CLINICAL OBSERVATION ON 96 CASES OF PRIMARY DYSMENORRHEA TREATED BY MEDICINE-SEPARATED MOXIBUSTION AND INVESTIGATION ON ITS MECHANISMS

Objective： To observe the therapeutic effect of medicine-separated moxibustion for primary dysmenorrhea and its influence on plasma hormone level. Methods. Ninety-six patients suffering from primary dysmenorrhea were randomly and evenly divided into trealment group treated with medicine-separated moxibustion of Shenque （神阙 CV 8, 3-5 cones every time, beginning 1 week before onset of menstruation and stopping on the 3^rd day after onset, with 10 sessions being a therapeutic oourse, 3 courses all together）, and control group treated with oral administration of Yueyueshu （月月舒 menstruation-smoothing granule, 10 g/time, b.i.d, 3 courses altogether）. Menses prostaglandin E2（PGF2α） and plasma oxytocin （OT） during menstruation were determined by radioimmunoassay. Results; After the treatment, of the two 48 cases in treatment and control groups, 18 and 5 were cured, 24 and 9 had marked improvement in their symptoms, 6 and 26 had improvement, 0 and 8 failed in the treatment, with the total effective rates being 100. 096 and 83.3% respectively, the therapeutic effect of treatment group was markedly superior to that of control group （P〈0.05）. After the treatment, the contents of menses PGF2α in treatment group and plasma OT in both groups were significantly lower than those of pre-treatment （ P〈 0.01 ）. The therapeutic effect of moxibustion was significant- ly better than that of medication in lowering plasma OT. Conclusion： Medicine-separated moxibustion works well in treating primary dysmenorrhea, and moxibustion induced decrease of menses PGF2α and plasma OT may contribute to its effect in relieving dysmenorrhea.

Effects of ginger moxibustion combined with Chinese medicine iontophoresis on patients with primary dysmenorrhea

Objective:To observe the effects of Ginger moxibustion combined with iontophoresis with traditional Chinese medicine on the improvement of symptoms, serum platelet activating factor (PAF) level and uterine artery pulsation index in patients with primary dysmenorrhea.Methods 114 patients with primary dysmenorrhea who were treated in our hospital from August 2017 to February 2019 were divided into two groups according to the different treatment schemes. 57 patients in the control group were treated with ibuprofen capsules, and 57 patients in the study group were treated with Ginger moxibustion combined with iontophoresis with traditional Chinese medicine. After three menstrual cycles of treatment, the curative effect was evaluated and the improvement of symptoms was counted. PAF, PAF-AH and platelet adhesion rate were compared, uterine artery hemodynamics was measured, and levels of serum hs-CRP and IL-6 were measured.Results The overall response rate of the study group was significantly higher than that of the control group (P < 0.05). After treatment, the scores of different symptoms in the two groups were significantly lower than those before treatment (P < 0.05), and the scores of different symptoms in the study group were significantly lower than those in the control group (P < 0.05). After treatment, PAF and platelet adhesion rate in the two groups were significantly lower than those before treatment (P < 0.05), PAF-AH was significantly higher than that before treatment (P < 0.05), and PAF and platelet adhesion rate in the study group were significantly lower than those in the control group (P < 0.05), PAF-AH was significantly higher than that in the control group (P < 0.05). After treatment, the pulsation index, resistance index and peak systolic-diastolic ratio in the study group were significantly lower than those before treatment (P < 0.05), and the pulsation index, resistance index and peak systolic-diastolic ratio in the study group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of serum hs-CRP and IL-6 in the two groups were significantly lower than those before treatment (P < 0.05), and the levels of serum hs-CRP and IL-6 in the study group were significantly lower than those in the control group (P < 0.05).Conclusions Ginger moxibustion combined with iontophoresis with traditional Chinese medicine is helpful to improve the overall response rate of primary dysmenorrhea treatment, reduce the score levels of different symptoms, rationally improve PAF, PAF-AH, platelet adhesion rate, and the pulse index, resistance index, peak systolic-diastolic ratio are decreased significantly, and serum hs-CRP and IL-6 levels tend to be normal.

A Systematic Review and Meta-Analysis of Herb-Partitioned Moxibustion in the Treatment of Primary Dysmenorrhea

OBJECTIVE: To systematically evaluate the clinical effects of herb-partitioned moxibustion on patients with primary dysmenorrhea. METHODS: Randomized controlled trials of herb-partitioned moxibustion for primary dysmenorrhea published from the year the database was established to November, 2017 were searched from CNKI,Wanfang Database, VIP database, CBM, PubMed, Embase, and Cochrane Library. Data extraction and quality evaluation were performed in papers meeting inclusion criteria. The outcomes measurements included clinical effect rate, visual analogue score(VAS), plasma PGF2α, adverse events, recurrence rate, and quality of life. The Rev Man 5.3 software was applied for meta-analysis. RESULTS:(1) A total of 16 studies were eligible and included in the meta-analysis involved1126 patients.(2) A statistically significant increasing in clinical effective rate was found in HMP group compared with control group [OR=3.49, 95%CI(2.25, 5.39), P<0.00001].(3) There was significant difference between two groups in visual analogue score [MD=–7.48, 95%CI(–9.93, –5.02), P<0.00001], which suggested the patients who received HPM had lower VAS scales than those who received no HPM.(4) There was significantly difference in serum PGF2α between the groups receiving HPM and the control group [MD=–4.61, 95%CI(–9.19, –0.03), P=0.05].(5) 2 trials reported followup duration, and all included studies did not mention the recurrence of PD during the follow-up stage, and all included studies did not mention the improvement of quality of life of PD during period of management and follow-up stage.CONCLUSIONS: Herb-partitioned moxibustion is beneficial for primary dysmenorrhea. However, the conclusion is not completely accurate with limitations of the current RCTs. The safety of herb-partitioned moxibustion remains to be defined by future studies. Attention should be paid to long-term effects of herb-partitioned moxibustion in clinical research. High-quality RCTs are required to confirm the effectiveness of herb-partitioned moxibustion for primary dysmenorrhea.

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.

Moxibustion with different doses for primary dysmenorrhea of cold congelation and blood stasis type:A randomized controlled trial

Objective:To explore the clinical effect differences of moxibustion with different doses on primary dysmenorrhea with cold congelation and blood stasis type.Methods:A total of 60 patients of primary dysmenorrhea were randomized into an intensified dose group and a conventional dose group.All of the patients were treated with moxibustion.In the intensified dose group,the treatment was given three times daily(once every morning,afternoon and at bedtime successively) and during the trial,1 case was dropped out and 29 cases were included in the statistical analysis finally.In the conventional dose group,the treatment was given once daily and 1 case was dropped out during trial and 29 cases were included in the statistical analysis.The score of visual analogue scale(VAS) at the worst painful time point,the score of dysmenorrhea symptoms and recurrence rate were observed and compared before and after treatment in the patients between the two groups.The clinical therapeutic effects were observed in the two groups too.Results:VAS difference value(D-value) and dysmenorrhea symptoms D-valuebefore and after treatment in the intensified dose group were higher than those in the conventional dose group respectively(both P<0.05).The recurrence rate was 14.29% in the intensified dose group,lower than 42.31% in the conventional dose group,with the statistical significance(P<0.05).The total clinical effective rate was 96.55%in the intensified dose group,higher than 89.66% in the conventional dose group,with the statistical significance(P<0.05).Conclusion:Compared with the conventional dose moxibustion,moxibustion with intensified dose achieves satisfactory therapeutic effect on primary dysmenorrhea of cold congelation and blood stasis type.This therapy is low in recurrent rate and convenient in manipulation,thus it deserves to be promoted in clinical application.

China Association of Acupuncture–Moxibustion Evidence-based clinical practice guideline of acupuncture and moxibustion: Primary dysmenorrhea

Dysmenorrhea refers to periodic abdominal pain,or radiating to lumbosacral region.For the severe case,it is intolerable,combined with nausea and vomiting sometimes.This disease is commonly seen in unmarried young women.Epidemiological studies have shown that dysmenorrhea is the most common gynecological disease,especially in young women[1].Acupuncture and moxibustion have a long history in the treatm ent of primary dysmenorrhea(hereinafter referred to as PD),and compared with medication,the advantages are presented in the treatment.Entrusted by the Standardization Working Committee of China Association for Acupuncture and Moxibustion(CAAM),Department of Acupuncture and Moxibustion,Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine has undertaken the drafting of Evidence-Based Clinical Practice Guideline of Acupuncture and Moxibustion:Primary Dysmenorrhea(hereinafter referred to as the Guideline).The Guideline was issued in 2014 by CAAM.It summarizes the research achievements in acupuncture-moxibustion treatm ent for dysmenorrhea in recent decades and is intended to standardize the clinical regimen of treatm ent with acupuncture and moxibustion so as to improve the clinical effect.

Effectiveness and Safety of Moxibustion Robots on Primary Dysmenorrhea:A Randomized Controlled Pilot Trial

Objective To conduct a pilot trial to explore the effectiveness and safety of moxibustion robots in treating primary dysmenorrhea(PD)and evaluate its feasibility in clinic.Methods A total of 70 participants with PD were allocated to either moxibustion robot(MR)group(35 cases)or manual moxibustion(MM)group(35 cases)using computer-generated randomization.One acupoint Guanyuan(CV 4)was selected to receive moxa heat stimulation.Two groups of participants were given 3 menstrual cycles of MM and MR treatment respectively(once a day,5 days a session)and received another 3 menstrual cycles follow-up.The degree of pain was evaluated by short-form McGill pain questionnaire(SF-MPQ)and the symptoms of dysmenorrhea were evaluated by Cox Menstrual Symptom Scale(CMSS).The safety was measured by the occurrence rate of adverse events(AEs),including burns(blisters,red and swollen),itching,bowel changes,menstrual cycle disorder,menorrhagia and fatigue,etc.Results A total of 62 patients completed the trial,32 in MR group and 30 in MM group.Compared with baseline,scores of SF-MPQ and CMSS significantly decreased in both groups(P<0.05),and no significant difference was observed between the two groups in the 3rd and 6th menstrual cycles(P>0.05).The total occurrence rate of AEs in MR group was 2.1%,which was significantly lower than MM group(7.2%,P<0.05).Conclusions MR has the same effect as MM at SF-MPQ and CMSS in patients with PD.However,MR is safer than MM(Trial registration No.ChiCTR1800018236).

Observation on the Effect of Umbilical Therapy of Herbal Medicine Combined with Self-Made Dysmenorrhea Paste on Primary Dysmenorrhea

Objective:To investigate the clinical effect of self-made dysmenorrhea paste combined with umbilical therapy of herbal medicine on primary dysmenorrhea.Methods:160 patients with primary dysmenorrhea were recruited from Changle People’s Hospital.Participants were randomly divided into control group and treatment group,with 80 cases in each group.The control group were administered the dysmenorrhea paste sold on the market for 5 days during three menstruation cycles,and the treatment group was given the umbilical therapy of herbal medicine combined with self-made dysmenorrhea paste.The outcome was the intensity of menstrual pain measured by using the visual analogue scale,TCM symptom score and dysmenorrhea symptom score of patients,responder rate.The clinical outcomes were measured on each menstrual cycle at baseline,treatment course(3 cycles),and follow-up period.Results:In this study,there was no significant difference in age and severity of disease between the two groups before treatment.After treatment,VAS score,TCM symptom score and dysmenorrhea symptom score of patients in both groups decreased.The total effective rate was 90.75%in the treatment group and 81.25%in the control group.Conclusion:The treatment of primary dysmenorrhea patients with self-made dysmenorrhea paste combined with application of drugs and moxibustion naval-button method has a significant clinical effect.This method can reduce the pain of patients,improve the quality of life of patients,and homemade dysmenorrhea paste has a good taste,long shelf life,easy to carry,and is worthy of promotion and application.

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.

基于调节前列腺素水平探讨中医药治疗原发性痛经研究进展

中医药治疗原发性痛经的方法多种,主要包括中药单体提取物、单味中药、常用药对、中药复方、针灸、推拿、耳穴贴压及联合疗法等,均能通过调节前列腺素水平而达到治疗原发性痛经的目的,但仍存在以下问题:(1)由于不同患者体质状况不同,对同一种治疗方法的反应也会有所不同,这使得中医药治疗在标准化和可重复性上面临一定困难;(2)汤剂作为中药最常用的剂型之一,由于口感欠佳让患者难以坚持长期服用;(3)虽然针刺疗法在原发性痛经的治疗中疗效显著,但部分患者由于对针刺疼痛或不适感的恐惧以及耐受力差,难以接受或坚持治疗;(4)饮食不规律、作息紊乱、缺乏运动等不良习惯不仅会加重原发性痛经症状,还可能削弱中医药治疗的效果。今后,应在确保临床疗效及安全性的基础上优化治疗方案,例如通过大数据分析、人工智能等现代技术手段精准评估患者体质状况、病情特点以及生活习惯等因素,制定更加个性化、精准化治疗方案;其次,研发出更多口感好、服用方便、疗效确切的中药制剂,提高患者对中药的接受度。同时,要注重中医药内治法与外治法的结合,形成更加全面系统的治疗模式,有助于提高原发性痛经的治疗效果,减少复发率。

壮医针灸治疗寒凝血瘀型原发性痛经疗效观察

目的:观察壮医针灸治疗寒凝血瘀型原发性痛经的临床疗效。方法:选取2020年6月-2021年6月广西中医药大学第一附属医院壮医针灸科60例原发性痛经患者,按照随机数字分组法分为观察组和对照组,每组各30例。对照组采用布洛芬片口服治疗;观察组采用壮医针灸治疗。连续治疗3个月经周期。分别在治疗1月后、治疗3月后及疗程后1个月比较两组患者VAS视觉模拟评分及中医证候积分变化,观察治疗3个月经周期后,两组患者治疗的临床疗效和不良反应发生率。结果:经治疗后,两组患者各时间点VAS评分及中医证候积分与治疗前比较,均得到明显改善(P<0.05)。组间比较,观察组中医证候积分改善程度均优于对照组,且起效快,疗效更稳定(P<0.05);观察组临床疗效优于对照组,不良反应发生率也低于对照组,差异均有统计学意义(P<0.05)。结论:壮医针灸治疗寒凝血瘀型原发性痛经起效快,能明显减轻疼痛程度,临床疗效显著、稳定,且无痛、操作简便,副作用少,值得临床推广应用。

经皮电刺激配合艾灸八髎穴治疗寒凝血瘀型原发性痛经的临床效果

目的探讨经皮电刺激配合艾灸八髎穴治疗寒凝血瘀型原发性痛经的效果。方法选取2023年1月至6月江西省妇幼保健院收治的200例寒凝血瘀型原发性痛经患者作为研究对象,采用随机数字表法将其分为对照组与治疗组,每组100例。对照组采用布洛芬缓释胶囊治疗,治疗组采用经皮电刺激联合艾灸八髎穴治疗,比较两组患者的疗效、中医证候积分、疼痛评分、不良反应发生率。结果治疗组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗组治疗3个月时的中医证候积分、视觉模拟评分法(VAS)评分均低于对照组,差异有统计学意义(P<0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论采用经皮电刺激联合艾灸八髎穴对寒凝血瘀型原发性痛经患者进行治疗,可改善痛经症状,且安全性高,值得临床广泛应用及推广。

耳穴压豆联合隔物灸治疗寒湿凝滞型原发性痛经效果分析

目的探讨寒湿凝滞型原发性痛经患者行耳穴压豆+隔物灸治疗的效果。方法选取94例寒湿凝滞型原发性痛经患者为研究对象,按照随机数表法分为对照组和研究组,每组47例。对照组实施常规对症治疗,研究组在对照组基础上给予耳穴压豆+隔物灸治疗,比较两组临床疗效、中医证候积分、疼痛程度、疼痛持续时间、痛经症状程度。结果治疗后研究组视觉模拟评分法(VAS)评分低于对照组,疼痛持续时间短于对照组(P<0.05);治疗后研究组COX痛经症状量表(CMSS)评分低于对照组(P<0.05);治疗后研究组中医证候积分低于对照组(P<0.05);研究组总有效率为93.62%,高于对照组的74.47%(P<0.05)。结论寒湿凝滞型原发性痛经采用耳穴压豆联合隔物灸治疗效果较好,可减轻中医证候,快速消除症状,减轻患者痛感,并加快患者康复,值得临床推广与应用。

转化医学视角下针灸治疗原发性痛经的研究现状与思考

针灸是治疗原发性痛经的有效手段。转化医学理念为针灸学传承创新与发展开辟了新的路径,同样为针灸治疗本病带来了新的机遇。基于转化医学视角,对本病的针灸研究成果向临床标准的转化和针灸创新发明向技术产品的转化进行述评,并讨论当前针灸转化医学存在的问题。从组方选穴、针灸时机和针法参数三个方面筛选整合近年文献,期望助力本病针灸标准化操作的优化。从针灸新材料、针灸新设备两个方面对典型专利技术转让产品进行列举,为针灸特色技术产品的创新研发与成果转化提供思路,以期促进针灸转化医学研究,让针灸更好、更快、更直接服务临床和社会。

温和灸对寒湿凝滞型原发性痛经大鼠下丘脑BDNF/TrkB信号通路蛋白表达的影响

目的观察温和灸对寒湿凝滞型原发性痛经(PD)大鼠的镇痛效果及对下丘脑BDNF/TrkB信号通路蛋白表达的影响,探讨其治疗痛经的作用机制。方法将32只Wistar雌性未孕大鼠随机分为空白组、模型组、西药组和温和灸组,每组8只。除空白组外,其余组采用苯甲酸雌二醇腹腔注射联合冰水浴+缩宫素腹腔注射建立寒湿凝滞型PD大鼠模型,造模第8日起,温和灸组选取“神阙”“关元”温和灸10 min,西药组予布洛芬溶液灌胃,连续4 d。观察大鼠扭体潜伏期并计算扭体评分,Western blot和PCR检测下丘脑组织c-fos、脑源性神经营养因子(BDNF)、酪氨酸激酶受体B(TrkB)蛋白及mRNA表达。结果与空白组比较,模型组大鼠扭体潜伏期缩短、扭体评分增加(P<0.01),下丘脑组织c-fos、BDNF、TrkB蛋白和mRNA表达升高(P<0.01,P<0.05);与模型组比较,温和灸组大鼠扭体潜伏期延长、扭体评分降低(P<0.01),下丘脑组织c-fos、BDNF、TrkB蛋白和mRNA表达升高(P<0.01,P<0.05)。结论温和灸可有效改善寒湿凝滞型PD大鼠疼痛状态,其机制可能与下调c-fos表达、抑制BDNF/TrkB信号通路激活,从而抑制疼痛信号传递,调节疼痛发生和维持有关。

时素华运用阴阳温经灸治疗原发性痛经的经验

原发性痛经(PD)是妇科常见病,艾灸治疗PD有一定优势。时素华基于传承李志刚教授“通督启神”针法充督启阳、通督启神之理念并结合多年艾灸诊治PD的临床经验,总结出痛经具有“虚、寒、瘀、滞”的病机特点,重视情志因素对痛经的影响,在此基础上提出以“补虚散寒,逐瘀通滞为主,兼通督启神,灸畅情志”的灸治原则,临床以阴阳温经灸为主随证加减灸治PD。该灸法在改良岳美中“大灸”基础上结合重灸法,以择时逆灸,量大时久,重灸透达为主要灸治特点,具灸面大,火力足,温透力强且高效的灸疗优势。本文结合时素华对PD病因病机的认识,介绍阴阳温经灸,并结合典型病案以供参考,为临床艾灸治疗此类疾病提供新思路。

砭石艾灸治疗原发性痛经的效果

目的探讨砭石艾灸治疗原发性痛经的临床效果。方法选取2022年1月至2023年1月在北京按摩医院门诊治疗的120例原发性痛经患者作为研究对象,通过随机信封法分为砭石艾灸组(60例,砭石艾灸)和药物组(60例,布洛芬缓释胶囊)。比较两组治疗前后视觉模拟评分法(VAS)和COX痛经症状量表评分及临床疗效。结果砭石艾灸组治疗有效率高于药物组(P<0.05);两组治疗后即刻、治疗1个月后和治疗2个月后VAS评分均降低,且砭石艾灸组低于药物组(P<0.05);治疗后,两组总发作时间和平均严重程度评分均降低,且砭石艾灸组低于药物组(P<0.05)。结论砭石艾灸治疗原发性痛经的临床效果较好,能减轻疼痛,缓解临床症状。

艾灸神阙穴对原发性痛经模型大鼠的作用及其机理

目的:探究艾灸神阙穴对原发性痛经模型大鼠的作用及其机制。方法:通过阴道涂片实验确定大鼠动情周期后使用苯甲酸雌二醇联合缩宫素制备原发性痛经大鼠模型。通过观测原发性痛经大鼠体质量、脏器指数、扭体潜伏期和扭体分数变化,检测各组大鼠血清性激素、前列腺素和疼痛因子等各项指标水平,比较艾灸治疗原发性痛经大鼠药效差异,其艾灸种类包括有烟艾灸与无烟艾灸。结果:在大鼠一般情况和行为学测试观察中,模型组比空白组扭体反应显著增加(P<0.01),表明造模成功;而与模型组比较,两个艾灸组大鼠体质量减轻相对缓慢,扭体潜伏期显著增加,扭体反应显著减少(P<0.05),其中有烟艾灸组和无烟艾灸组、阳性药物组大鼠扭体抑制率分别为54.89%、37.21%、68.82%。与模型组比较,两个艾灸组大鼠血清中雌二醇、缩宫素、前列腺素F_(2α)、白介素-6浓度均显著降低(P<0.05),前列腺素E_(2)和β-内啡肽水平显著升高(P<0.05)。结论:艾灸大鼠神阙穴能够有效缓解原发性痛经,调节机体性激素、前列腺素和疼痛相关因子可能是其潜在的作用机制。

艾灸对原发性痛经寒凝血瘀证患者小肠经热学特性的影响

目的:基于红外热成像技术探究原发性痛经寒凝血瘀证患者小肠经相关经穴的热学特性,以及艾灸关元穴对其热学特性的影响。方法:选取原发性痛经寒凝血瘀证患者21例(痛经组)及正常女性21名(正常组)。在月经来潮的第1~3天,采用红外热成像仪检测两组受试者小肠经相关经穴(腕骨、养老、小海、肩贞、臑俞、关元)的红外辐射温度,比较两组的红外温度变化;痛经组在关元穴进行单次30 min的艾灸治疗,比较艾灸前后痛经组患者小肠经相关经穴的温度变化及腹痛视觉模拟评分法(VAS)评分。结果:与正常组比较,痛经组患者关元、双侧养老、左侧小海、左侧肩贞、双侧臑俞红外温度均降低(P<0.05);与艾灸前比较,痛经组患者艾灸后腹痛VAS分值降低(P<0.05),痛经组患者关元、双侧腕骨、养老、小海、肩贞、臑俞红外温度增高(P<0.05)。结论:原发性痛经寒凝血瘀证患者小肠经穴位的红外温度低于正常女性,验证了小肠经与胞宫的特异性联系。原发性痛经寒凝血瘀证患者艾灸后肠经穴位温度显著升高,提示小肠经温度升高可能是艾灸关元穴疗效的经络效应机制之一。

针灸刺激任脉治疗原发性痛经概述及其病例注册登记研究展望

文章系统、全面地分析了针灸刺激任脉治疗原发性痛经的现状,从文献研究及临床研究两方面进行概述,发现关元、气海、中极、神阙是目前较为常用的任脉穴位。同时发现目前关于针灸刺激任脉治疗原发性痛经的临床研究缺乏高质量的循证医学依据。通过梳理相关文献,认为面对国际“去经络化”的倾向,病例注册登记研究更能体现针灸特色,符合中医辨证论治的观念,能最大程度地还原临床复杂的干预情况,节约资源并提高效率。同时病例注册登记研究也面临诸多挑战,如数据管理与数据共享、数据利用等。因此提出搭建病例注册登记平台并开展病例注册登记研究,收集真实世界数据,为针灸刺激任脉治疗原发性痛经提供临床依据具有重要意义。参考文献29篇。