针刺结合TDP照射治疗原发性痛经的临床观察

发布时间：2018-05-04 15:39

本文选题：TDP + 原发性痛经　；参考：《北京中医药大学》2014年硕士论文

【摘要】：研究目的通过对中国中医科学院望京医院针灸科及妇科门诊原发性痛经病人进行临床观察,验证针刺配合TDP照射治疗原发性痛经的优效性、安全性、简便性,为临床进一步推广此治疗方法提供依据。研究方法 1.文献研究通过中医、西医对原发性痛经的病因病机、诊断、治疗等多方面的详细论述,并阐述了针刺结合TDP照射在镇痛及治疗原发性痛经方面的部分作用机制。 2.临床研究将符合纳入标准和除外排除标准的60例患者随机分为2组：治疗组和对照组,按1：1的比例随机分配治疗组：针刺结合TDP照射治疗,取穴以气海、关元、中极、天枢(双)、子宫(双)、血海(双)、足三里(双)、三阴交(双)、丘墟透照海(双)为主穴,结合辨证取穴气滞血瘀加太冲、肾气亏损加太溪,平补平泻,以得气为度,针刺留针30min,留针时同时配合TDP灯照射患者小腹,以患者感觉温热舒适为宜,患者于月经来潮前半个月进行治疗,隔日治疗一次,七次为一个疗程,连续治疗三个月经期。对照组：服用芬必得药物治疗,患者于每次月经前2-3天开始口服芬必得,每次0.3g,每日两次,疼痛消失时停止,连续口服治疗3个月经周期。在患者治疗前、治疗三个疗程后及治疗结束3个月后分别进行疗效评价,采用组间对比、组内对比的方法对即使疗效、近期疗效、远期疗效进行评价。 3.研究结果治疗组和对照组在治疗开始前采用均衡比较的方法,结果表明：两组患者在年龄、初潮年龄、病程、痛经症状积分及VAS评分、病情程度的差异均无统计学意义(P0.05),表示两组之间具有可比性。疗效比较：两组经过治疗后,治疗组和对照组的即时疗效总有效率为93.33%和83.33%,经统计分析,两组具有显著差异(P0.05)；两组近期疗效对比治疗组和对照组愈显率分别为83.33%和60.00%,总有效率分别为96.67%和86.67%,经统计分析,两组具有显著统计学差异(P0.05)；两组远期疗效进行对比愈显率分别为76.67%和40.00%,总有效率分别为93.33%和80.00%,经统计分析,两组具有显著性统计学差异(P0.05)。说明本课题所选方法在即时疗效、近期疗效、远期疗效方面明显优于对照组。将两组治疗前后及随访的痛经症状积分和VAS评分进行对比,P0.05,说明治疗前后比较结果具有统计学差异,说明这两种方法在治疗原发性痛经方面具有确切的疗效。综合影响因素后分析：患者病程越短,病情越轻,配合度越高,患者所取得的疗效就越好。结论：针刺结合TDP照射治疗原发性痛经有确切的临床疗效,具有即时效果好,近期疗效和远期疗效优良,临床不良反应少,患者容易接受等许多的优点,此方法值得在临床中推广应用。
[Abstract]:Research purpose Through clinical observation of primary dysmenorrhea patients in Department of Acupuncture and Gynecology, Wangjing Hospital, Chinese Academy of traditional Chinese Medicine, the efficacy, safety and simplicity of acupuncture combined with TDP irradiation in the treatment of primary dysmenorrhea were verified. It provides the basis for further popularizing this method in clinic. Research method 1. Literature research The etiology, pathogenesis, diagnosis and treatment of primary dysmenorrhea were discussed in detail by traditional Chinese medicine and western medicine, and the mechanism of acupuncture combined with TDP irradiation in analgesia and treatment of primary dysmenorrhea was expounded. 2. Clinical research 60 patients who met the inclusion criteria and exclusion criteria were randomly divided into two groups: the treatment group and the control group, randomly allocated according to the 1:1 ratio. Treatment group: acupuncture combined with TDP irradiation treatment, taking points to Qihai, Guanyuan, the middle pole, Tianshu (Shuangzao, uterus (Shuangli), Xuehai (Shuangzhu, Zusanli (Shuangzhuo, Qiuxuzhaohai (Shuang) points), Combined with syndrome differentiation, point Qi stagnation and blood stasis plus Taochong, deficiency of kidney qi plus Taixi, flat tonifying and purging, acupuncture for 30 mins, combined with TDP lamp to irradiate the lower abdomen of the patient, it is appropriate for the patient to feel warm and comfortable. The patient was treated half a month before menstruation, once every other day, seven times as a course of treatment for three consecutive months. In the control group, the patients were treated with fenpiride 2-3 days before menorrhagia, 0.3 g per time, twice a day, and stopped when the pain disappeared. The patients were given oral treatment for 3 consecutive menstrual cycles. Before treatment, after three courses of treatment and 3 months after the end of the treatment, the curative effect was evaluated by the methods of inter-group and intra-group comparison, even if the curative effect, the short-term effect, and the long-term effect were evaluated. 3. Research results The patients in the treatment group and the control group were treated with balanced comparison before treatment. The results showed that: age, menarche age, course of disease, score of dysmenorrhea symptom and VAS score were used in the two groups. There was no significant difference in the severity of the disease between the two groups (P 0.05), indicating that there was comparability between the two groups. Comparison of curative effects: after treatment, the total effective rates of the treatment group and the control group were 93.33% and 83.33%, respectively. There was significant difference between the two groups (P 0.05), the effective rates of treatment group and control group were 83.33% and 60.005%, respectively, the total effective rates were 96.67% and 86.67%, respectively. There was significant statistical difference between the two groups (P 0.05), and the effective rates of the two groups were 76.67% and 40.000.The total effective rates were 93.33% and 80.000.The statistical analysis showed that the two groups had significant statistical difference (P 0.05). The results showed that the method was superior to the control group in immediate effect, short-term effect and long-term effect. The scores of dysmenorrhea symptoms and VAS scores of the two groups were compared before and after treatment and followed up (P0.05). The results showed that there was statistical difference between the two groups before and after treatment, which indicated that the two methods had definite curative effect in the treatment of primary dysmenorrhea. Comprehensive analysis of influencing factors: the shorter the course of disease, the lighter the patient's condition, the higher the degree of cooperation, the better the curative effect of the patient. Conclusion: Acupuncture combined with TDP irradiation has a definite clinical effect on primary dysmenorrhea, which has many advantages, such as good immediate effect, good short-term and long-term curative effect, less adverse clinical reactions, and easy acceptance by patients, etc. This method is worth popularizing in clinic.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.51

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