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.

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。

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。