dysmenorrhea due to damp- cold retention. Methods Eighty cases with primary dysmenorrhea due to damp-cold retention were randomly divided into a moxibustion group （40 cases） and a medication group （40 cases）. Moxibustion at Guonyudn （关元 CV 4） and Shiqizhui （十七椎 EX-B 8） was adopted for treatment of the moxibustion group a week before the period, which lasted for 10 days as a treatment course. Fenbid was used as oral administration for three continue menstrual periods for the medication group. The treatment lasted for 3 menstrual periods in two groups. The Cox Menstrual Symptom Scale （CMSS） was adopted to grade the menstrual symptoms, and differences between the two groups were compared. Results The total effective rate of the moxibustion group was 97.5% （39/40）, and the total effective rate of the medication group was 72.5% （29/40）. The effect of the moxibustion group was obviously better than the medication group （P〈0.05）. Before and after treatment the menstrual symptom scores of the moxibustion group were 9.78±1.86 and 2.25±3.33, while the medication group were 9.71±1.64 and 5.31±4.26. The scores of both groups decreased obviously after treatments. And the decreased amplitude of the moxibustion group was much more obvious than that of the medication group （P〈0.05）. Conclusion The effect of moxibustion on primary dysmenorrhea due to damp-cold retention is obvious, which is better than Fenbid.

Mild moxibustion at different intervention times on the levels of ET-1 and NO in the uterine tissues of rats with cold-damp coagulation and stagnation type dysmenorrhea

Objective： To observe the differences in analgesic effect of moxibustion at different intervention times on dysmenorrhea rats and explore its effect mechanism.Methods： Forty-five female Wistar rats were randomly divided into blank control group（group A）, model group（group B）, pre-moxibustion group（group C）, instant moxibustion group（group D） and pre-instant moxibustion group（group E）,with 9 rats in each group. Cold-damp coagulation and stagnation type dysmenorrhea models were established. In group C,mild moxibustion on ＂Shenque（神阙 CV 8） ＂ and＂Guanyuan（关元 CV 4）＂ was carried out from the time after modeling on the 8 th day for 3 consecutive days. In group D, mild moxibustion was given as the same methods with group C after injection with oxytocin on the 11 th day. In group E, mild moxibustion was given as the same methods from the time after modeling on the 8 th day to that after injection with oxytocin on the 11 th day for 4 consecutive days. The writhing behavior and the changes in levels of ET-1 and NO in uterine tissues of rats with dysmenorrhea in each group were observed.Results： Comparison of the latent period： compared with（4.38 ± 1.06） min in group B,the latent period of rats in group C（9.67 ± 1.32） min,group D（11.78 ± 1.30） min and group E（15.00 ± 1.22） min obviously prolonged（all p 0.01）. Compared with group C, the latent period of group E obviously prolonged（p 0.01）. Compared with group D, the latent period of group E obviously prolonged（p 0.01）.Comparison of the writhing times： compared with（4.38 ± 1.06） in group B,the writhing times of rats in group C（9.67 ± 1.32）,group D（11.78 ± 1.30） and group E（15.00 ± 1.22） reduced（all p 0.01）. Compared with group C,the writhing times of rats in group D and group E reduced（both p 0.01）. Compared with group D, the writhing times in group E reduced（p 0.05）. Comparison of the total writhing score：compared with（4.38 ± 1.06） in group B,the total writhing score of rats in group C（9.67±1.32）,group D（11.78 ± 1.30） and group E（15.00 ± 1.22） decreased（all p 0.01）. Compared with group C,the total writhing score of rats in group D and group E decreased（both p 0.01）. Compared with group D,the total writhing score of rats in group E decreased（p 0.05）. Comparison of ET-1 level： compared with（4.80 ± 0.47） in group A,the ET-1 level in uterine tissues of rats in group B（7.57±0.69） significantly increased（P 0.01）. Compared with group B, the ET-1 level in uterine tissues of rats in group C（6.20 ±0.50）,group D（5.67 ±0.29） and group E（5.16±0.33） obviously decreased（all p 0.01）. Compared with group C, the ET-1 level in uterine tissues of rats in group D and group E obviously decreased（p 0.05, p 0.01）. Compared with group D, the ET-1 level in uterine tissues of rats in group Eobviously decreased（p 0.05）. Comparison of NO level： compared with（6.63±1.83） in group A, the NO level in uterine tissues of rats in group B（1.62 ±0.58） significantly decreased（p 0.01）. Compared with group B, the NO level in uterine tissues of rats in group C（3.60±0.59）,group D（4.77 ±0.67） and group E（5.99±0.63） obviously increased（all p 0.01）. Compared with group C,the NO level in uterine tissues of rats in group Dand group E obviously increased（p 0.05, p 0.01）. Compared with group D, the NO level in uterine tissues of rats in group E obviously increased（p 0.01）.Conclusion： The analgesic effect of mild moxibustion at different intervention times on cold-damp coagulation and stagnation type dysmenorrhea rats was different, which was the most significant in pre-instant moxibustion group. One of the mechanisms of action may be related with the adjustment of abnormal levels of ET-1 and NO.